The document discusses sharing electronic health records between healthcare providers in New Zealand from the perspective of a general practice and its patients. It provides an overview of the benefits and concerns of sharing records, along with the results of a patient survey. The survey found that patients are generally comfortable sharing key health information but have some privacy concerns. It also recommends developing a shared record system that allows for individualized access permissions and involves stakeholders in decision making.
Balancing access, efficiency, and quality in health care aspires digital health interventions. Aging populations, high prevelance of chronic disease, and shortages in the health workforce, build the case for augmented coordinated care and citizen participation. However progress has been slow partly due to limited use of consistent standards and tools, and gaps in trust and skills for collaboration and information sharing. Integrated management of resources for face-to-face and remote appointments linked to personal health records, provider and patient facing apps, and diagnostics may improve access to quality care. Starting with a patient case, we discuss standard interfaces and data formats for appointments to explore challenges for patients and providers in emerging blended models of health care, as we strive for particiaption, productivity, professionalism, and accountability. Health care appointments will be discussed with initiatives from Denmark and Norway as the backdrop of the new generation of interoperability standards exemplified by HL7 FHIR initiative.
Morten Brunn-Rassmussen, Mediq, Odense, Denmark
Jan Petersen MedCom, Odense, Denmark
Anne Moen, University of Oslo, Oslo, Norway
Petter Hurlen, Akershus University Hospital, Lørenskog, Norway
Catherine Chronaki, HL7 Foundation, Brussels, Belgium
Aiming for a Higher Performing Health Care System: Learning from Cross-Nation...The Commonwealth Fund
Robin Osborn, Vice President and Director, International Program in Health Policy and Innovation at The Commonwealth Fund, discusses international health care systems. These slides were presented at the Queen’s Health Policy Change Conference, May 6, 2015 in Toronto, Canada.
Opening Keynote"From Patient to Population: Providing Optimal Care - The Role for Technology"
Ronald Paulus, MD, MBA
President & CEO
Mission Health System
Evidence shows us that specialised mood disorder clinics deliver cost savings, better clinical outcomes and improved patient satisfaction. Presented to the Trent Division of the Royal College of Psychiatrists, November 2013, Sheffield.
Balancing access, efficiency, and quality in health care aspires digital health interventions. Aging populations, high prevelance of chronic disease, and shortages in the health workforce, build the case for augmented coordinated care and citizen participation. However progress has been slow partly due to limited use of consistent standards and tools, and gaps in trust and skills for collaboration and information sharing. Integrated management of resources for face-to-face and remote appointments linked to personal health records, provider and patient facing apps, and diagnostics may improve access to quality care. Starting with a patient case, we discuss standard interfaces and data formats for appointments to explore challenges for patients and providers in emerging blended models of health care, as we strive for particiaption, productivity, professionalism, and accountability. Health care appointments will be discussed with initiatives from Denmark and Norway as the backdrop of the new generation of interoperability standards exemplified by HL7 FHIR initiative.
Morten Brunn-Rassmussen, Mediq, Odense, Denmark
Jan Petersen MedCom, Odense, Denmark
Anne Moen, University of Oslo, Oslo, Norway
Petter Hurlen, Akershus University Hospital, Lørenskog, Norway
Catherine Chronaki, HL7 Foundation, Brussels, Belgium
Aiming for a Higher Performing Health Care System: Learning from Cross-Nation...The Commonwealth Fund
Robin Osborn, Vice President and Director, International Program in Health Policy and Innovation at The Commonwealth Fund, discusses international health care systems. These slides were presented at the Queen’s Health Policy Change Conference, May 6, 2015 in Toronto, Canada.
Opening Keynote"From Patient to Population: Providing Optimal Care - The Role for Technology"
Ronald Paulus, MD, MBA
President & CEO
Mission Health System
Evidence shows us that specialised mood disorder clinics deliver cost savings, better clinical outcomes and improved patient satisfaction. Presented to the Trent Division of the Royal College of Psychiatrists, November 2013, Sheffield.
Kontor i all ära, men arbete är ju inte längre bara _en_ plats. Peter Bjellerup på IBM berättar varför han vill att vi ska dela med oss av information på arbetet på samma sätt som vi gör privat i sociala medier.
Kontor i all ära, men arbete är ju inte längre bara _en_ plats. Peter Bjellerup på IBM berättar varför han vill att vi ska dela med oss av information på arbetet på samma sätt som vi gör privat i sociala medier.
EuroBioForum 2013 - Day 2 | Mark PoznanskyEuroBioForum
EuroBioForum 2013 2nd Annual Conference
27-28 May 2013 - Hilton Munich City, Munich, Germany
http://www.eurobioforum.eu/2013
=======================================
# REGIONAL PERSPECTIVES #
Ontario Genomics Institute, Canada:
Innovative Research, Innovative Translation
Dr Mark Poznansky
President and CEO Ontario Genomics Institute
=======================================
http://www.eurobioforum.eu
News from the Coal Face: There’s light at the end of the tunnel. Presented by Dr Andrew Miller, General Practitioner, at HINZ 2014, 11 November 2014, 4.30pm, Marlborough Room
The mismatch between information that people need and what we provide them withCILIP
Jane Fox (Programme Manager – The Information Standard, NHS England) and Jonathan Berry's (National Policy Lead – Health Literacy, NHS England) presentation at the CILIP 2017 Conference in Manchester #CILIPConf17
This session will be an interactive workshop session to explore the mismatch between the information that is produced in health and care and the level at which the target audience need it to be. The session will share real life examples of the problems, share good practice and introduce tools and techniques to help drive up not only the quality but the functionality of information for the public. Whether you commission, produce or want to be able to signpost to good quality information this session will equip you with what you need to know and what’s out there to help you. Although based on experiences in health and care information this will be of relevance to anyone that relies on consumer information that people can not only understand but also act on.
20131210 Electronic Health Records - Is the NHS ready? What about patientsamirhannan
On 12th December 2013, Dr Hannan (GP / family physician) along with Marilyn Gollom (patient) presented this talk to Health 2.0 Manchester. You can watch the talk by going to http://www.htmc.co.uk/pages/pv.asp?p=htmc0519.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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How to Give Better Lectures: Some Tips for Doctors
Sharing EHRs - A GP and patient perspective
1. Health Informatics New Zealand
www.hinz.org.nz
Sharing health
records
A general practice and
patient perspective
Sandra Hicks, IPAC, December 2006
• Local general practice and patient
perspective
• Pointers from the UK
• What should we do in New Zealand?
1
2. Health Informatics New Zealand
www.hinz.org.nz
Sharing Electronic Health
Records
• What
• When
• Why
• Who
But not
• How or
• Where
General Practice
• A typical general practice?
2
3. Health Informatics New Zealand
www.hinz.org.nz
Halswellhealth
Halswellhealth – the partners
3
5. Health Informatics New Zealand
www.hinz.org.nz
The records
Demographics
The patients
• 9261 enrolled patients
• 4305 male
• 4955 female
• 6% Maori
• 1.5% Pacific Island
• 2.6% Asian
5
6. Health Informatics New Zealand
www.hinz.org.nz
Demographics
The Staff
• 4 partners, soon to be 5
• 3 associate doctors
• 1 GP registrar
• 5 practice nurses (& often a student nurse)
• 5 receptionists
• 2 administrators
• 1 practice manager
• 1 podiatrist
The practice manager is the only full-timer, although
all the partners work at least 40 hours per week
in the practice
Shared Electronic
Health Records
• Why?
– Rapid access to clinical information
• e.g. allergies, medication lists, past surgery
– Prevent duplication of labs, Xrays etc
• Test and Xray results available electronically
– Reduced administration time chasing missing
notes, results, referral letters etc.
6
7. Health Informatics New Zealand
www.hinz.org.nz
Shared Electronic
Health Records
• Why not?
– Privacy
– Security
– Takes more time – particularly in general
practice
• Generating health summaries
• Recording (in a standardised way) the
reasons for prescriptions
7
8. Health Informatics New Zealand
www.hinz.org.nz
Shared Electronic
Health Records
• What do the patients think?
8
9. Health Informatics New Zealand
www.hinz.org.nz
Patient Questionnaire
Sharing Your Health Records
• At the moment your health record is held in many
different places, although mostly with your GP
(general practitioner). But obviously some information
relating to you can also be held at the hospital, with
GPs in other cities, physios, the laboratory (blood
tests), and at the local after hours surgery or other
places that you may have visited.
• This could cause problems as each place may not have
a complete record of your health experiences when
looking after you. Things such as your medications,
allergies, any previous operations and recent blood
test or X-ray results may not be available to the
person that you are seeing.
Patient Questionnaire cont
• Health Information New Zealand (HINZ), a
government initiative, along with the Ministry of
Health, ACC and other organisations are looking at
developing an electronic health record where at
least some parts of your record would be available
to other health professionals.
• I have been asked to speak at a HINZ seminar
about what GPs think about sharing health
records electronically. I am particularly keen to
ensure that I advocate accurately on your (i.e.
patients’) behalf when giving this presentation.
9
10. Health Informatics New Zealand
www.hinz.org.nz
Patient Questionnaire cont
• To help me I would like to know what you think
about sharing your health records with other
health professionals. I have designed some
questions and would like your help. Please be really
honest in your response to these questions.
• On a scale of 1 to 5 please indicate how happy you
would be to have the following pieces of your
health record available centrally to all health
professionals who can access a secure electronic
health network.
Very happy Do not want this ever
1 2 3 4 5
Patient Survey – 100
surveys, return rate of 90%
Age and Sex of respondents
40
number of respondent
35
30
25 female
20 male
15 not stated
10
5
0
<25 25-40 40-60 60+
age
10
11. Health Informatics New Zealand
www.hinz.org.nz
years at the practice
50
average number of
40 years =17.25 (7 people
did not respond to this
30 question)
years
20
10
0
1 5 9 13 17 21 25 29 33 37 41 45 49 53 57 61 65 69 73 77 81 85 89
respondents
What would you be happy to share?
• The list of medicines that you are taking
• A list of medicines that you are allergic to
• A list of current and previous health problems
(e.g. asthma, diabetes, hysterectomy, knee
reconstruction etc)
• The records from hospital admissions
• Summaries of hospital admissions (like the
discharge letter that goes to your GP)
• The records from your general practitioner
• Summaries of problems for which you have seen
your general practitioner.
11
12. Health Informatics New Zealand
www.hinz.org.nz
What would you be happy to share?
• What about lab results – at the moment these are
held by the person who requested them, and at
each of the three laboratories (Southern
Community, Medlab and Canterbury Health
Laboratories).
• How comfortable would you be to have all the
laboratory results go into a central laboratory
repository which could be looked up by other
health professionals who were treating you?
Sharing health record
patient degree of com fort (scale 1 to
2.5
2
1.5
1
0.5
0
h o s p ita l
M e d ica tio n s
s u m m a rie s
s u m m a rie s
L a b re s u lts
p ro b le m lis t
A lle rg ie s
re co rd s
G P re co rd s
d is c h a rg e
G P event
h o s p ita l
L is t o f
parts of the record
12
13. Health Informatics New Zealand
www.hinz.org.nz
Anything else?
• Is there anything (other than already
indicated above) that you would NOT
want available? (You may list
examples that don’t apply to you
personally, but that you think should
be kept private.)
Information that respondents
would not want shared
Mental health issues that may be circumstantial
rather than inherent. Could be misconstrued or
perhaps viewed unfavourably.
Hospital admission for surgery would be fine to be
accessed by others. However not hospital
admissions such as intoxication. I wouldn't like all
people having access to as it doesn't affect my
health and creates an area to be judged
13
14. Health Informatics New Zealand
www.hinz.org.nz
Information that respondents
would not want shared
There may be some discussions you
prefer to be kept private - perhaps the
option of that being on the Central
Register?
Perhaps genetic records
Irrelevant information that would not
be applicable to care from another
provider
Abortion
Any private personal issues
Lab Results not to be shared
I cannot think of anything but if
something pops up I would mention it
STD's etc may be best kept as an
optional choice
anything that doesn't directly relate
Specific STI's, TOPs etc which may be
requested by Insurance companies from
a GP and they may feel compelled to
divulge info when the individual went
elsewhere specifically so that the family
Dr would not have info
14
15. Health Informatics New Zealand
www.hinz.org.nz
Access to Records
Would you be happy for the following groups of people to have access
to your records?
• your general practitioner
• practice nurses
• after hours doctors
• other general practitioners
• hospital doctors (includes emergency department, outpatient
clinics, specialists, doctors on the ward if you are an inpatient)
• hospital nurses (includes emergency department, outpatient
clinics, specialist nurses, nurses on the ward if you are an
inpatient)
• Physiotherapists
• Chiropractors
• Plunket nurses
• mental health workers
• Family Planning doctors and nurses
• Vision and Hearing Testers
• Dentists
• Pharmacists
• Alternative medicine practitioners
• Yourself
• Your family/whanau
Allow Access Part 1
100
90
80
70
60 Yes
50
40 No
30
20
10
0
after hours
own general
other general
practice nurse
hospital doctors
hospital nurses
physiotherapists
chiropractors
practitioner
practitioners
doctors
15
16. Health Informatics New Zealand
www.hinz.org.nz
Allow Access Part 2
90
80
70
60
50 Yes
40 No
30
20
10
0
Plunket mental `Family Vision and Dentists Pharmacists Alternative Yourself Your family/
nurses health Planning Hearing medicine whanau
workers doctors and Testers practitioners
nurses
Holding Records
Who do you think should hold your records?
Please tick as many as you wish.
• the different professionals you see (as
now)
• your general practitioner
• Yourself
• the Ministry of Health
• a secure electronic site where they can be
accessed as required
16
17. Health Informatics New Zealand
www.hinz.org.nz
Holding the health record
90
80
70
60
50 Yes
40 No
30
20
10
0
yourself
professionals
your general
the Ministry
electronic
a secure
practitioner
of Health
individual
site
health
Other comments
Survey is quick decision making. A longer time for
thought would have been appreciated as there are
important considerations to be answered
especially with consideration to lower echelon
access and all info available to specific
professionals when they would only require
specific info
my main concern would be security of electronic
and physical storing of files
only if absolutely secure
as much information available as possible
An electronic site is fine if our nation continues in
safety - if it fell into bad hands it could be
dangerous and used against people with
disability/hereditary illness etc.
17
18. Health Informatics New Zealand
www.hinz.org.nz
Other comments
I understand this to mean my GP is the 'main'
holder of the records with other professionals
having access to them
Health practitioners who do have access should
hold this information as confidential and not be
able to discuss this with other
peoples/professionals without consent (possibly in
writing)
I would like it to be secure, i.e. that those people
who happen to work within the healthcare
industry but don't have a direct input into the
patient's care aren't accessing for general
interest rather than for individual care
Don't mind other professionals having access as
necessary
Other comments
I think that the more info a medical practitioner
can have about you the better they would be able
to treat you correctly
It will be great to have a secure electronic site
which all medical practitioners can view including
person viewing their own records e.g. id no
required, but no access to other members of the
public
I feel that it is useful for health professionals
that adhere to a strict confidentiality code to
have records but do have some issues with such a
wide variance of people holding the records
18
19. Health Informatics New Zealand
www.hinz.org.nz
Hippocratic Oath
• What I may see or hear in the course of
the treatment or even outside of the
treatment in regard to the life of men,
which on no account one must spread
abroad, I will keep to myself, holding such
things shameful to be spoken about.
(Classical version)
• I will respect the privacy of my patients,
for their problems are not disclosed to me
that the world may know. (Modern version)
Recent developments in
the UK
• Much money being spent on improving IT systems
• NHS Connecting for Health
– NHS Care Records Service
– Choose and Book, electronic booking service
– Electronic Transmission of Prescriptions
– National Network (N3) – broadband connectivity and IT
infrastructure
– Contact – central email and directory service for the
NHS
– PACS Picture Archiving and Communications Systems
– IT supporting GPs, including QMAS, QoF and GP to GP
record transfer
19
20. Health Informatics New Zealand
www.hinz.org.nz
Pre-requisites for Shared
Electronic Health Records
• In general practice
– Ability to electronically transfer notes
between general practices
– Excellent search tools
– Smart decision support tools
– Training in the use of the technology
20
21. Health Informatics New Zealand
www.hinz.org.nz
Pre-requisites for Shared
Electronic Health Records
• In the hospital
– Clinical notes on the computer
– Electronic referrals and discharges
Pre-requisites for Shared
Electronic Health Records
• In general
– Dialogue with the people of New Zealand
as to what they want
– Solving the privacy and security issues
– A national approach which constructively
involves all the stakeholders
21
22. Health Informatics New Zealand
www.hinz.org.nz
Recommendations
• Ask the patients
• Develop a system that allows for individualised
permissions
• The shared electronic health record should be
accessible to patients
• Ensure that the pre-requisites have been dealt
with
• Have a national approach with decision-making
which involves all stakeholders
• Don’t forget the Hippocratic Oath
22