EHR Personas Workshop - eHealth Ireland · EHR Personas Workshop Fran Thompson Programme Director Workshops –Dublin Castle Tuesday 31 stJanuary and Wednesday 1 February 2017 #EHRPersonas

EHR Personas Workshop

Fran Thompson

Programme Director

Workshops – Dublin Castle

Tuesday 31st January and Wednesday 1st February 2017

#EHRPersonas #ehealth4all

Delivering eHealth Ireland | Office of the Chief Information Officer #EHRPersonas #eh2030

EHR Personas Development Workshop

Welcome to the workshop!

Sincere thanks to our partners for facilitating us here today


What is the National Electronic Health Record?

The National EHR

comprises:

What does the National EHR do?

• Transforms patient experience

• Delivers greater patient safety and more

effective care

• Drives efficient delivery of health services

• Makes the wider reform programme

possible:

- Underpins integrated care

- Provides the information for

proactive health and wellbeing

initiatives

- Provides the operational systems to

realise CHO’s and Hospital Groups

- Captures accurate information on

activities that show the true cost of

treating a patient

!The National EHR is a fundamental cornerstone for the delivery of high quality,

comprehensive and accurate information in a timely manner for the provision of

patient centred, effective and efficient care

Pharmacy

GP Systems Private Hospitals


The EHR Programme

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

Examples:

• Single MPI

• Scheduling

• Clinical Notes / Records

• Screening & Surveillance

National

Shared

Record

Community

Operational

Systems

Acute

Operational

Systems

Individual Health Identifier

The “glue” that binds all this together

and maintains integrity and security

across the system

eHealth Blueprint

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

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Re

lati

on

ship

M

ana

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ent

Consumer Health & Wellbeing

Pat

ien

t to

Pro

vid

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re M

ess

agin

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Self

-Hea

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M

ana

gem

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Sch

edu

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and

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dm

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Nat

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atie

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Po

rtal

Vir

tual

Car

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Edu

cati

on

&

Aw

are

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Community Healthcare Organisations

Pat

ien

t A

dm

inis

trat

ion

Ca

se M

anag

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en

t

Elec

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Do

cum

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Man

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Clin

ical

No

tes

and

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cord

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Pat

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est

Re

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Ca

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Ma

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alth

M

ana

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Co

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d P

hys

icia

n O

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r En

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Hospital Groups

Ho

spit

al P

atie

nt

Ad

min

istr

ati

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Ho

spit

al M

ed

ical

Imag

ing

Ho

spit

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abo

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Dis

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Man

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Elec

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Man

age

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Elec

tro

nic

Clin

ical

No

tes

and

R

eco

rds

The Individual Health Identifier

Programme is a key enabler that

allows information to be shared about

a patient

PharmacyGP Systems

Private

Hospitals

Other healthcare providers will

access and contribute to the National

Shared Record through the

Integration Capability


Transformation – Not an IT Project!

The National EHR implementation is not considered an IT

programme but is being approached as a broader change

and transformation journey

It is a clinically led programme because the National EHR

is a crucial element that will help deliver new models of

care and greater standardisation of care processes and

pathways

The National Electronic Health Record is

not a large IT project!


The EHR Persona Development Project

Why develop Personas?

Communications and

Engagement

The Personas and Scenarios help make the National

EHR real by outlining how interactions will look and feel in

the future. This will be important as part of clinician, health

service worker and citizen engagement and

communication.

Requirements

Development

The process of engaging with stakeholders to create the

Personas and Scenarios helps to develop and deepen the

set of National EHR requirements in a way that is

meaningful for all stakeholders. The approach also takes

a more holistic view of overall outcomes required.

Managing

Supplier

Engagement

The Personas and Scenarios can be used as part of

managing the engagement with potential suppliers. They

provide a consistent set of cases through which suppliers

can illustrate functionality and showcase how they can

achieve the outcomes that will address some of our

existing challenges


Personality

Primary Care Persona Example

7

John O’Brien

John at a Glance

• Age: 60

• Location: Sligo

• Family Status: Married

with 4 Children

• Education: Leaving Cert

• Employment Status:

Self Employed

BioJohn is a 60 year old self-employed carpenter. He likes to spend time with his family which

includes using technology to keep up with his children and grandchildren. John doesn’t pay too

much attention to his own health and wellbeing.

Extrovert Introvert

Organised Disorganised

Emotional Rational

Health StatusJohn smokes about 1 pack of cigarettes a week. He describes himself as being reasonably

healthy but he rarely goes to see a doctor for check-ups. Sometimes he has shortness of breath.

Whenever he is sick, he’s not good at following treatment regimes.

GoalsHe wants to stay healthy without having to make major adjustments to his lifestyle.

Frustrations/FearsHe doesn’t like interacting with the health service and is very protective of his personal healthcare

information.

Technology Broadband Access Smartphone/

Tablet

Low High

Tech ComfortLow High

Internet Usage


Primary Care Scenario Example

8

Actors:Citizen (John O’Brien), GPs (Dr. Mooney & Dr. Wilson), Pharmacist, Radiologist, Consultant

Scenario: Patient Diagnosed with COPD

John O’Brien, 60, sees his family GP, Dr. Mooney, for the first time in over four years. To this point in his life, John has rarely gone to the

doctor but over the last two years he has been suffering from a persistent cough with intermittent episodes of shortness of breath.

Dr. Mooney accesses his practice system and carefully reviews the history of his present illness, as well as John’s past medical, family and

social history. He discovers John has a 45 to 50 pack per year history of smoking. Upon completion of the examination, Dr. Mooney’s

presumptive diagnosis is COPD (chronic obstructive pulmonary disease). Using his practice system, (which is integrated with the EHR), Dr. Mooney

creates and sends an electronic referral request for a chest x-ray and an electronic referral request for pulmonary function tests at the local hospital.

Finally he prescribes a short-acting B2 agonist inhaler and counsels John to stop smoking. Dr. Mooney records all of the findings from this visit in the

practice system.

Later in the day, John goes to the pharmacy and purchases his inhaler.

John also goes to the Diagnostic Imaging department of the local hospital and gets his chest x-ray done. The radiologist views the image later that day

and creates a report indicating findings consistent with COPD.

Three weeks later, John attends his appointment for pulmonary function tests at the hospital outpatient department. The test is interpreted the next day

by a consultant who finds evidence of obstructive airway disease and creates a report.

Unfortunately, John really enjoys smoking and is not convinced it is related to his breathing problems. As a result, he continues to smoke. He finds the

inhaler difficult to manage so he rarely uses it. A few months later, John develops an upper respiratory tract infection (URTI). His cough and breathing

worsen significantly so he returns to see Dr. Mooney accesses John’s results for the tests he had ordered and prescribes an antibiotic and two types of

inhalers. John goes to a different pharmacy than he used previously but only gets the antibiotic prescription filled.

Ten days later John is in a small town in a neighbouring county visiting family. His breathing and cough have not improved so he goes to a local GP, Dr.

Wilson. The assistant in the clinic uses information provided by John to create a new profile linked to his Individual Health Identifier (IHI). Dr. Wilson tries

to access John’s summary health record from the national health portal but is denied access saying the patient has restricted access to his health data.

John has a choice to whether to allow Dr. Wilson access to his Electronic Health Record. John grants access to Dr. Wilson via a consent tracking

service. Dr. Wilson is now able to access John’s Electronic Health Record and obtains a list of his five most recent encounters with the health system.

Using this information along with her own examination, Dr. Wilson feels there is bacterial resistance to the antibiotic prescribed, along with non-

compliance using the inhalers. She prescribes a different antibiotic and counsels John on using his inhaled medications.

+


Primary Care Scenario Example

9

Actors:Citizen (John O’Brien), GPs (Dr. Mooney & Dr. Wilson), Pharmacist, Radiologist, Consultant

Scenario: Patient Diagnosed with COPD

John O’Brien, 60, sees his family GP, Dr. Mooney, for the first time in over four years. To this point in his life, John has rarely gone to the

doctor but over the last two years he has been suffering from a persistent cough with intermittent episodes of shortness of breath.

Dr. Mooney accesses his practice system and carefully reviews the history of his present illness, as well as John’s past medical, family and

social history. He discovers John has a 45 to 50 pack per year history of smoking. Upon completion of the examination, Dr. Mooney’s

presumptive diagnosis is COPD (chronic obstructive pulmonary disease). Using his practice system, (which is integrated with the EHR), Dr. Mooney

creates and sends an electronic referral request for a chest x-ray and an electronic referral request for pulmonary function tests at the local hospital.

Finally he prescribes a short-acting B2 agonist inhaler and counsels John to stop smoking. Dr. Mooney records all of the findings from this visit in the

practice system.

Later in the day, John goes to the pharmacy and purchases his inhaler.

John also goes to the Diagnostic Imaging department of the local hospital and gets his chest x-ray done. The radiologist views the image later that day

and creates a report indicating findings consistent with COPD.

Three weeks later, John attends his appointment for pulmonary function tests at the hospital outpatient department. The test is interpreted the next day

by a consultant who finds evidence of obstructive airway disease and creates a report.

Unfortunately, John really enjoys smoking and is not convinced it is related to his breathing problems. As a result, he continues to smoke. He finds the

inhaler difficult to manage so he rarely uses it. A few months later, John develops an upper respiratory tract infection (URTI). His cough and breathing

worsen significantly so he returns to see Dr. Mooney accesses John’s results for the tests he had ordered and prescribes an antibiotic and two types of

inhalers. John goes to a different pharmacy than he used previously but only gets the antibiotic prescription filled.

Ten days later John is in a small town in a neighbouring county visiting family. His breathing and cough have not improved so he goes to a local GP, Dr.

Wilson. The assistant in the clinic uses information provided by John to create a new profile linked to his Individual Health Identifier (IHI). Dr. Wilson tries

to access John’s summary health record from the national health portal but is denied access saying the patient has restricted access to his health data.

John has a choice to whether to allow Dr. Wilson access to his Electronic Health Record. John grants access to Dr. Wilson via a consent tracking

service. Dr. Wilson is now able to access John’s Electronic Health Record and obtains a list of his five most recent encounters with the health system.

Using this information along with her own examination, Dr. Wilson feels there is bacterial resistance to the antibiotic prescribed, along with non-

compliance using the inhalers. She prescribes a different antibiotic and counsels John on using his inhaled medications.

+

Background

Typical interactions or activities

How the EHR will be used

Outcomes


Workshop Overview

Instructions and examples are provided

Within your table:

Self-select a person to act as the scribe for the table and a person to act as

the table coordinator

First develop the view of the Persona

The Persona should be representative of a typical person in terms of demographics and

attitudes

Create two Scenarios that are set in a future where the National EHR

capabilities that are proposed have been introduced

focus on conditions that impact on large numbers of health service users

focus on a typical set of activities that the person would do during their working day

10


Conclusions

Feedback and queries

Email to follow with short feedback survey

Next steps

Outputs from today will be written up and contribute to the final

Personas and Scenarios

Personas and Scenarios will be published online by May 2017

11


Conclusions

Follow progress of EHR Personas

Website: www.ehealthireland.ie/personas

Templates are online if you wish to contribute to further Personas and

Scenarios

Facebook: eHealth Ireland

Twitter: #EHRPersonas, @eHealthIreland

Email: [email protected]

Council of Clinical Information Officers

Email: [email protected]

Website: www.ccio.ie

12

http://www.ehealthireland.ie/personas

mailto:[email protected]

mailto:[email protected]

http://www.ccio.ie/


Conclusions

Many thanks for your

participation today

13

Documents

EHR Personas Workshop - eHealth Ireland · EHR Personas Workshop Fran Thompson Programme Director Workshops –Dublin Castle Tuesday 31 stJanuary and Wednesday 1 February 2017 #EHRPersonas