EHR Implementations: Revolutionising Health Information Management

1. EHR Implementations:Revolutionising Health Information Management Denis Tebbutt Managing Director, InterSystems ANZ

2. Software for Connected Healthcare HealthShare – #1 health information exchange platform Regional / National EHR TrakCare – Advanced Web-based healthcare information system Institutional / Community EPR Ensemble - #1 rated healthcare integration software Application Level Caché - #1 database in clinical applications worldwide

3. National & Regional Sharing of Clinical Information • Around the world healthcare delivery systems are increasingly focused on the creation of an EHR • Increases accessibility of important health information across the spectrum of care • Improves the quality of care • Reduces the costs of care through elimination of duplicate tests and prescriptions • In emergency situations can literally save lives • Facilitates the development of integrated community based care • Can outreach to health based NGO’s

4. The EHR Basics • Identify the patient across facilities • Authentication of the requesting clinician/viewer • Consent Management • Security • Terminology • Messaging • Leave clinical data at the source

5. Technology Challenges Clinical Viewer & Patient Portal Ensemble HL7/CDA/CCD/DICOM/NCPDP/RLS HealthShare • Clinical access through a ‘Portal’ • There must be an integrated clinical application that fits all levels of a facility • A powerful, health focused, integration platform supporting HL7 and other IT based standards • A strong standards based approach • Repository and Record Locator Service • Rapid Application development and deployment with incremental and massive scalability TrakCare Clinical Patient Record EMPI/RLS Cache

6. So What is HealthShare? • Massively scalable integrated healthcare suite for the deployment of Regional and National Electronic Health Records: • Clinical Viewer • Enterprise Master Patient Index • Clinically proven database and application • Fully integrated and clinically proven integration and development platform • Harvests the data held in all of the repositories that support the operation of a healthcare facility/state/region/country

7. The Structure of HealthShare? • The HealthShare EPR is a sophisticated browser-based Electronic Patient Record that doctors and other clinicians use to access patient data • The HealthShare Hub is a central index of patients and providers, it uniquely identifies a patient and specifies which edge Caches maintain data for that patient • The HealthShare Edge Cache Repository is a clinical database that holds all of the data that a provider is willing to share • The HealthShare Gateway is a health integration platform optimised for providing multiple provider organisations

8. Populating the Hub

9. Locating Patient Records

10. HealthShare Patient Viewer

11. Ensemble at the Heart of HealthShare • One data model • One metadata repository • One developmentenvironment • One managementenvironment • One learningcurve

12. HealthCare Deployment Examples Long Island, Rhode Island RHIO’s, Sweden & Netherlands National Systems

13. Long Island Patient Information eXchangeMission • Mission: To create an achievable, sustainable and replicable model for integrating clinical information across multiple health care organizations in order to improve access to patient data at the point of care; improve health care quality; and reduce inappropriate utilization and cost. • Focus on support for the “transitions of care” • Emphasis on infrastructure and Proof of Concept in Phase 1 Benjamin Stein, MD Chief Executive Officer, LIPIX Director of CIS, North Shore LIJ Health System

14. Long Island Patient Information eXchange Scope • Clinical Data Exchange (CDE) • “Data of convenience” • Workflow integration • Need to support “pull” and “push” transactions • Meta - Master Patient Index (M-MPI) • Supports health information exchange • Provides patient identification services to individual member organizations • Future growth • Public Health module • E-imaging • e-Rx • Ambulatory EMR • PHR

15. Long Island Patient Exchange (LIPIX) • 5.2 Million Residents 8,000 GP’s (Assoc with NS-LIJ Health System)   • Connecting 15 healthcare organizations on New York’s Long Island • Initial LIPIX Deployment • 4 Hospitals • 2 Physician Practices • Home Care Agency • Municipal Health Center • EMS Organization • Reference Laboratory • Long Term Care Facility • Public Health Department

16. Long Island Patient Information eXchangeScope

17. USA Rhode Island • Having a useful, usable and used interconnected health information system that: • A total of 1.1Million Residents 3,000 GP’s • Puts the right information into the hands of clinicians and their patients when and where it is needed • Allows for population health information to be analyzed and used for surveillance, health policy, and research • Using InterSystems HealthShare for state-wide master patient index and clinical data exchange • Connecting 14 healthcare organizations across the state (85%+ of all lab and medication data) • Governor has an “Anytime, Anywhere Healthcare” agenda

18. Sweden - National Patient Overview (NPO) • Population 9 million • 21 healthcare regions • National EHR • Carelink is Government appointed group to manage the project. • InterSystems in partnership with Tieto Enator. • Contract signed March 18th

19. Netherlands (NICTIZ) • National Healthcare Messaging Hub • National solutions for Access, Identity & Consent • HL7 V.3 for Health Information Exchange • Strategy of inclusion for existing suppliers and end-user solutions • Concept of “well-behaved systems” [GBZ] • Encouraging utilisation of the infrastructure

20. EHR Implementations:Revolutionising Health Information Management Denis Tebbutt Managing Director, InterSystems ANZ