Transcript ABA Presentation

Defining Core Patient Centred Data
Sets: A National Priority
Dr Pamela Hussey
Nursing & Midwifery Informatics
Nursing informatics science and
practice integrates nursing, its
information and knowledge and their
management with information and
communication technologies to
promote the health of people,
families and communities world
IMIA-NI definition, adopted July 2009, Helsinki,
Finland- http://imia-medinfo.org/ni/
Background and Context
• New models of care eHealth ECO systems ,
technical , social and political aspects
• Tactical planning
• PARTNERS concepts & terms
• HISINM
• EHRInsight
Technical: eHealth & Interoperability
 First steps in this process of development
is design for technical interoperability
 Health Informatics Standards
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HISA EN12967
Contsys EN13940
ISO 18104
EHRcom ISO13606
HL7 IHE Profiles
Core Components Interoperability
HISINM’s Accepted Opinion
Context is not unwelcome noise nor a
confounding variable to be controlled but an
integral part of a programme - Davidoff, 2009
Where there is policy there is politics and
performance measurement – Pawson, 2013
Social: Nursing Ecosystems & 3C’s
• Collaboration
• Co-operation
• Convergence
Political: Global EU & National
• PAHO WHO
• Digital Agenda for Europe – Living, Healthy
Ageing, Well
• ACENDIO- Common European Nursing Language
• HISINM – Irish Informatics Group Nursing and
Midwifery
Leadership is a Key Requirement
UK : 46 per cent of respondents reported that they received no consultation about the
introduction of eHealth developments in their workplace, while 78 per cent said
they had little or no influence on eHealth use in their Workplace
Positioning Nursing in a Digital World RCN 2013
Sweden : nurses should play an active role in terms of formulating requirements as
well as acting as innovators in the development of technical solutions
and e.health services
Swedish 2012 eHealth Strategy for Nursing
http://www.rcn.org.uk/__data/assets/pdf_file/0020/530390/004_440.pdf
http://www.swenurse.se/Documents/Publikationer%20pdf-filer/ehealth.a.strategy.for.nurses.pdf
Irish Context Focused Engagement
• Engage with us to create
solution focused agendas
• Goal is tactical outputs
which will require
different approaches and
people at different times
• Help nurses/midwives
understand eHealth
domain education and
training programmes
required.
Small Case Study
• PARTNERS example of what we discovered on
inter agency communication in nursing in
2011 with 6 service providers
• Eighteen cases were followed for 6 month
period using shared record.
• Only 3 achieved IAC
Organisational Theory
Context Mechanism and Outcome Configuration
PARTNERS Concepts and Terms
Acute
Acute care 1
Case 13
T/F to Acute 2
Unable to
participate due
to Ethics
Case 15
Discharged from
Acute 1
Case 1
T/F in to Acute 1
Discharged to
PHN unable to
participate in study
due to workload
Primary Care
Acute care 2
Primary care 1
Continuing Care
Primary care 2
Case 8
T/F to Acute 2 & From Acute 2
Record lost in service
Unable to participate due to
ethics for acute episode
Case 2
Discharged from
PC2 to PHN
November
Case 9
Care ongoing with
PHN condition
deteriorating
Case 3
T/F from PC2 to
Acute 2
Died RIP
Case 10
Care ongoing with
PHN
Case 7
Withdrew from
study
Case 17
Successful T/F to
Primary care 2
Case 11
Care ongoing with
PHN
Case 12
T/F from PC2 to PHN
PHN participated in
study
Case 14
T/F from PC2 to PHN
participated in study
Acute Hospital
services 2
Additional PHN
Health centre
Cont care 1
Cont care 2
Case 4
Discharged from
CC1
Case 16
Care ongoing
Case 5
Care ongoing
Day Hospital
PHN unable to
participate in study
Case 6
Care ongoing
Day Hospital
Case 18
Care ongoing
Political: Complexity and Change
The volitions of stakeholders impacted upon by
change programmes do not come in two modes
keen versus not bothered. They range along a
continuum from hostility to apathy to ignorance
to caution to stoicism to enthusiasm and
preferences are not exercised at one point in
time but over time along the way – Pawson,
2013
Tactical Planning is Required
• To achieve programme effectiveness
• Some examples of what we have done so far
– HISINM grass roots voice of pragmatism
– Contextual mapping of our care processes
– Education and training resources free on line
Ireland - HISINM website
http://hisinm.ie/
Irish Nursing Midwifery Informatics
National Agendas – HISINM
Validate
Transformational
Programme
• Seek Clarity in
Advance
Proactive Stance on
Models of Care
• Context is Key
National Data Sets a
Priority
• Primary Data
Collection at Point of
Care
International Directors : Wales, Canada, Northern Ireland IMIA NI SIG ACENDIO
Thanks to all the PARTNERS
Vision to Implementation LEARN
Listen to clinical leaders to determine what the
requirements are?
Early engagement in design – content in context
Adopt reuse and adapt from international colleagues
best evidence and HI standards
Realistic evaluation input process output bottom up and
top down - stratified approach
Needs analysis focusing on individual clients in the
community using wellness (not illness) approach
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Conclusion
• Nursing and midwifery
approach to the
transformational programme
and in particular to the
emerging models of eHealth
needs to be both practical
and tactical
• Different tactics at different
times will require practicing
nurses and midwives from all
clinical services to inform the
process of programme
implementation
Thank You
Contact: Dr Pamela Hussey
Email: [email protected]
References
• PAHO http://www.paho.org/ict4health/index.php?lang=en
• European Union A Digital Agenda for Europe specifically Living Health
Aging Well ec.europa.eu/digital-agenda/
• ACENDIO http://www.acendio.net/
• Health Informatics Society of Ireland Nursing and Midwifery Group
http://www.hisi.ie
• RCN Report Positioning nursing in a digital world
http://www.rcn.org.uk/__data/assets/pdf_file/0020/530390/004_440.pdf
• Pawson R 2013 The Science of Evaluation A Realist Manifesto Sage London
• PARTNERS Community of Practice Online Resource Available from
http://www.partnerscop.com/ see PARTNERSCT section on main website
Accessed 2nd September 2013
• EHRInsight Online Resource Available from http://www.ehrinsight.net/
Accessed 2nd September