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Department of Health is a Smoke Free Workplace
eHealth Standards and Best Practice Models
Michelle McGuirk
Manager TeleHealth NTRegistered Nurse, Master of Public Health
Email: [email protected]
2
Overview
My eHealth Record
Digital Regions Project
&
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Overarching Structures in Health Informatics
Department of Health is a Smoke Free Workplace
My eHealth Record - Journey
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Situation Highly mobile patients with high health needs, accessing multiple
providers in acute and primary settings across public, private and non-Government sectors
Task The first shared electronic health record in NT containing key health
information needed for ongoing care across multiple health care providers with the patient’s consent.
Action Development of My eHealth Record underpinned by:
Primary care clinical software Strong clinical engagement via Clinical Advisory Committee’s consumer engagement central focus Full integration of My eHealth Record into clinical workflows User friendly, easy to use interface
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Clinician Engagement Clinician confidence Develop as a essential component of healthcare service delivery Highlight benefits from integrated records Highly skilled and mature teams of staff, clinical champions, clinical
advisory committees, ICT technical expertise, corporate knowledge
Consumer feedback Consumers rated the shared electronic health record at ‘medium to high’ level of achievement in the following key areas: Clear registration and consent process Culturally appropriate communications regarding sharing health
information- benefits for improving care Improved communications between themselves and health centre
staff Consumers better able to manage their own health care
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Jun-2005 Jun-2006 Jun-2007 Jun-2008 Jun-2009 Jun-2010 Jun-2011 Jun-2012 Jun-2013 Feb-20140
20000
40000
60000
80000
100000
120000
140000
160000
180000
200000
My eHealth Record growth June 2005 - February 2014
Registered Consumers Clinician updates to patient records (monthly) Clinician views of patient records (monthly)
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Proven that it enables best practice and improves healthcare delivery by breaking down the barriers: culture, language, distance and accessing information needed for care.
Keys to success Effective Consumer, Community and Clinical engagement Simple consent model accepted by consumers and
providers Strong advocacy by healthcare providers instilling
consumer confidence in MyeHR Integration of My eHealth Record into clinical workflow
and CIS User interface and design
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Access to Services in Remote NT
Photo Western McDonald Rangers courtesy of Greg Simon, Alice Springs
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Digital Regions InitiativeHealth eTowns Program
Infrastructure upgrades 17 major Territory Growth Towns
TeleHealth Network Advanced Shared
electronic Care Plan (ASeCP)
eLearning Framework
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TeleHealth Overview
Infrastructure Equipment
Medicarts VC software IP Patient Monitors
TeleHealth NT Web interface Ease of access Directory services Who has it?
Services and clinical frameworks
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Infrastructure Upgrades
Increased bandwidth
Wireless mesh networks implemented
Multiagency approach
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Digital Regions: TeleHealth Project
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Equipment - Medicarts
High Definition wireless Medicarts with plug and play peripheral equipment:
Tele-Specialist clinics. Assist with training and workforce
support solutions Provide facilities where patients can
connect with their local communities Remote case management Remote Trauma and Critical Care
Management
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Equipment – Desktop VC
Flexibility within the Video conferencing network
Easily installed Enables access for
services with minimum outlay
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Equipment : IP Emergency Monitors
Easy to operate on the ground Real time Video accessed by
clinicians External access
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TeleHealth Strategic VisionTeleHealth services deliver client based services in 3 main areas of care
Tele-Specialist Services Tele-Critical Care Tele-Workforce Support
Additional in 2014 Tele-Complex Conditions Management
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Why: Trends in Patient Travel
Cost of Patient Travel in NTG Dept. of Health Annual Reports 2007-2012. Records are inclusive of retrieval and emergency services.
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Why: Specialist Services Profile
Ambulatory care service and Visiting specialists service NT. Some complexities relating to FIFO modes Patient flow/ waitlisting Triage process Implementation of care
plan/ handover to PHC Review and case
coordination
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TeleHealth NT Secure Access model of care• Clinical care can be
coordinated relative to needs of the service/patient.
• Resourcing: doctor/patient clinician can be anywhere and Telehealth can be done at anytime.
What do Telehealth Services Offer?
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Tele-Specialist Services
Ambulatory care services provide 3 key service models Specialist
Outreach Patient Travel TeleHealth
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Tele-Critical Care Services
Emergency IP Monitors to support; Patient end service –
clinical decision support On-call services Remote
Medical Practitioners Retrieval services Receiving service (ED
Consultant and other identified Specialists)
Facilitating coordinated care at initial point of presentation
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TeleHealth Converge
Web Interface; acts as directory with ‘click and connect’ functionality
Secure Access Model of CareAccess is so important when it comes to
any eHealth services. It needs to be easy and quick.
Developed initially for IP Emergency Cameras- Expanded in 2014 to include all other TeleHealth equipment.
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Where to from here?
Interoperability Services Implementing National Standards / Guidelines
Continue to expand quality services. National Directory/ registration for TeleHealth
enabled services. Improved eHealth records- access to
documentation ASAP for accurate and advised clinical decision making.
Improved infrastructure. Home/ Self Monitoring Technology. Evaluations/ Academic Research Opportunities
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Multiple components- not just Infrastructure and technology
Ryan 2011
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Implementing services
Governance Community engagement Clinical input Expert Health IT advice Supporting mobile workforce
frameworks Agile Resourcing
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Social Accountability Pentagram
WHO, 2010
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Thank you
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Special Thank You
Economic Times India Health Summit Organisers
NTG Department of Health
eHealth Operations Team
Greg Simon (Photos)
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References Ryan Chris (2011) Video Consulting Telehealth- From
Hospitals to the Home and Everywhere in between. Pulse IT magazine, pp 40-48 Issue 25, November 2011. Available online at
http://www.pulseitmagazine.com.au/index.php?option=com_content&view=article&id=771:video-consulting-from-hospitals-to-the-home-and-everywhere-in-between&catid=16:oz-hit&Itemid=226
World Health Organization ‘Telemedicine Opportunities and Developments in Member states’ 2010 available http://whqlibdoc.who.int/publications/2010/9789241564144_eng.pdf