rare disease day - feb 29th 2016 - richard corbridge

[email protected]

Chief Information Officer – Health Service Executive - Ireland

Chief Executive Officer – eHealth Ireland

eHealthIreland.ie| @eHealthIreland @R1chardatron

eHealth in Ireland – What Next…

Delivering eHealth Ireland | Office of the Chief Information Officer

Evolution of Time

Ireland and France didn’t

adopt Greenwich time.

Dublin 25 minutes ahead

of London until October ’16.

Railway stations adopted

the national time.

Ulster and Bangor stations

maintain local time and Dublin

time.


Evolution of Time

Before 1840 local time was

Standard (UK).

Remove confusion and

create a standard.

Eradicate near accidents.

Local resistance (Leeds 7

minute ‘local time’ ‘70s)

Benefits balance.

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiJuqzOwJzLAhVIZg8KHT_ODXIQjRwIBw&url=http://www.britannica.com/place/Dublin/images-videos&bvm=bv.115339255,d.d24&psig=AFQjCNGgccwi1TvcKu28PwF0cNU4MRV2YQ&ust=1456819186423644

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiJuqzOwJzLAhVIZg8KHT_ODXIQjRwIBw&url=http://www.britannica.com/place/Dublin/images-videos&bvm=bv.115339255,d.d24&psig=AFQjCNGgccwi1TvcKu28PwF0cNU4MRV2YQ&ust=1456819186423644


eHealth Ireland

287417

2013 2050

Healthcare Spend for age 60+ (€M)

0 10 20 30 40 50 60 70 80 90

Ireland

Sweden

Cyprus

Netherlands

Belgium

Greece

UK

Malta

Luxembourg

Denmark

Spain

Romania

Austria

EU28

France

Bulgaria

Italy

Slovakia

Germany

Slovenia

Finland

Czech Republic

Poland

Hungary

Estonia

Croatia

Portugal

Lithuania

Latvia

8440

9367

10162

11676

12709

14321

1518615520

1481814078

13317

0

2000

4000

6000

8000

10000

12000

14000

16000

18000

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

€ (

Mil

lio

ns)

Public Expenditure on Health 2002 –2012

Source: Department of Health Key Trends

• Health expenditure in Ireland accounts for approximately 20% of total current public expenditure.

• In 2015, approximately 17% of healthcare expenditure was spent on pharmaceuticals.

• Cumulative budget impact since 2009 is a 15% reduction in health spending


The IT strategy question?

Cross

Setting

Information

Integration

Electronic

Health

Records

National

Support

Systems

Care

Delivery

Enablement

Integrated, Patient Centric,

Efficient Care Delivery

Health

Service

Insights

Knowledge & Information Delivery Transformation

Clinical & Information Governance

Knowledge & Information Plan

Office of the CIO | Delivering eHealth Ireland

Personal / Data

Security

Resources / Funding

Instrument Panel /

Business Intelligence

Guidance/Insight/

Communication/Safety

Access to information

Healthcare Airways


AGILITY

Benefits yesterday,

today and tomorrow

needed

TRANSPARENCY

Investment in tech is

investment in health.

Balancing Act

8 years

56 days

10 hours

& 26 minutes

Can we have 5 years to “do” eHealth?


A Year in Numbers - 2015

Delivering eHealth Ireland | Office of the Chief Information Officer 17


Current…


Security.

Data Quality.

Information Governance.

Data Dictionary.


•

•

•

•

•

— Robert Wachter

Technology has transformed hotel,

transport, retail, banking, communications

………healthcare?

The goals of Reform cannot be delivered

without a National EHR

The 4th Utility


Overall Blueprint defined as the long term vision for eHealth in Ireland and endorsed by industry – Solutions for Hospital Groups identified as a core area

eHealth Blueprint - EHR


National EHR Registries and Domains

Stakeholders

Clinical Management / Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

I.A.A.A.Layer

Pro

vid

er H

ealt

h P

ort

al

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data & Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fin

an

ce M

an

age

me

nt

Pro

cure

me

nt

Hu

ma

n R

eso

urc

es

and

P

ayro

ll M

anag

eme

nt

Ass

et M

an

age

me

nt

Hea

lth

& S

afe

ty

Co

ntr

act

Man

age

men

t

Faci

litie

s M

ana

gem

ent

Ro

ste

rin

g Ti

me

Re

cord

ing

Pro

gram

Man

age

me

nt

Cu

sto

mer

Re

lati

on

ship

M

ana

gem

ent

Consumer Health & Wellbeing

Pat

ien

t to

Pro

vid

er

Secu

re M

ess

agin

g

Self

-Hea

lth

M

ana

gem

ent

Sch

edu

ling

and

A

dm

inis

tra

tio

n

Nat

ion

al P

atie

nt

Po

rtal

Vir

tual

Car

e

Edu

cati

on

&

Aw

are

ne

ss

Community Healthcare Organisations

Pat

ien

t A

dm

inis

trat

ion

Ca

se M

anag

em

en

t

Elec

tro

nic

Do

cum

ent

Man

age

men

t

Clin

ical

No

tes

and

Re

cord

s

Pat

ien

t T

est

Re

sult

s

Ca

re P

ath

way

s an

d D

eci

sio

n

Sup

po

rt

Ref

err

al M

ana

gem

ent

Mo

bile

Clin

ical

Ma

nag

em

en

t

Po

pu

lati

on

He

alth

M

ana

gem

ent

Co

mp

ute

rize

d P

hys

icia

n O

rde

r En

try

eP

resc

rib

ing

Hospital Groups

Ho

spit

al P

atie

nt

Ad

min

istr

ati

on

Ho

spit

al M

ed

ical

Imag

ing

Ho

spit

al L

abo

rato

ry

Ho

spit

al P

har

ma

ceu

tica

ls

Ca

se M

anag

em

en

t

Dis

ease

Man

age

me

nt

Ca

re P

ath

way

s an

d D

eci

sio

n

Sup

po

rt

Co

mp

ute

rize

d P

hys

icia

n O

rde

r En

try

Ref

err

al M

ana

gem

ent

Po

pu

lati

on

He

alth

M

ana

gem

ent

Elec

tro

nic

Do

cum

ent

Man

age

men

t

eP

resc

rib

ing

Elec

tro

nic

Clin

ical

No

tes

and

R

eco

rds

Community

Operational

Systems

Acute

Operational

Systems

National

Shared

Record

Integration

Moving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples:

• Order Communications /

Results Reporting

• Medicines Management

• Clinical Notesstems

The “glue” that binds all this together

and maintains integrity and security

across the system

Systems

Examples:

• Single MPI

• Scheduling

• Clinical Notes / Records

• Screening & Surveillance

eHealth Blueprint



5 Years 10 Years

Cri

tic

al Ta

cti

ca

l

So

luti

on

sIn

no

va

tive

Sp

ec

iali

st

So

luti

on

s

National Solutions

PAS

Replacement

Initial National Shared

Record

Haemophilia

Lighthouse Project

Epilepsy

Lighthouse Project

BiPolar Lighthouse

Project

Portal

(Organisation)

Other Future

Projects

Order/Comms

Other Future

Projects

NCH Implementation Other

Single

Solution Set

Evolving to a single

solution set will require

agility and a governance

approach that supports a

dynamic environment

Other Future

Projects

National Shared Record Development

MEDLis

MN-CMS

NICIS

Acute Operational Components – Phased Implementation in HG’s

Community Operational Components – Phased Implementation in CHO’s

NIMIS

National Solutions

Other

Other



Epilepsy: All patients on the EHR, Patient mobile application,

Population health analysis, GP access and image reviews, IHI,

Genomic sequencing for under 5s.





Haemophilia: National Integration to hospital PAS, Open

source platform, Open Data pilot, Patient mobile application,

IHI, Secure clinical communicator, Next generation solution.





Haemophilia: National Integration to hospital PAS, Open

source platform, Open Data pilot, Patient mobile application,

IHI, Secure clinical communicator, Next generation solution.

Bipolar Disorder: Secure clinical communicator, Information

integration regardless of setting, Open Source solution,

Innovation led approach, Clinical support tool.

Year 1800 6 Hours

31

One hour of reading light!

Year 1880 15 Mins

Year 1950 8 Secs

Year 2014 0.5 Secs


Horizontal Innovation!

rare disease day - feb 29th 2016 - richard corbridge

Health & Medicine