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Development And Implementation Strategies - Roy Harper
1. Development and Implementation Strategies A Clinician’s Perspective Dr Roy Harper Consultant Physician & Endocrinologist The Ulster Hospital Visiting Professor, School of Mathematics and Computing The University of Ulster
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4. Timeline for Health Computing (Informatics) in Health and Social Care in Northern Ireland (1999 – Present) – A Personal View 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Diamond Diabetes ECR installed HPSS ICT ‘Vision’ HPSS ICT ‘From Vision to Reality’ Emergency Care Record Pilot Goes Live ECCH set up Start of H&C Number roll out Wireless Carts NI BCS Health set up First COM 723 at UUJ Local PACS Tablet PCs and remote access Regional EHR Research Group Established 2009 PatientCentre [email_address] Appointed as Physician in UCHT RPA Roll out of PCs in all OPD Consulting Rooms Pilot ECR NIPACS
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9. Timeline for Health Computing (Informatics) in Health and Social Care in Northern Ireland (1999 – Present) – A Personal View 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Diamond Diabetes ECR installed HPSS ICT ‘Vision’ HPSS ICT ‘From Vision to Reality’ Emergency Care Record Pilot Goes Live ECCH set up Start of H&C Number roll out Wireless Carts NI BCS Health set up First COM 723 at UUJ Local PACS Tablet PCs and remote access Regional EHR Research Group Established 2009 PatientCentre [email_address] Appointed as Physician in UCHT RPA Roll out of PCs in all OPD Consulting Rooms Pilot ECR NIPACS
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14. Timeline for Health Computing (Informatics) in Health and Social Care in Northern Ireland (1999 – Present) – A Personal View 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Diamond Diabetes EMR installed HPSS ICT ‘Vision’ HPSS ICT ‘From Vision to Reality’ Emergency Care Record Pilot Goes Live ECCH set up Start of H&C Number roll out Wireless Carts NI BCS Health set up First COM 723 at UUJ Local PACS Tablet PCs and remote access Regional EHR Research Group Established 2009 PatientCentre [email_address] Appointed as Physician in UCHT RPA Roll out of PCs in all OPD Consulting Rooms Pilot ECR NIPACS
15. Ongoing Information & Support Regular Feedback on Progress Patients increasingly need (and demand) ready access to feedback on their progress with advice from HCPs
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21. Transformation from Industrial Age Medicine to Information Age Healthcare Source: Adapted from Malaysian Telemedicine Blueprint Industrial Age Medicine Information Age Medicine Transformation Through Cost-Effective Use of Information & Communication Technologies Person Community Primary Secondary Tertiary Individual Self-Care Friends and Family Community Networks Professionals as Facilitators Professionals as Partners Professionals as Authorities
22. Home (self) monitoring technologies can transform episode driven health services into a relationship based continuum of care E A Balas 1999 Does it work in diabetes care?
32. Timeline for Health Computing (Informatics) in Health and Social Care in Northern Ireland (1999 – Present) – A Personal View 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Diamond Diabetes ECR installed HPSS ICT ‘Vision’ HPSS ICT ‘From Vision to Reality’ Emergency Care Record Pilot Goes Live ECCH set up Start of H&C Number roll out Wireless Carts NI BCS Health set up First COM 723 at UUJ Local PACS Tablet PCs and remote access Regional EHR Research Group Established 2009 PatientCentre [email_address] Appointed as Physician in UCHT RPA Roll out of PCs in all OPD Consulting Rooms Pilot ECR NIPACS
39. Before ECR PAS A&E PACS South Eastern Labs Renal G P Comm H&C Others Belfast Northern Southern Western Western GP’s
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49. Before ECR PAS A&E PACS South Eastern Labs Renal G P Comm H&C Others Belfast Northern Southern Western Western GP’s
50. With ECR Patient Access to Personal Health Records Belfast Western Northern Southern Southeastern Single sign-on, Security, Auditing, Business rules GP’s
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58. Timeline for Health Computing (Informatics) in Health and Social Care in Northern Ireland (1999 – Present) – A Personal View 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Diamond Diabetes ECR installed HPSS ICT ‘Vision’ HPSS ICT ‘From Vision to Reality’ Emergency Care Record Pilot Goes Live ECCH set up Start of H&C Number roll out Wireless Carts NI BCS Health set up First COM 723 at UUJ Local PACS Tablet PCs and remote access Regional EHR Research Group Established 2009 PatientCentre [email_address] Appointed as Physician in UCHT RPA Roll out of PCs in all OPD Consulting Rooms Pilot ECR NIPACS
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67. Timeline for Health Computing (Informatics) in Health and Social Care in Northern Ireland (1999 – Present) – A Personal View 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Diamond Diabetes ECR installed HPSS ICT ‘Vision’ HPSS ICT ‘From Vision to Reality’ Emergency Care Record Pilot Goes Live ECCH set up Start of H&C Number roll out Wireless Carts NI BCS Health set up First COM 723 at UUJ Local PACS Tablet PCs and remote access Regional EHR Research Group Established 2009 PatientCentre [email_address] Appointed as Physician in UCHT RPA Roll out of PCs in all OPD Consulting Rooms Pilot ECR NIPACS
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73. Development and Implementation Strategies A Clinician’s Perspective Dr Roy Harper Consultant Physician & Endocrinologist The Ulster Hospital Visiting Professor, School of Mathematics and Computing The University of Ulster
Editor's Notes
Introduction
No surprises here – the solution is to move to computerized clinical information systems. Much better.. Have a good IT infrastructure. We have computing power right up to the bed-side now. We just don’t have the clinical information systems as yet but we need to be freed to work on these! We need to move away from the big bulky inflexible systems from large usual suspect suppliers who provide lousy solutions at inflated costs.
That’s what I am passionate about. I believe …. Seeing it already….. exemplars locally in teleneurology and in paediatric cardiology … time now for diabetes and other chronic diseases. Pilots up and running. Looking at integrating these new approaches into routine clinical care… privelege to be heavily involved in improving on what is already out there … in developing and testing new ‘prototype’ technological solutions.
Introduction
Second problem is the way we store our information. Paper charts. Not working now. One copy. Hard to transport and store. Not available when needed in acute situations. 1 in 6 chance will not be available at clinic. Information hard to find. No longer complete as not enough clerical staff now to file everything. No way to search, analyze or learn from the information recorded. We need a better solution asap.
Paperwork overload. Bit of an exaggeration – frontline HSC staff don’t have desks! Spending so much time documenting the care we give that it is seriously eating into the time we have for direct patient bed-side care. Well meaning folks from patient safety side, infection control, medicines management side, governance side are coming up with very valid new processes but what that usually means for staff on the frontline is another page or two of an A4 form to fill out!
No surprises here – the solution is to move to computerized clinical information systems. Much better.. Have a good IT infrastructure. We have computing power right up to the bed-side now. We just don’t have the clinical information systems as yet but we need to be freed to work on these! We need to move away from the big bulky inflexible systems from large usual suspect suppliers who provide lousy solutions at inflated costs.
What I have discovered is that a lot of the key information we need as clinicians to support patient care is already available in lots of different clinical computer systems spread across the service. Some are good some are not. Some we have access to some we don’t but there is information in there that is really valuable – allergies, medication lists, letters, laboratory results, x-ray reports and images, and lots more. Hard to get at as you can imagine. We need to bring it all together.
Collapse – world today - What is this attempting to convey? Regions are not sharing emr, ehr or domain data?
An this is the answer - …… this is a key step in improving how we use our clinical information . We have seen it elsewhere. In various parts of the word. Very different approach to that taken in England which has been a disaster. I am sure you are aware of this ….
Instead of talking about it we are doing it now.
I do not have time to do a live demo but hear are a few screenshots of what the pilot ECR looks like. Amazing information. Looks complex but for clinicians easy – takes a few minutes training to get up to speed.
All the documents I need at the click of a button
Lab results collated from various laboratories
X-ray reports and images
Up to date medication lists. Some people are on a lot of pills!! No longer have to ring GP surgery and ask them to fax through list of medications!!
Collapse – world today - What is this attempting to convey? Regions are not sharing emr, ehr or domain data?
