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Addressing Scotland’s eHealth Goals. NHS Scotland, August 2011 Dr John Heavens. Session Goal. Within the context of the new Scottish eHealth Strategy, to provide some perspectives on a way forward to achieving success, based on Orion Health’s global eHealth experience. Agenda.
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Addressing Scotland’s eHealth Goals • NHS Scotland, August 2011 • Dr John Heavens
Session Goal Within the context of the new Scottish eHealth Strategy, to provide some perspectives on a way forward to achieving success, based on Orion Health’s global eHealth experience
Agenda • Review Scottish eHealth Approach • Orion Health’s Global Experience • Our perspectives
Scotland’s eHealth Policy Context: The Healthcare Quality Strategy for NHSScotland(May 2010) – the 3 Quality Ambitions: Effective (Evidence based) Right care at the right time in the right place Eradication of variation Person-centred Safe Health & Social Care Collaboration & Integration Financial Scotland’s eHealth Strategy
Scotland’s To use information and technology to: Maximise efficient working practices, minimise wasteful variation, bring about savings and ensure value for money Support people to manage their own health and wellbeing, and to become more active participants in the care and services they receive Contribute to shifting the balance of care and support people to self manage, and to provide appropriate information for people with long term conditions and mental health problems Improve the availability of appropriate information for healthcare workers and the tools to use and communicate that information effectively to improve quality Improve medication management as an essential part of peoples’ care Scotland’s eHealth Strategic Goals
Globally Traditional Burden of Disease Young Infectious Diseases & Injuries Traditional Care Model Acute hospital based Curative Speciality orientated Episodic Globally - A Changing “Burden of Disease” • Current Burden of Disease • Elderly • With LTCs & related: • Mental Health problems • Socio-economic problems • Significant cost escalation • New Care Models • Community based • Prevention focussed • MDT orientated • Continuous care and review • Use of assistive technologies • Behaviour modification
New Care Integrated H&S care delivery through: Multidisciplinary Teams (MDTs) Working in an interdisciplinary way Across care boundaries Focussing on: Community based care Patient and care giver involvement New Care Models - 1
New Care Continuous care and review with a preventative focus, which may include: Evidence based, disease focussed, programs of care Case Management principles ‘Virtual Ward’ approaches Call centre support, which may include: Behaviour modification Use of Assistive Technologies Video Conferencing Telehealth – Physiological monitoring Telecare – Environmental monitoring New Care Models - 2
Mechanisms Mechanisms to deal with these changes include: Workflow re-engineering eHealth support Mechanisms
Orion Health A global provider of eHealth solutions Our Mission - To create innovative, world-leading health technology solutions that improve peoples' lives Provide clinical systems, designed by clinicians for clinicians ‘Tools’ based approach Orion Health
eHealth Support Delivery of coordinated, cross boundary, evidence based, community orientated, MDT quality care with patient and care giver involvement requires: Systems interoperability – Integration Engine An integrated, single view of Patient Records accessible by: Health & Social Care providers – Clinical Portal Patients and Care Givers – Patient Portal eHealth Support - 1
eHealth Support - 2 Process support tools – Problem Lists, Medicines Reconciliation, Orders, Discharge Letters, etc. Clinical Workflow tools – Disease & Case Management tools Outcome measures – Business Intelligence tools eHealth Support - 2
Orion Health Orion Health - History Healthcare Professionals Patients Access – Patient EHR Clinical Process/Workflow Integration & Decision Support National & Regional Systems Telehealth & Telecare Clinical Data Repositories Currentsystems Hospital, GP, SS Other Systems Application Integration
Orion Health Orion Health – Integration Engine Healthcare Professionals Patients Access – Patient EHR Clinical Process/Workflow Integration & Decision Support National & Regional Systems Telehealth & Telecare Clinical Data Repositories Currentsystems Hospital, GP, SS Other Systems Application Integration Integration Engine: • Message mapping • Message routing & delivery • Rules based message filtering/transformation
Orion Health Orion Health – Clinical Portal Healthcare Professionals Patients Access – Patient EHR Clinical Process/Workflow Integration & Decision Support National & Regional Systems Telehealth & Telecare Clinical Data Repositories Currentsystems Hospital, GP, SS Other Systems Application Integration Clinical Portal: • Integrated , single view of patient data • Secure Authentication/Authorities, CCOW enabled SSO (Single Sign-On) to multiple systems with RBAC (Role Based Access) & LR (Legitimate Relationships) capabilities • CDV (Clinical Document Viewer) - including results, sign-off and charting • DPS (Dynamic Patient Summary) – windowlets of any electronically available data • Secure messaging 7 notifications
Clinical Porta Passive – Balearic Islands Active - Glasgow Clinical Portal - Examples
Orion Health Orion Health – Patient Portal Healthcare Professionals Patients Access – Patient EHR Clinical Process/Workflow Integration & Decision Support National & Regional Systems Telehealth & Telecare Clinical Data Repositories Currentsystems Hospital, GP, SS Other Systems Application Integration Patient Portal: • Secure Registration plus Authentication & Authorities for both patients and/or care givers • Secure messaging • Notifications • Access to information, appointments, results, prescription requests, etc.
Patient Portal Australia - national Personally Controlled Electronic Health Record (PCEHR) Patient Portal - Examples
Orion Health Orion Health – Clinical Workflow Healthcare Professionals Patients Access – Patient EHR Clinical Process/Workflow Integration & Decision Support National & Regional Systems Telehealth & Telecare Clinical Data Repositories Currentsystems Hospital, GP, SS Other Systems Application Integration Clinical Workflow Tools: • PL (Problem & Diagnoses List, Allergies & Alerts, Family History) • Medicine Reconciliation • Order Entry • Disease Management: • Forms designer • Rules Engine • Program Builder • Role based Task List management • Decision Support
Clinical Work New Zealand – Medicine Reconciliation (Med Rec) Balearic Islands – Case Management pathways of care Clinical Process/Workflow - Examples
Orion Health Orion Health – Business Intelligence Healthcare Professionals Patients Access – Patient EHR Clinical Process/Workflow Integration & Decision Support National & Regional Systems Telehealth & Telecare Clinical Data Repositories Currentsystems Hospital, GP, SS Other Systems Application Integration OHBI: • Data ETL (Extraction, Transformation & Load) platform • Data Mining and Analysis • Reporting – Clinical, Operational & Strategic
Business Intel US Meaningful Use Criteria: Functional capabilities Quality measures Saudi Arabia National Guard – Medical Research Centre Business Intelligence - Examples
Mechanisms Mechanisms: Workflow re-engineering eHealth support Requirements: Clinically driven but with Informatics & Management involvement Done jointly Think: ‘Delivery of coordinated, cross boundary, evidence based, community orientated, MDT quality care with patient and care giver involvement. ‘ How do you start?
Mechanisms With the foundations: Integration Engine Clinical Portal Understand local health & social care priorities Take a phased approach to delivery Know the importance of Change Management Where do you start?
Orion eHealth Maturity Model Patients Professionals Maturity Level V Health Management Co-responsibility Active Patient Involvement Patient & Carer Integration Patient Portal Coordinated Quality Care MDT Workflow & Decision Support Workflow Integration Disease & Case Management IV Process Integration OE / Med. Rec. / Prescribing Process Automation and Standardisation Improved Quality of Care III Information Integration Clinical Portal – EPR / EHR / HIE Shared Single View of Patient Data Shared Information II Resource Optimization Application Integration Integration Engine & Standards Quality Data I Cross Boundary Integration Business Intelligence Capability
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Discussion? Discussion?