EHR = Care Continum

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8 Δεκ 2013 (πριν από 3 χρόνια και 10 μήνες)

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EHR = Care Continum

Hospital Services

Not just a medical emergency


part of the care continum

Tromso, Norway, eHealth ‘05

Ursula O’Sullivan

eMail:
-

osullivanu@mailp.hse.ie

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 + eHealth

eGovernment


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…..

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

9

Patient / Citizen Education

9

Information Publishing and
Communication


Universal
Access

Intranet

9
Work flow Technologies

9
Self
-
Serve HR, Administration


Browser Access to Databases
(research, knowledge, medical,
administrative)

Establish

Communications
Infrastructure

& Productivity


Enhancers

Extranet

Secure Remote
Communications and
Access


Patient Registration, appointment requests

9
“Push” Customised Content to Patients /
Diagnostic Groups

9
Direct order entry and results


GP to Health Board interaction


External Access to speciifics

New healthcare technologies

are redefining healthcare and society

Informatics

Industrial

Internet

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

e
Health Foundation

Secure E
-
Health

Network Infrastructure

Core Healthcare

Applications

Longitudinal

Patient Data

Surveillance &

Analysis

Self
-
Service

Portals


Appropriate


Accessible


Affordable


Effective


Efficient


Satisfying


20
th

Century

21
st

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 Goals

1.
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
e
SHB

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

e
Citizen

Defined
Enterprise
Architecture
Support

Advanced
Communi
-
cations

SHBnet

Information
& Knowledge
Management

eLearning

Organisation

Single
Patient
Record

e
SHB

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.......

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
e
SHB
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….

e
SHB….. 2001
-

2005


Care Continum

Contact Details:
-

Ursula O’Sullivan

eMail:
-

osullivanu@mailp.hse.ie

Web:
-

www.shb.ie

Phone:
-

021
-
4922990

Hospital Services

Not just a medical emergency


part of the care continum

Tromso, Norway, eHealth ‘05

EHR = Care Continum