Building a sustainable health information infrastructure

Jane Grimson Director of Health Information and

Deputy Chief Executive

Health Information and Quality Authority

The perfect storm

Gap

Good quality information is critical

Role of the Health Information and

Quality Authority:

To drive continuous improvements in the quality and safety of health and social

care in Ireland.

Develop standards and guidance for health information

Identify gaps in health information Publish accurate information about the performance of the health and social care system

Health information function

Develop standards and guidance for health information Guidance on Information governance for health and social care services Guidance on Privacy Impact Assessment What you should know about information governance What you should know about data quality Catalogue of national health information sources Guiding principles for health and social care data collections GP messaging standard (v2) Referral data set, discharge data set, demographic data set Guidance on messaging standards for Ireland Guidance on classification and terminology standards for Ireland Overview of healthcare interoperability standards

Identify gaps in health information Provide advice in relation to identifiers for individuals, professionals and organisations

Publish accurate information about the performance of the health and social care system

All inspection and investigation reports published

Work completed to date

Key principles for a sustainable health information infrastructure

1. Patient-centred

2. Integrated

3. Standards-based

Key principle 1:

Patient centered

Informed, knowledgeable and empowered patient

Tertiary

Secondary

Primary

Self-Care

(off the Map)

INDUSTRIAL AGE MEDICINE

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Professional

Care

Source: Tom Ferguson, “Consumer Health Informatics,” Healthcare Forum Journal, Jan/Feb 1995, pp 28-33.

(doctom@doctom.com, wwwfergusonreport.com

INFORMATION AGE HEALTHCARE

E

N

C

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R

A

G

E

D

D

I

S

C

O

U

R

A

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D

$

¢

Source: Tom Ferguson, “Consumer Health Informatics,” Healthcare Forum Journal, Jan/Feb 1995, pp 28-33.

(doctom@doctom.com, wwwfergusonreport.com

Individual self-care

Friends and family

Self-help networks

Professionals as facilitators

Professionals as partners

Professionals as authorities

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Information flows the wrong way

Patient Pathway

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Patient Pathway

Threatens patient safety and

increases costs

Source: eHealth Strategy for Ireland, Department of Health, 2013.

The ability of share information is at the heart of patient-centred eHealth

Key principle: 2

Integrated

Eliminate duplication and fragmentation

Current information infrastructure in Ireland

very fragmented

Drivers for integrating health information

• Connect multiple locations of care delivery

• Support team-based care

• Deliver evidence-based healthcare

• Improve safety – Reduce errors and inequalities

– Reduce duplication and delay

• Improve cost-effectiveness of health services

• Empower and involve citizens

• Underpin population health and research

• Protect patient privacy

Key principle: 3

Standards-based

Support efficient information sharing

Benefits of standards

• Major role in ensuring safety e.g. Safe Surgery Saves Lives (WHO)

• Support health service improvements

• Deliver economic benefits

• Benefits stakeholders including patients

“the lack of ICT systems interoperability and of widely accepted

standards directly implies compromised quality of healthcare

and unnecessarily high costs”

[Empirica 2008]

Standards in healthcare

Conclusions

• What’s the best approach?

• How much will it cost?

• Will it deliver the benefits?

• How do we get there?

• What standards should we use?

• ……

Why has progress been so slow?

What can we learn?

• Don’t assume that solution which works well in one context will work well in another

• Identify and implement the key building blocks for eHealth • Build on local solutions based on standards to ensure that everything

fits together • Benefits claimed should be evidence-based • Strategic goal should be better healthcare, not cash • Engage pro-actively with all stakeholders including patients • Make sure all information flows are identified from direct patient care,

to clinical audit, quality improvement, reimbursement, population health, service planning, and research

• Put in place robust governance to ensure privacy and confidentiality • Leadership for the long term is critical • Ensure that eHealth strategy enables and supports all policy objectives

Can we leapfrog?

• Go directly to Personal Health Records at national level?

• Adopt an integrated approach to primary and secondary information

Thank you