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Orion Health's eHealth Maturity Model provides some signposts as to the challenges and opportunities ahead as the new national eHealth strategy is implemented - particularly as Scotland faces the growing 'care burden' of patients with long term conditions.
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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
Clinical Process/Workflow Integration & Decision Support
Patients
Orion Health
Orion Health – Integration Engine
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
Clinical Process/Workflow Integration & Decision Support
Patients
Integration Engine:• Message mapping •Message routing & delivery• Rules based message filtering/transformation
Orion Health
Orion Health – Clinical Portal
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
Clinical Process/Workflow Integration & Decision Support
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
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
Clinical Process/Workflow Integration & Decision Support
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
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
Clinical Process/Workflow Integration & Decision Support
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
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
Clinical Process/Workflow Integration & Decision Support
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
Discussion?Discussion?
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www.orionhealth.com
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