Primary Care Strategy Implementation


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Dougal McKechnie

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Primary Care Strategy Implementation

  1. 1. HINZ: Primary Care Strategy Implementation How can information help get us there? Friday, 16 March 2007 Health Information Strategy Action Committee (HISAC) To provide governance of, oversight of, and leadership for the implementation of the Strategy to the Health and Disability Sector. Accountable to the Minister for sector implementation of the strategy. 2 1
  2. 2. How HISAC operates • The Committee: Paul Cressey (Chair), Chai Chuah, Debbie Chin, Graeme Osbourne, Tony Cooke, Julian Inch, Harry Pert, Tim Gardiner, Andrea Pettett, Helmut Modlik and David Rankin. • Sub-Committees: Infrastructure Sub-Committee, Health Information Standards Sub-Committee, and National Collections Sub-Committee. • HISAC Office: 8 full time positions – a semi autonomous group within the Ministry of Health. 3 Engagement Approach • Leadership • Priorities and direction setting • Stimulate change – Solution broker – Selection / acceptance criteria – Incentives / funding models – Communicating ideas / progress / success • Governance • Project endorsement / alignment to HIS-NZ – ‘the HISAC tick’ • Participate in governance of sector projects • Oversight • Measure progress • Participate in governance of sector projects 4 2
  3. 3. What HISAC is focused on currently • Agree priorities • Standards programme • Direct the HISO work programme • Involve implementation leads • Adoption / endorsement of standards that are developed elsewhere • Confirm implementation leads • Confirm where we want leads • Select lead from candidate (s) • Active monitoring 5 Challenges with Primary Care Information Today • Patients cannot reliably access individual health information needed for decisions about care and self management. • Primary care teams, and other stakeholders cannot reliably access the information required to demonstrably improve care quality and outcomes for their respective populations. • It can be difficult to access high quality evidence based information needed for care and to continuously improve the quality of services. • It is difficult for care services and organisations to access relevant information needed to coordinate the provision of care. • There are significant variations in information management capability, particularly in the wider primary care community. • Clinical and administrative data is not consistently defined and recorded. 6 3
  4. 4. HIS-NZ Action Zones & The Primary Health Care Strategy • Delivering the Primary Care Strategy requires elements from all 12 Action Zones Care Delivery, AZ 7: Long Term Condition Management Funding, Planning, Use Local Policy & Research AZ 10: Primary Care Information Views of Information AZ9: Outpatients Information Transactional AZ 4: AZ 5: AZ 6: AZ 8: Sector Ownership Informational Flows ePharmacy eLabs eDischarges eReferrals Information Information AZ 2: AZ 3: Anchors NHI HPI Interoperability AZ11: National Systems Access & Access AZ 1: National Network Enabling National AZ 12: Anchoring Framework 7 Some Key Linkages to AZ 10: Primary Care Information • AZ 7: Management of Long Term Conditions • Proactive identification and treatment for long term care is centred in primary care. • This requires certain information systems capabilities and the availability of relevant primary care information. • AZ 9: Outpatient Information • As more services are shifted to 1°care there is a need to re-examine how we build a complete picture of individual and population health. • This requires the ability to integrate 1°and 2°care information as needed. • AZ 12: Anchoring Framework • Action Zone 12 focuses on the key enablers for information sharing and interoperability within the Sector, including primary care information. • This includes standardised architectural and data models, business processes, information technologies, usage principles and policies. 8 4
  5. 5. Vision & Strategy – AZ 10: Primary Care Information • Vision • Excellence in information management supporting excellence in primary care. • Strategy • Capture and use standardised primary health care information locally as part of normal activities. • Use agreed evidence based indicators to support improved clinical governance and population health. • Ensure that appropriate subsets of local information are available regionally and nationally and provide appropriate views of this information. 9 Design Principles - AZ 10: Primary Care Information • Data collection is integrated into every day work practices. • Detailed data is used and maintained locally at the point of care (enter once and use many times). National National Views Views Relevant views ity Appropriate information views or subsets flow upwards through groups of information Po • Appropriate views / un District / /Regional above. p p pu District Regional that regularly use the informationViews subsets of the / ensure its accuracy. mm la la lat information below. Views i Co o o on • Relevant Capture, of information held at any given level are available to views the levelsuse, and and to individualsViews below, Local / communities / populations. Local Views share information locally. • Information flows are governedIndividual by agreed principles and processes. Standards Standards Indicators Indicators Health Outcomes Health Outcomes 10 5
  6. 6. Solution Components - AZ 10: Primary Care Information 1. Focused information systems; 2. Appropriate information exchange; 3. Evidence-based improvement; 4. Coordinated care; 5. Extended information capability; 6. Appropriately standardised data. The scope and approach document lists the required information environment capabilities in each area and is available from 11 Supporting Standards - AZ 10: Primary Care Information • Information sharing agreements; • Evidence-based indicators & outcome measures; • Health event summaries; • Clinical code sets; • Sector data model / data dictionary; • Electronic patient file transfer. 12 6
  7. 7. HISAC Priorities to Progress in 2007 (draft work in progress) • HISAC General • HISO • Sector knowledge base • ePharmacy data exchange • Evidence based indicators and • Medicines terminology outcome measures • Clinical coding / terminology • eReferrals reference sites • Health event summary standards • eLabs reference sites • GP2GP patient file transfer • Legal support for ePrescribing • HISAC - ISC • HISAC - NCSC • Health Network COP & PAS • Information sharing guides / • Securely connectivity agreements • Network directory service • National systems governance / access • NHI improvements • HPI uptake and registries 13 Access/Interop. Anchors Transactional Flows Info. Views National Sys Access LTC (Chronic Care) Mapping Priorities Anch. Framework Primary Care Info Outpatient Info eDischarges ePharmacy eReferrals Network eLabs NHI HPI AZ1 AZ11 AZ12 AZ2 AZ3 AZ4 AZ5 AZ6 AZ8 AZ7 AZ9 AZ10 HISAC General Sector Knowledge Base Evidence Based Indicators / Outcome Measures eReferrals implementations eLabs Reference implementations Legal Support for ePrescribing HISO ePharmacy Data Exchange Medicines Terminology Clinical Coding / Terminology Event Summary Standards PMS Patient File Transfer Infrastructure Sub Committee Health Network C.O.P & P.A.S Secure Connectivity Network Directory Service National Collections Sub Committee Information Sharing Guides / Agreements National Systems Governance / Access NHI Improvements HPI Uptake and Registries Chronic Disease Child and Youth Minister's Priorities The 2007 draft priority areas The 2007 draft priority areas Primary Health Health of Older People nearly all contribute to improved nearly all contribute to improved Infrastructure Value for Money primary care information. primary care information. Elective Services 14 7