how to address scotland’s five strategic ehealth goals an orion health perspective

Addressing Scotland’s eHealth Goals

NHS Scotland, August 2011

Dr John Heavens

Session Goal

Within the context of the new Scottish eHealth Strategy, to provide some perspectives on a way forward to achieving success, based on Orion Health’s global eHealth experience

Agenda

I. Review Scottish eHealth Approach

II. Orion Health’s Global Experience

III. Our perspectives

SCOTTISH E-HEALTH APPROACH

Scotland’s eHealth

Scotland’s eHealth Strategy

Policy Context:

The Healthcare Quality Strategy for NHSScotland (May 2010) – the 3 Quality Ambitions:

Effective (Evidence based)Right care at the right time in the right placeEradication of variation

Person-centredSafe

Health & Social Care Collaboration & Integration

Financial

Scotland’sScotland’s eHealth Strategic GoalsTo use information and technology to:

Maximise efficient working practices, minimise wasteful variation, bring about savings and ensure value for money

Support people to manage their own health and wellbeing, and to become more active participants in the care and services they receive

Contribute to shifting the balance of care and support people to self manage, and to provide appropriate information for people with long term conditions and mental health problems

Improve the availability of appropriate information for healthcare workers and the tools to use and communicate that information effectively to improve quality

Improve medication management as an essential part of peoples’ care

ORION HEALTH’S EXPERIENCE

GloballyGlobally - A Changing “Burden of Disease”

Traditional Burden of Disease

YoungInfectious Diseases & Injuries

Traditional Care Model

Acute hospital based CurativeSpeciality orientatedEpisodic

Current Burden of Disease

ElderlyWith LTCs & related:

Mental Health problems Socio-economic problems

Significant cost escalation

New Care Models

Community basedPrevention focussedMDT orientatedContinuous care and reviewUse of assistive technologiesBehaviour modification

New CareNew Care Models - 1

Integrated H&S care delivery through:

Multidisciplinary Teams (MDTs)

Working in an interdisciplinary way

Across care boundaries

Focussing on:Community based carePatient and care giver involvement

New CareNew Care Models - 2

Continuous care and review with a preventative focus, which may include:

Evidence based, disease focussed, programs of careCase Management principles‘Virtual Ward’ approachesCall centre support, which may include:

Behaviour modification Use of Assistive Technologies

Video ConferencingTelehealth – Physiological monitoringTelecare – Environmental monitoring

Mechanisms

Mechanisms

Mechanisms to deal with these changes include:

Workflow re-engineering

eHealth support

Orion Health

Orion Health

A global provider of eHealth solutions

Our Mission - To create innovative, world-leading health technology solutions that improve peoples' lives

Provide clinical systems, designed by clinicians for clinicians

‘Tools’ based approach

eHealth Support

eHealth Support - 1

Delivery of coordinated, cross boundary, evidence based, community orientated, MDT quality care with patient and care giver involvement requires:

Systems interoperability – Integration Engine

An integrated, single view of Patient Records accessible by:

Health & Social Care providers – Clinical PortalPatients and Care Givers – Patient Portal

eHealth Support - 2

eHealth Support - 2

Process support tools – Problem Lists, Medicines Reconciliation, Orders, Discharge Letters, etc.

Clinical Workflow tools – Disease & Case Management tools

Outcome measures – Business Intelligence tools

Orion HealthOrion Health - History

Current systems Hospital, GP, SS

National &RegionalSystems

OtherSystems

Access – Patient EHR

Clinical DataRepositories

Telehealth &Telecare

Application Integration

Healthcare Professional

s

Clinical Process/Workflow Integration & Decision Support


Patients

Orion Health

Orion Health – Integration Engine



OtherSystems






s



Patients

Integration Engine:• Message mapping •Message routing & delivery• Rules based message filtering/transformation

Orion Health

Orion Health – Clinical Portal



OtherSystems






s



Patients

Clinical Portal:• Integrated , single view of patient data •Secure Authentication/Authorities, CCOW enabled SSO (Single Sign-On) to multiple systems with RBAC (Role Based Access) & LR (Legitimate Relationships) capabilities•CDV (Clinical Document Viewer) - including results, sign-off and charting•DPS (Dynamic Patient Summary) – windowlets of any electronically available data• Secure messaging 7 notifications

Clinical Porta

Clinical Portal - Examples

Passive – Balearic Islands

Active - Glasgow

Orion Health

Orion Health – Patient Portal



OtherSystems






s



Patients

Patient Portal:•Secure Registration plus Authentication & Authorities for both patients and/or care givers•Secure messaging •Notifications•Access to information, appointments, results, prescription requests, etc.

Patient Portal

Patient Portal - Examples

Australia - national Personally Controlled Electronic Health Record (PCEHR)

Orion Health

Orion Health – Clinical Workflow



OtherSystems






s



Patients

Clinical Workflow Tools:• PL (Problem & Diagnoses List, Allergies & Alerts, Family History)• Medicine Reconciliation• Order Entry

• Disease Management:• Forms designer• Rules Engine• Program Builder • Role based Task List

management• Decision Support

Clinical Work

Clinical Process/Workflow - Examples

New Zealand – Medicine Reconciliation (Med Rec)

Balearic Islands – Case Management pathways of care

Orion Health

Orion Health – Business Intelligence



OtherSystems






s



Patients

OHBI:• Data ETL (Extraction, Transformation & Load) platform •Data Mining and Analysis• Reporting – Clinical, Operational & Strategic

Business Intel

Business Intelligence - Examples

US Meaningful Use Criteria:Functional capabilitiesQuality measures

Saudi Arabia National Guard – Medical Research Centre

OUR PERSPECTIVES

Mechanisms

How do you start?

Mechanisms:Workflow re-engineeringeHealth support

Requirements:Clinically driven but with Informatics & Management involvementDone jointlyThink:

‘Delivery of coordinated, cross boundary, evidence based, community orientated, MDT

quality care with patient and care giver involvement. ‘

Mechanisms

Where do you start?

With the foundations:Integration EngineClinical Portal

Understand local health & social care priorities

Take a phased approach to delivery

Know the importance of Change Management

Orion eHealth Maturity Model

Matu

rity

Level

Business Intelligence Capability

Shared Single Viewof Patient Data

Information IntegrationClinical Portal – EPR / EHR / HIE

Shared Information

Workflow IntegrationDisease & Case Management

Coordinated Quality Care

MDT Workflow & Decision Support

Process IntegrationOE / Med. Rec. / Prescribing

ImprovedQuality of Care

Process Automation and Standardisation

Application IntegrationIntegration Engine & Standards

Resource OptimizationQuality Data

Patient & Carer IntegrationPatient Portal

Active Patient Involvement

Health Management Co-

responsibility

I

II

III

IV

Patients Professionals

Cross Boundary Integration

V

Orion Health – eHealth Architecture

Orion Health

Orion Health Support

Orion Health are here to support you with:eHealth solutions

Professional Services:ClinicalTechnical

RichardC

this slide is fine, so long as it is said modestly... :-)

Discussion?Discussion?

how to address scotland’s five strategic ehealth goals an orion health perspective

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