ehr = care continum hospital services not just a medical emergency – part of the care continum...
TRANSCRIPT
EHR = Care Continum
Hospital ServicesNot just a medical emergency
– part of the care continum
Tromso, Norway, eHealth ‘05
Ursula O’Sullivan
eMail:- [email protected]
Web:- www.shb.ie
If you don’t know where you are going…. any road will get you there? Even though there are a lot of possibilities it’s still important to set a direction.
ICTs are providing direction and opportunities so we need to introduce new technologies with business / service models in a way that maximises potential.
EHR = Care Continum
eGovernment + eHealtheGovernment• Access to Services and
Information• Citizens and their right
to information• Backend re-organising
systems and services to provide better access
eHealth• Using technology to
improve Healthcare delivery e.g. Telemedicine, Lab Results to GPs, Out-reach Clinics, Appointment Booking
• Electronic Patient Record
Despite the seeming chaos…..
Core Transaction Systems
Enterprise Systems
Consumer Health Systems
eLearning Systems
Decision Support Systems
Clinical Systems
Environmental Health Systems
Electronic Medical Records
Clinical Data Repositories
Data Integration
Internet/Extranet/Intranet
Computer-Telephony Integration
Electronic Commerce
Integrated Medical Devices
Workflow Technologies
Imaging
Telemedical Technologies
Workforce Enabling Technologies
Research Systems
Expert Logic
GP Systems
Wireless
Customer Relationship Management Systems
Networks/Connectivity
eProcurement
Laboratory Systems
Foundation Technologies
• Networks/Connectivity/CDRs/
• Data Integration
• Internet/Intranet/Extranet
• Integrated Medical Devices
• Imaging
• Interactive Computer Telephony Integration
……There is structure in Healthcare
Advanced Technologies
Consumer/Patient Health Systems
Electronic Commerce Relationship Management
Systems Workflow Technologies Research Systems Expert Logic Wireless
Today’s Health Architecture
Value Creation
Sample Capabilities
Public Use
Functions and Features of Clinical, Managed Care and Administrative Applications
Core Data Systems(Patient Care, Clinical,
Administration, Finance)
Uniform Access to Core
Systems
Web
Site
Branding and Identity - TRUST
Patient / Citizen Education
Information Publishing and Communication
Universal Access
Intranet
Work flow Technologies
Self-Serve HR, Administration
Browser Access to Databases (research, knowledge, medical, administrative)
EstablishCommunications
Infrastructure& Productivity
Enhancers
Extranet
Secure Remote Communications
and Access
Patient Registration, appointment requests
“Push” Customised Content to Patients / Diagnostic Groups
Direct order entry and results
GP to Health Board interaction
External Access to speciifics
New healthcare technologies are redefining healthcare and society
New healthcare technologies are redefining healthcare and society
Informatics IndustrialInternet
Wireless
Genomics & Proteomics
New pharmaceuticals
Digital imaging
Minimally invasive surgery
Nanotechnology
Medical devices
• Greatest advances in the history of medicine are happening now through an explosion in new technology
• Societies have the opportunity to eliminate disease, extend life, improve health and wellness
• And to make healthcare more accessible, affordable and satisfying for all participants
• Greatest advances in the history of medicine are happening now through an explosion in new technology
• Societies have the opportunity to eliminate disease, extend life, improve health and wellness
• And to make healthcare more accessible, affordable and satisfying for all participants
eHealth FoundationeHealth Foundation
Secure E-Health Network Infrastructure
Core HealthcareApplications
LongitudinalPatient Data
Surveillance &Analysis
Self-ServicePortals
• Appropriate
• Accessible
• Affordable
• Effective
• Efficient
• Satisfying
20th Century 21st Century
• Internet technologies have broadened access to data and information in a way that shatters previous models
– Cost control
– Information access
– Clinicians, Healthcare Professionals
– Patients, Citizens
1. We need to understand that large advances are coming within 3-5 years, and current investments may require replacement / upgrading
2. Develop strong healthcare professionals education programme today to prepare for the tools that will be available in the near- and mid-term
EHR = Care Continum
A short overview of the SHB experiences addressing the
challenges and opportunities of Electronic Health Record
Lessons and experiences from regional implementation now
applied nationally
EHR = Care Continum
Environment
• 4,700 sq miles
• 564k population base
• 18,000 Staff, 6,000 field based
• 250 Locations
• Personal Computers – 6,800 Laptop Computers - 1500
• Mobile Phones – 2,200
• Extensive WAN and Local Area Networks
EHR = Care Continum
Drivers• Internal
– Low Morale – No Communications– 20 year old Paper Based processes– Need for change
• External– Consumerism, Patient Centered– Integration– Legislation, Regulations
EHR = Care Continum
EHR = Care Continum
10 Goals1. Integration of patient based services
2. New ways of delivering services and information
3. Manage information as an asset
4. Manage creation of knowledge
5. Optomise use of resources
6. Create an effective organisation
7. Achieve an Electronic Health Record [EHR]
8. eEnable Clinical Systems
9. eEnable Administrative Systems
10. Develop an enabling Technology Architecture
Health eSHB
What do we mean by that?
• Providing Citizen Access– Listening Days, eGovt Initiatives,
• Information & Knowledge Management– Medical Protocols, Research, Best Practice
• Development of Single Patient Record
• Advanced Communications
• Telemedicine
EHR = Care Continum
Building Blocks
eGovt
eEU
eBroke
r
eCitizen
eService
Defined Enterprise
Architecture Support
Advanced Communi-
cations SHBnet
Information & Knowledge Management
eLearning
Organisation
Single Patient Record
eSHB
New IT Systems –
Labs, PACs, Radiology,
EHR = Care Continum
Practical Examples
• eProcurement
• eServices– Births, Death & Marriages
– Environmental Health, Bridges Dental
• Word Based Content Management System
• Nation-wide VPN [Virtual Private Network]
• Integrated patient records– Community, Mobile Computing
• Blended eTraining / eLearning
EHR = Care Continum
Integrated EHR
MOBILE & COMMUNITY PIMs
EHR = Care Continum
MOBILE & COMMUNITY PIMs
Integrated Service Delivery
EHR = Care Continum
Interactive Hospital School
EHR = Care Continum
From the chaos….. To.......
Core Transaction Systems
Enterprise Systems
Consumer Health Systems
eLearning Systems
Decision Support Systems
Clinical Systems
Environmental Health Systems
Electronic Medical Records
Clinical Data Repositories
Data Integration
Internet/Extranet/Intranet
Computer-Telephony Integration
Electronic Commerce
Integrated Medical Devices
Workflow Technologies
Imaging
Telemedical Technologies
Workforce Enabling Technologies
Research Systems
Expert Logic
GP Systems
Wireless
Customer Relationship Management Systems
Networks/Connectivity
eProcurement
Laboratory Systems
Applications Blueprint
• Consolidation of access for the Patient Information Management System (including Lab, PACS and Community PiMS)
• E-enablement of Health Board Processes (where currently addressed)
• SHBnet Infrastructure collaboration (Hardware/Software and Communication links)
• Content Management Application (Intranet and other WEB Form Applications)
• Change Management (program to foster e-culture throughout the Southern Health Board’s community of users)
• Migration to Web Services environment
Benefits to Date
EHR = Care Continum
Lessons Learned
• Check the Power Supply…
• Involve Users
• Plan for ‘big picture’
• Be Flexible
• Develop ‘Partnership’ approach
EHR = Care Continum
Where are we going now?• Continue to implement Health eSHB
goals but on a national basis
• New National EHR Contract [iSOFT]
• New National Health Strategy• Recent replacement of 11 Health Boards by one
national organisation - HSE
• Continue to work with eGovt. initatives
• eServices, Benchmarks, EU Indicators, Govt. VPN, develop new means of delivery e.g. Digital TV, Health Portal, GP Access, etc….
EHR = Care Continum
‘E’ …. is not just about computers and systems.
It is about people and processes and most importantly it is about thinking differently….
eSHB….. 2001- 2005
Care Continum
Contact Details:- Ursula O’Sullivan
eMail:- [email protected]
Web:- www.shb.ie
Phone:- 021-4922990
Hospital ServicesNot just a medical emergency
– part of the care continum
Tromso, Norway, eHealth ‘05
EHR = Care Continum