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
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Clinician Engagement
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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

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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
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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

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Infrastructure Upgrades
 Increased
bandwidth
 Wireless mesh
networks
implemented
 Multiagency
approach
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Digital Regions: TeleHealth Project
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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
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Equipment – Desktop VC
Flexibility within the
Video conferencing
network
 Easily installed
 Enables access for
services with minimum
outlay

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Equipment : IP Emergency Monitors
 Easy to operate on the ground
 Real time Video accessed by
clinicians
 External access
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TeleHealth Strategic Vision
TeleHealth services deliver client based services in 3
main areas of care
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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.
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Tele-Specialist Services
Ambulatory care
services provide 3
key service models
 Specialist
Outreach
 Patient Travel
 TeleHealth
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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
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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
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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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