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EHR = Care Continum. Hospital Services Not just a medical emergency – part of the care continum Tromso, Norway, eHealth ‘05. Ursula O’Sullivan eMail:- [email protected] Web:- www.shb.ie. EHR = Care Continum.

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Ehr care continum l.jpg

EHR = Care Continum

Hospital Services

Not just a medical emergency – part of the care continum

Tromso, Norway, eHealth ‘05

Ursula O’Sullivan

eMail:- [email protected]

Web:- www.shb.ie


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EHR = Care Continum

If you don’t know where you are going…. any road will get you there? Even though there are a lot of possibilities it’s still important to set a direction.

ICTs are providing direction and opportunities so we need to introduce new technologies with business / service models in a way that maximises potential.


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eGovernment + eHealth

  • eHealth

  • Using technology to improve Healthcare delivery e.g. Telemedicine, Lab Results to GPs, Out-reach Clinics, Appointment Booking

  • Electronic Patient Record

eGovernment

  • Access to Services and Information

  • Citizens and their right to information

  • Backend re-organising systems and services to provide better access


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Despite the seeming chaos…..

Electronic Commerce

Enterprise Systems

Clinical Systems

Networks/Connectivity

Core Transaction Systems

Wireless

Decision Support Systems

Imaging

Customer Relationship Management Systems

Laboratory Systems

Internet/Extranet/Intranet

Telemedical Technologies

Consumer Health Systems

eProcurement

Clinical Data Repositories

Environmental Health Systems

Expert Logic

Computer-Telephony Integration

Integrated Medical Devices

GP Systems

Data Integration

Research Systems

eLearning Systems

Electronic Medical Records

Workforce Enabling Technologies

Workflow Technologies


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……There is structure in Healthcare

  • Foundation Technologies

  • Networks/Connectivity/CDRs/

  • Data Integration

  • Internet/Intranet/Extranet

  • Integrated Medical Devices

  • Imaging

  • Interactive Computer Telephony Integration

Advanced Technologies

  • Consumer/Patient Health Systems

  • Electronic Commerce

  • Relationship Management Systems

  • Workflow Technologies

  • Research Systems

  • Expert Logic

  • Wireless


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  • Branding and Identity - TRUST

  • Patient / Citizen Education

  • Information Publishing and Communication

Universal Access

Web Site

  • Patient Registration, appointment requests

  • “Push” Customised Content to Patients / Diagnostic Groups

  • Direct order entry and results

  • GP to Health Board interaction

  • External Access to speciifics

Secure Remote Communications and Access

Extranet

  • Work flow Technologies

  • Self-Serve HR, Administration

  • Browser Access to Databases (research, knowledge, medical, administrative)

Establish

Communications Infrastructure

& Productivity

Enhancers

Intranet

Uniform Access to Core Systems

Functions and Features of Clinical, Managed Care and Administrative Applications

Core Data Systems

(Patient Care, Clinical, Administration, Finance)

Public Use

Today’s Health Architecture

Sample Capabilities

Value

Creation


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Industrial

Internet

Digital imaging

Informatics

  • Greatest advances in the history of medicine are happening now through an explosion in new technology

  • Societies have the opportunity to eliminate disease, extend life, improve health and wellness

  • And to make healthcare more accessible, affordable and satisfying for all participants

Minimally invasive surgery

Wireless

Genomics & Proteomics

Medical devices

Nanotechnology

New pharmaceuticals

New healthcare technologies

are redefining healthcare and society


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eHealth Foundation

20th Century

21st Century

  • Appropriate

  • Accessible

  • Affordable

  • Effective

  • Efficient

  • Satisfying

Self-Service

Portals

Surveillance &

Analysis

Longitudinal

Patient Data

Core Healthcare

Applications

Secure E-Health

Network Infrastructure


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EHR = Care Continum

  • Internet technologies have broadened access to data and information in a way that shatters previous models

    • Cost control

    • Information access

    • Clinicians, Healthcare Professionals

    • Patients, Citizens

  • We need to understand that large advances are coming within 3-5 years, and current investments may require replacement / upgrading

  • Develop strong healthcare professionals education programme today to prepare for the tools that will be available in the near- and mid-term


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EHR = Care Continum

A short overview of the SHB experiences addressing the challenges and opportunities of

Electronic Health Record

Lessons and experiences from regional implementation now applied nationally


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EHR = Care Continum

Environment

  • 4,700 sq miles

  • 564k population base

  • 18,000 Staff, 6,000 field based

  • 250 Locations

  • Personal Computers – 6,800 Laptop Computers - 1500

  • Mobile Phones – 2,200

  • Extensive WAN and Local Area Networks


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EHR = Care Continum

Drivers

  • Internal

    • Low Morale – No Communications

    • 20 year old Paper Based processes

    • Need for change

  • External

    • Consumerism, Patient Centered

    • Integration

    • Legislation, Regulations


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EHR = Care Continum


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Health eSHB

10 Goals

  • Integration of patient based services

  • New ways of delivering services and information

  • Manage information as an asset

  • Manage creation of knowledge

  • Optomise use of resources

  • Create an effective organisation

  • Achieve an Electronic Health Record [EHR]

  • eEnable Clinical Systems

  • eEnable Administrative Systems

  • Develop an enabling Technology Architecture


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EHR = Care Continum

What do we mean by that?

  • Providing Citizen Access

    • Listening Days, eGovt Initiatives,

  • Information & Knowledge Management

    • Medical Protocols, Research, Best Practice

  • Development of Single Patient Record

  • Advanced Communications

  • Telemedicine


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eService

eEU

eSHB

eBroker

eCitizen

New IT Systems – Labs, PACs, Radiology,

eGovt

Single Patient Record

eLearning

Organisation

Information & Knowledge Management

Defined Enterprise Architecture Support

Advanced Communi-cations

SHBnet

EHR = Care Continum

Building Blocks


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EHR = Care Continum

Practical Examples

  • eProcurement

  • eServices

    • Births, Death & Marriages

    • Environmental Health, Bridges Dental

  • Word Based Content Management System

  • Nation-wide VPN [Virtual Private Network]

  • Integrated patient records

    • Community, Mobile Computing

  • Blended eTraining / eLearning


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EHR = Care Continum

MOBILE & COMMUNITY PIMs

How many times would you like to have this done??

Integrated EHR


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EHR = Care Continum

MOBILE & COMMUNITY PIMs

Integrated Service Delivery


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EHR = Care Continum

Interactive Hospital School


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From the chaos….. To.......

Electronic Commerce

Enterprise Systems

Clinical Systems

Networks/Connectivity

Core Transaction Systems

Wireless

Decision Support Systems

Imaging

Customer Relationship Management Systems

Laboratory Systems

Internet/Extranet/Intranet

Telemedical Technologies

Consumer Health Systems

eProcurement

Clinical Data Repositories

Environmental Health Systems

Expert Logic

Computer-Telephony Integration

Integrated Medical Devices

GP Systems

Data Integration

Research Systems

eLearning Systems

Electronic Medical Records

Workforce Enabling Technologies

Workflow Technologies


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Applications Blueprint


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EHR = Care Continum

Benefits to Date

  • Consolidation of access for the Patient Information Management System (including Lab, PACS and Community PiMS)

  • E-enablement of Health Board Processes (where currently addressed)

  • SHBnet Infrastructure collaboration (Hardware/Software and Communication links)

  • Content Management Application (Intranet and other WEB Form Applications)

  • Change Management (program to foster e-culture throughout the Southern Health Board’s community of users)

  • Migration to Web Services environment


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EHR = Care Continum

Lessons Learned

  • Check the Power Supply…

  • Involve Users

  • Plan for ‘big picture’

  • Be Flexible

  • Develop ‘Partnership’ approach


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EHR = Care Continum

  • Where are we going now?

  • Continue to implement Health eSHB goals but on a national basis

  • New National EHR Contract [iSOFT]

  • New National Health Strategy

    • Recent replacement of 11 Health Boards by one national organisation - HSE

  • Continue to work with eGovt. initatives

    • eServices, Benchmarks, EU Indicators, Govt. VPN, develop new means of delivery e.g. Digital TV, Health Portal, GP Access, etc….


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Care Continum

‘E’ …. is not just about computers and systems.

It is about people and processes and most importantly it is about thinking differently….

eSHB….. 2001- 2005


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EHR = Care Continum

Hospital Services

Not just a medical emergency – part of the care continum

Tromso, Norway, eHealth ‘05

Contact Details:- Ursula O’Sullivan

eMail:- [email protected]

Web:- www.shb.ie

Phone:- 021-4922990


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