HealthConnect: Sharing information to improve health care 29 July 2005 Dr Brian Richards National Director, e-Health Implementation Department of Health and Ageing

Health care is changing ‘20 th Century’ health care‘21 st Century’ health care Short duration, episodic treatmentCare extending over months/years Treatment by a single physicianTreatment involving several professions Focus on single body systemMulti-systemic pathologies and treatments Rapid escalation to hospital Capacity to manage more (& more services complex) conditions on an ambulatory basis Limited use of diagnostic Heavier reliance on multiple technology diagnostic technologies

‘20 th Century’ health care‘21 st Century’ health care Bilateral (patient ↔ doctor) Multilateral (patient ↔ care team & information flow within care team) information flow Straightforward record-keepingComplex record-keeping and sharing Patient passive recipient of informationPatients actively involved in decisions Treatment orientationPrevention and early intervention – recalls, registers, care plans Face-to-face treatment ‘in-hours’ Growth of remote care delivery and in a practice setting patient monitoring both ‘in-hours‘ and ‘after-hours’ Information needs are changing

Sharing Information Level 1:Non-electronic data (eg mail, telephone) Level 2:Machine-transportable data (eg faxed or scanned documents) Level 3:Machine-organisable data (eg , proprietary file formats) Level 4:Machine-interpretable data (eg structured data within standardised messages)

Level 4 Information Sharing 1.Store health data electronically at point of care –Structured standardised clinical data (electronic clinical record) –Digital images 2.Exchange clinical data electronically –Standardised structured messages ( semantic interoperability ) –Automate data handling (accuracy and efficiency) –Use broadband (high speed connections, always on) 3.Build shared summary EHR over time –By-product of clinical data entry and messaging –Enables electronic care planning and decision support –Ongoing stakeholder engagement (consumers, providers, industry) required

Health Care Applications Clinical Admin Web-based Workflow Infrastructure National Identifiers Data stores Hospital / Practice Standards Security, messaging, networks Data, coding, classification Architectures The e-health iceberg NeHTA Jurisdictions / Providers Industry Providers and patients Health Connect

An overarching change management strategy, based on partnerships, aimed at improving health care delivery in Australia Improves the quality and safety of health care decisions by improving access to relevant health information at the point of care

HealthConnect Implementation Strategy The HealthConnect implementation strategy was developed with inputs from: consultations on the draft HealthConnect Business Architecture evaluation of HealthConnect and MediConnect trials national e-health governance arrangements stakeholder feedback

Roles in HealthConnect Implementation DoHA manages national coordination States and territories cooperate as implementation partners Regional priorities identified by states and territories Stakeholders (eg consumers, providers, industry) actively consulted Existing state, territory and private sector initiatives leveraged Outcomes delivered locally (including in advance of national infrastructure), migrating to national interoperability over time NEHTA specifies standards and architectures for interoperability Strategic investment stimulated by states, territories and the private sector

Kalgoorlie EHR Rural & Remote Context with Indigenous Focus EHR elective surgery Open EHR Architecture with Chronic Disease Focus EHR chronic disease 65+ EHR children’s health EHR Medications EHR diabetes EHR Whole of State Broadband Connectivity in Metro-Like, Rural & Remote EHR Whole of State

Private Sector Clinical Data Administrative Data eg HIC claims data Public Sector Clinical Data HIC Online PBS Online Eclipse AIHW AHCA Health Connect NeHTA HealthConnect in the e-health Mud Map

Implementation philosophy Investment strategy & stakeholder relations (Governments) National standards (NeHTA) Development & marketing (Industry)

Early Results

In summary Health care is a complex, information-intensive industry HealthConnect is a key enabler for improving health outcomes by providing better access to information at the point of decision-making HealthConnect implementation is a change management issue, not just a technological challenge

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