Development of Interoperability Standards and Best
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Transcript Development of Interoperability Standards and Best
eHealth Standards and Best
Practice Models
Michelle McGuirk
Manager TeleHealth NT
Registered Nurse, Master of Public Health
Email: [email protected]
Department of Health is a Smoke Free Workplace
Overview
My eHealth & Digital Regions
Record
Project
2
Overarching Structures in Health
Informatics
3
My eHealth Record - Journey
Department of Health is a Smoke Free Workplace
Situation
Task
Highly mobile patients with high health needs, accessing multiple
providers in acute and primary settings across public, private and
non-Government sectors
The first shared electronic health record in NT containing key health
information needed for ongoing care across multiple health care
providers with the patient’s consent.
Action
Development of My eHealth Record underpinned by:
Primary care clinical software
Strong clinical engagement via Clinical Advisory Committee’s
consumer engagement central focus
Full integration of My eHealth Record into clinical workflows
User friendly, easy to use interface
5
Clinician Engagement
Clinician confidence
Develop as a essential component of healthcare service delivery
Highlight benefits from integrated records
Highly skilled and mature teams of staff, clinical champions, clinical
advisory committees, ICT technical expertise, corporate knowledge
Consumer feedback
Consumers rated the shared electronic health record at ‘medium to
high’ level of achievement in the following key areas:
Clear registration and consent process
Culturally appropriate communications regarding sharing health
information- benefits for improving care
Improved communications between themselves and health centre
staff
Consumers better able to manage their own health care
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My eHealth Record growth June 2005 - February 2014
200000
180000
160000
140000
120000
100000
80000
60000
40000
20000
0
Jun-2005
Jun-2006
Registered Consumers
Jun-2007
Jun-2008
Jun-2009
Jun-2010
Clinician updates to patient records (monthly)
Jun-2011
Jun-2012
Jun-2013
Feb-14
Clinician views of patient records (monthly)
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Proven
that it enables best practice and
improves healthcare delivery by breaking
down the barriers: culture, language,
distance and accessing information
needed for care.
Keys to success
Effective Consumer, Community and Clinical engagement
Simple consent model accepted by consumers and
providers
Strong advocacy by healthcare providers instilling
consumer confidence in MyeHR
Integration of My eHealth Record into clinical workflow and
CIS
User interface and design
8
Access to Services in Remote NT
Photo Western McDonald Rangers courtesy of Greg Simon,
Alice Springs
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Digital Regions Initiative
Health eTowns Program
Infrastructure
upgrades 17 major
Territory Growth
Towns
TeleHealth Network
Advanced Shared
electronic Care Plan
(ASeCP)
eLearning Framework
10
TeleHealth Overview
Infrastructure
Equipment
Medicarts
VC software
IP Patient Monitors
TeleHealth NT Web interface
Ease of access
Directory services
Who has it?
Services and clinical frameworks
11
Infrastructure Upgrades
Increased
bandwidth
Wireless mesh
networks
implemented
Multiagency
approach
12
Digital Regions: TeleHealth Project
13
Equipment - Medicarts
High Definition wireless Medicarts with
plug and play peripheral equipment:
Tele-Specialist clinics.
Assist with training and workforce
support solutions
Provide facilities where patients can
connect with their local communities
Remote case management
Remote Trauma and Critical Care
Management
14
Equipment – Desktop VC
Flexibility within the
Video conferencing
network
Easily installed
Enables access for
services with minimum
outlay
15
Equipment : IP Emergency Monitors
Easy to operate on the ground
Real time Video accessed by
clinicians
External access
16
TeleHealth Strategic Vision
TeleHealth services deliver client based services in 3
main areas of care
Tele-Specialist Services
Tele-Critical Care
Tele-Workforce Support
Additional in 2014
Tele-Complex Conditions Management
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Why: Trends in Patient Travel
Cost of Patient Travel in NTG Dept. of Health Annual Reports 2007-2012.
Records are inclusive of retrieval and emergency services.
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Why: Specialist Services Profile
Ambulatory care
service and Visiting
specialists service NT.
Some complexities relating to
FIFO modes
Patient flow/ waitlisting
Triage process
Implementation of care
plan/ handover to PHC
Review and case
coordination
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What do Telehealth Services Offer?
TeleHealth NT Secure
Access model of care
• Clinical care can be
coordinated relative
to needs of the
service/patient.
• Resourcing:
doctor/patient
clinician can be
anywhere and
Telehealth can be
done at anytime.
20
Tele-Specialist Services
Ambulatory care
services provide 3
key service models
Specialist
Outreach
Patient Travel
TeleHealth
21
Tele-Critical Care Services
Emergency IP Monitors to
support;
Patient end service –
clinical decision support
On-call services Remote
Medical Practitioners
Retrieval services
Receiving service (ED
Consultant and other
identified Specialists)
Facilitating coordinated care
at initial point of
presentation
22
TeleHealth Converge
Web
Interface; acts as directory with ‘click
and connect’ functionality
Secure Access Model of Care
Access is so important when it comes to
any eHealth services. It needs to be easy
and quick.
Developed initially for IP Emergency
Cameras- Expanded in 2014 to include all
other TeleHealth equipment.
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Where to from here?
Interoperability Services
Implementing National Standards / Guidelines
Continue to expand quality services.
National Directory/ registration for TeleHealth
enabled services.
Improved eHealth records- access to
documentation ASAP for accurate and advised
clinical decision making.
Improved infrastructure.
Home/ Self Monitoring Technology.
Evaluations/ Academic Research Opportunities
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Multiple components- not just
Infrastructure and technology
Ryan
2011
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Implementing services
Governance
Community
engagement
Clinical input
Expert Health IT advice
Supporting mobile
workforce frameworks
Agile Resourcing
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Social Accountability Pentagram
WHO, 2010
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Thank you
28
Special Thank You
Economic Times India Health Summit Organisers
NTG Department of Health
eHealth Operations Team
Greg Simon (Photos)
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References
Ryan Chris (2011) Video Consulting Telehealth- From
Hospitals to the Home and Everywhere in between. Pulse
IT magazine, pp 40-48 Issue 25, November 2011.
Available online at
http://www.pulseitmagazine.com.au/index.php?option=com_
content&view=article&id=771:video-consulting-fromhospitals-to-the-home-and-everywhere-inbetween&catid=16:oz-hit&Itemid=226
World Health Organization ‘Telemedicine Opportunities
and Developments in Member states’ 2010 available
http://whqlibdoc.who.int/publications/2010/9789241564144
_eng.pdf
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