Turning revolution into evolution Julie Roediger Deputy Director, Australian Institute of Health and Welfare Julie Roediger Deputy Director, Australian Institute of Health and Welfare

Australian Institute of Health and Welfare Outline The coming world The existing world The hybrid world Enduring tensions

Australian Institute of Health and Welfare E-Health activities Interoperability Clinical communications Unique health identification Identity management Secure messaging Individual electronic health record Supply chain Engagement and adoption

Australian Institute of Health and Welfare Implications Standards, standards, standards –IHI-I, IHI-O, IPI –Identification service –Messaging –Terminology –Authentication Structure, structure, structure –Generation of messages –Pull and push of data –Essential data and its meaning

Australian Institute of Health and Welfare Functions of existing-health Reimbursement Evidence based medicine Bench-marking and improvement Post-market evaluation Population health monitoring Policy development and program management Public Health Surveillance - Pandemic, Biosurveillance, Prevention Biomedical Research

Australian Institute of Health and Welfare Supporting infrastructure Wide variety of identifiers No identification service Data definitions –National Minimum Data Sets –Data Set Specifications Searchable stores for collected NMDS & DSS and other administrative data sets

Australian Institute of Health and Welfare Existing data standards: example

Australian Institute of Health and Welfare Unit records with coded values Clinician raises a natural language and/or form-based record Human coding assisted by guidelines Aggregate reports eg. national minimum data sets, registries, linked data sets, Patient interacts with clinician Information for research and analysis: Existing health

Australian Institute of Health and Welfare Clinician raises a terminology or rule-based record Machine coding according to maps Unit records with coded values Aggregate reports eg. NMDS, device registry, patient records linked by IHI Patient (IHI) interacts with clinician Information for research and analysis: e- health Map Classifications Terminology

Australian Institute of Health and Welfare Clinician or coder raises a terminology or rule-based record Machine coding according to maps Unit records with coded values Clinician raises a natural language and/or form-based record Human coding assisted by guidelines Aggregate reports eg. NMDS, device registry, patient records linked by IHI Patient (IHI) interacts with clinician Information for research and analysis: hybrid Map Classifications Terminology Paper-based systems

Australian Institute of Health and Welfare Clinician or coder raises a terminology or rule-based record Machine coding according to maps Unit records with coded values Clinician raises a natural language and/or form-based record Human coding assisted by guidelines Aggregate reports eg. NMDS, device registry, patient records possibly linked by IHI with consent Patient (IHI) interacts with clinician Information for research and analysis: hybrid Map Classifications Terminology

Australian Institute of Health and Welfare Proposed governance — data supply chain

Australian Institute of Health and Welfare Useful concepts for secondary use

Australian Institute of Health and Welfare Enduring tensions Appetite for information vs cost Responsiveness vs quality New requirements vs time series Privacy vs access Competing array of use cases

Thank you