Health Information Exchange - Trial Implementation Options
HEALTH INFORMATION EXCHANGETrial Implementation Options Stuart MacKinnon Analysis One Limited
Acknowledgements • Ministry of Health • healthAlliance • Aseem Agarwal • Michael Tapp
Why ‘Health Information Exchange’? Why Not an • ‘R-CDR’ using • ‘IHE XDS.b’, • ‘CDA’ and • ‘OpenEHR’?
HIE - Working Definition• A united collection of a number of individual CDRs.• Each CDR is a single database storing some particular kind of health information - e.g. lab results or medications lists or care plans - while the Health Information Exchange is a virtual database, which has the purpose of providing an index to the overall content of its component CDRs, via a registry.
eHealth VisionTo achieve high-quality healthcare and improve patientsafety, by 2014 New Zealanders will have a core set ofpersonal health information available electronically to themand their treatment providers regardless of the setting asthey access health services. National Health IT Plan, 2010 (p.5)
HISO 10040 - CDR Utility Services Health Information Exchange Virtual Repository Registry Patient ABC1234 1. eDischarge, Middlemore Hospital, 23/6/12 2. Care Plan, CMDHB Home Health Care, 24/6/12 3. Health Status Summary, 2 South Health IFHC, 15/7/12 1 3 4 DocumentDocument ConsumerPublisher
HISO 10040 - Content Model Generic CDA Structure OpenEHR Archetype <ClinicalDocument> for Blood Pressure ... CDA Header ... <structuredBody> <section> <text>...</text> <observation>...</observation> <substanceAdministration> <supply>...</supply> </substanceAdministration> <observation> </observation> </section> <section> <section>...</section> </section> </structuredBody> </ClinicalDocument>OpenEHR Archetypes can be used to standardise the content of the CDA-structured documents.
HISO 10040 Benefits • Supports a core electronic health record • Supports information being Clinical Benefits available wherever the patient is • Supports integrated care • Reduced interfacing costs Technical • Incorporates multiple data sources Benefits • Platform for data sharing across regions HISO • Defines Information Transport Interoperability • Defines Information Structure • Defines Information Content Standards
Trial Implementation Success Criteria• Align with one or more DHB-funded projects in the region• Demonstrate something new and important for the sector• Demonstrate key features of the HISO interoperability standards• Have potential to engage successfully with health system vendors• Provide a model for national HIE adoption
Options Compared (For Arguments Sake) Share Primary Care Summaries with After Hours and Emergency Health Services Potential Difficulty Share Hospital Discharge Summaries with After Hours and Emergency Health Services Share InterRAI Reports with Community Pharmacists Potential Value