Himss 2010 Asia Pac 2010

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This is a keynote presentation given to HIMSS Asia Pac 2010

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Himss 2010 Asia Pac 2010

  1. 1. The Future of Health is in Our HandsIntelligent Health<br />Steven C. Boyages<br />Copyright Not for Reproduction 2010<br />
  2. 2. Summary<br />We are on the verge of a great era of transformation in health care through health IT<br />Intelligent Investment<br />The future will be spearheaded by a better understanding of workflow<br />Intelligent Work<br />Better access to real time information about patient care and health system performance underpinned by sustained investment in technology<br />Business Intelligence Systems<br />This transformation will lead to a sustainable, flexible and safer health system where the patient is at the center of care as an active participant<br />Intelligent Health Care<br />
  3. 3. Intelligent Investment<br />Copyright Not for Reproduction 2010<br />
  4. 4. Challenges to the health system<br />Rising demand<br />Growing & ageing population<br />Chronic illness rising<br />High levels smoking, obesity, stress<br />High consumer expectations<br />Constrained capacity<br />Patient Safety<br />Workforce shortages and attitudes<br />Manage demand within finite resources<br />Cost vsinvestment<br />NSW spends about 28% of budget on health care<br />1.3 million dollars per hour<br />4<br />
  5. 5. Investing In Health IT<br />Benefits<br />Improved automation<br />Improved productivity<br />Reduced duplication<br />Improved safety<br />Improved patient and staff experience<br />Improved reach of information and service<br />Risks<br />Financial investment not realised<br />Poor connectivity<br />Lack of common standards<br />Increased risk to patients<br />Increased staff frustration and lower morale<br />Staff expectations not realised<br />5<br />
  6. 6. Investing in Health IT<br />Transformation steps<br />Build the case for Why?<br />Build the case for What and in what order (sequence)?<br />But most importantly:<br />Build the case for How?<br />Value proposition<br />Patients, payers, providers, places of care (4Ps)<br />Execution is the key<br />Evolution as opposed to revolution<br />Engagement with key staff in design<br />Integration with key legacy systems<br />Understand complexity and complex systems<br />Copyright Not for Reproduction 2010<br />
  7. 7. Health is a complex business<br />Copyright Not for Reproduction 2008<br />The organisational goals fundamental to Sydney West Area Health Service are clearly outlined in CAREFirst1, to: <br />Provide accessible and appropriate clinical services <br />Design safe, effective and innovative models of care <br />Invest in services that are value for money <br />Advocate a culturally appropriate model of service and community participation <br />Promote a culture of knowledge through teaching and research <br />Develop a highly skilled workforce.<br />
  8. 8. Sydney West delivers<br />On a typical day in Sydney West… <br />2,334 people receive inpatient care <br />546 people are seen in emergency departments <br />8,753 out-patient services are provided <br />1,488 primary care and community health occasions of service are provided, with 129 new referrals <br />266 occasions of service are provided by community mental health teams. <br />
  9. 9. Health Operating System-HOS<br />Complex and Connected<br />9<br />
  10. 10. Current Strategy<br />
  11. 11. Background<br />
  12. 12. InfrastructureComplexity<br />
  13. 13. Intelligent Work<br />Copyright Not for Reproduction 2010<br />
  14. 14. How do we evolve and adapt?<br />Copyright Not for Reproduction 2008<br />
  15. 15. Evolution<br />In biology, evolution is the process of change in the inherited traits of a population of organisms from one generation to the next<br />Natural selection, adaptations <br />Genetic drift, random<br />The concept of evolution may be applied to an organisation<br />Traits are the genetic code or constants in health, patient care<br />Adapting to external environmental factors<br />Copyright Not for Reproduction 2010<br />
  16. 16. Evolution<br />Copyright Not for Reproduction 2008<br />
  17. 17. The Process of Adaptation<br />Models of Care<br />Safety<br />Redesign<br />Information and Innovation<br />Technology Investment<br />Team First<br />Understanding the way we deliver care at the level of the “cellular unit”, what, how and who<br />Strong focus at the ward level<br />Copyright Not for Reproduction 2010<br />
  18. 18. Something old Constants of health<br />Copyright Not for Reproduction 2010<br />Patient Centred care<br />History, physical, investigations<br />Teams of health care workers<br />Care in the Home<br />Hospital Setting<br />
  19. 19. Team First<br />Copyright Not for Reproduction 2008<br />WARD<br />
  20. 20. COMPASS<br />Professional<br />Specialist<br />Teams<br />Redesign <br />FIT<br />BIT<br />ReFIT<br />Audio-video <br />Recording<br />Roles<br />SOPs<br />Policy<br />Vertical Process<br />Horizontal Process<br />Generalist<br />Teams<br />Team First<br />Social <br />Networking<br />Wiki, Blogs<br />Collaborative<br />Teams<br />WARD<br />Collaboration Tools<br />RSS, Sharepoint, Groove<br />Technology PlatformsSurface Computing, Bedside <br />WAND Display<br />Copyright Not for Reproduction 2010<br />
  21. 21. TeamFirst Workflow<br />Inflight<br />(DON)<br /><ul><li> Monitoring
  22. 22. LOS
  23. 23. EUR
  24. 24. E-consults</li></ul>Outbound<br />(CNU)<br />Inbound<br />(CNU)<br /><ul><li>Bed Allocation
  25. 25. Hospital Avoidance
  26. 26. Load Management
  27. 27. Hospital Bypass
  28. 28. Dashboard
  29. 29. Referrals to HealthOne & GP</li></ul>Care Navigation Unit <br />Patient Flow Manager<br />Copyright Not for Reproduction 2010<br />
  30. 30. How do we evolve and adapt?Something new<br />Copyright Not for Reproduction 2008<br />
  31. 31. Business Intelligence Systems<br />Copyright Not for Reproduction 2010<br />
  32. 32. Health IT systems<br />Clinical<br />Corporate<br />Integrated BI systems<br />Copyright Not for Reproduction 2010<br />
  33. 33. Layers of information<br />
  34. 34. Clinical Systems<br />Patient Administration Systems<br />Electronic Medical Records<br />Electronic Records<br />PACS/RIS<br />Pathology Systems<br />These are key building blocks or genetic code<br />Copyright Not for Reproduction 2010<br />
  35. 35. Current Applications<br />Orders (Order Entry)<br />
  36. 36. Current Applications<br />PowerChart (Flow Sheet)<br />
  37. 37. Current Applications<br />Respiratory<br />
  38. 38. Current Applications<br />Discharge Summary (eDRS)<br />
  39. 39. Layers of information<br />
  40. 40. Copyright Not for Reproduction 2008<br />
  41. 41. Copyright Not for Reproduction 2008<br />
  42. 42. Layers of information<br />
  43. 43. Mix of Patient & PerformanceManagement tools to support clinical care<br />EMR<br />Electronic Health Records<br />Bed Board (including LOS enhancements)<br />Ward Activity and Nursing Display (WAND)<br />eConsults<br />iHandover<br />Transport booking<br />Infectious Diseases Alerts<br />Pharmtrack<br />Uses up to date (near real time information) through CareFirst Dashboard – which includes:<br /><ul><li>Subject Area Dashboards (Patient Safety, Mental Health, Surgery, Nursing, Costing, ED etc.)
  44. 44. Links to hundreds of pre-populated Business Objects Reports (no performance issues)</li></ul>(a) Patient Care<br />(b) Performance Mgmt<br />35<br />
  45. 45. (b) Performance Mgmt<br />Enterprise Level<br />36<br />
  46. 46. (b) Performance Mgmt<br />Mix of Dashboards, Reports and Queries through an AHS Portal<br />“Traditional” KPI Dashboards<br />Admin<br /><ul><li>Bed Reporting
  47. 47. Health Entity Registration</li></ul>Ad-hoc Reporting<br /><ul><li>Controlled Business Objects Universes
  48. 48. SQL Server Reporting / Analytic Services</li></ul>Published / Static Reports<br />Operational / Subject Area Dashboards and Drilldowns<br />37<br />
  49. 49. Bed Board<br />38<br />
  50. 50. (a) Patient Care<br />39<br />
  51. 51. Real Time Health Systems<br />Definition<br />Responsive<br />Agile<br />Available<br />Flexible<br />Timely<br />Real time<br />Near Real time<br />Capability<br />Patient Care<br />Safety<br />Decision support<br />Outcomes Research<br />Patient Logistics<br />Performance Management<br />State<br />Area based<br />Hospital/cluster/network<br />Modality (scheduling)<br />Bedside<br />40<br />
  52. 52. Unified | …To Data FUSION<br />Labs<br />Cardiology<br />Procedure Documentation<br />Medication Administration<br />Electronic Medical Record<br />OR Management<br />Emergency Department<br />Pathology<br />Imaging<br />Hemodynamics<br />CPOE<br />Pharmacy<br />Dictation<br />Medication Dispensing<br />PACS<br />Charting<br />Clinical Notes<br />Orders<br />VIEWERS<br />FUNCTIONS<br />DATA CORE<br />Mobile Data<br />ICU/Critical Care<br />Advanced Analytics<br />Image Distribution<br />RIS<br />Nursing Workflow/ Documentation<br />Amalga<br />Amalga<br />Amalga<br />Contract Management<br />Revenue Management<br />Bed Management<br />Financial/ERP<br />Enterprise Scheduling<br />Business Decision Support<br />Inventory<br />Document Imaging<br />Physician Practice<br />Claims Management<br />Registration<br />Staff/Nurse Scheduling<br />Outcomes Management<br />Transcription<br />Purchasing<br />Access Management<br />Medical RecordsCoding<br />Call Management<br /> Microsoft Amalga is the new way to capture, consolidate, store, <br />access and quickly present data in meaningful ways<br />
  53. 53. Business Intelligence Systems<br />Allows leveraging of existing investment in legacy systems<br />Integrates patient level and performance level information<br />Allows Flexibility and Agility<br />Real Time<br />Rapid development<br />Culture<br />Governance<br />Copyright Not for Reproduction 2010<br />
  54. 54. Intelligent Health Care<br />Copyright Not for Reproduction 2010<br />
  55. 55. Patient Experience<br />Copyright Not for Reproduction 2008<br />
  56. 56. Evolutionary Pressures<br />Copyright Not for Reproduction 2010<br />Patients as partners in health<br />Health information and navigation<br />Personal health records<br />Greater expectations of citizens<br />
  57. 57. Improving Staff Experience<br />Desktop<br />Thin Client<br />Telephone<br />Vocera<br />Mobile<br />Computer On Wheels (COW)<br />
  58. 58. Intranet, tablets, blogs and wikis<br />Copyright Not for Reproduction 2010<br />
  59. 59. Improving Staff Experience<br />Lithgow Hospital Wireless LAN<br />
  60. 60. Summary<br />We on the verge of a great era of transformation in health care through health IT<br />Intelligent Investment<br />The future will be spearheaded by a better understanding of workflow<br />Intelligent Work<br />Better access to real time information about patient care and health system performance underpinned by sustained investment in technology<br />Business Intelligence Systems<br />This transformation will lead to a sustainable, flexible and safer health system where the patient is at the center of care as an active participant<br />Intelligent Health Care<br />
  61. 61. Future Health Care<br />Understanding the way we do our work<br />Technology simplifying work flow<br />Improving patient experience<br />Assuring patient safety<br />Copyright Not for Reproduction 2010<br />
  62. 62. Copyright Not for Reproduction 2010<br />

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