1. Department of Health is a Smoke Free Workplace eHealth Standards and Best Practice Models Michelle McGuirk Manager TeleHealth NT Registered Nurse, Master of Public Health Email: michelle.mcgurik@nt.gov.aumichelle.mcgurik@nt.gov.au

2. 2 Overview My eHealth Record Digital Regions Project &

3. 3 Overarching Structures in Health Informatics

4. Department of Health is a Smoke Free Workplace My eHealth Record - Journey

5. 5  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

6. 6 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

7. 7

8. 8 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

9. 9 Access to Services in Remote NT Photo Western McDonald Rangers courtesy of Greg Simon, Alice Springs

10. 10 Digital Regions Initiative Health eTowns Program  Infrastructure upgrades 17 major Territory Growth Towns  TeleHealth Network  Advanced Shared electronic Care Plan (ASeCP)  eLearning Framework

11. 11 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

12. 12 Infrastructure Upgrades  Increased bandwidth  Wireless mesh networks implemented  Multiagency approach

13. 13 Digital Regions: TeleHealth Project

14. 14 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

15. 15 Equipment – Desktop VC  Flexibility within the Video conferencing network  Easily installed  Enables access for services with minimum outlay

16. 16 Equipment : IP Emergency Monitors  Easy to operate on the ground  Real time Video accessed by clinicians  External access

17. 17 TeleHealth Strategic Vision TeleHealth 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

18. 18 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.

19. 19 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

20. 20 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?

21. 21 Tele-Specialist Services Ambulatory care services provide 3 key service models  Specialist Outreach  Patient Travel  TeleHealth

22. 22 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

23. 23 Tel e Health Converge WWeb Interface; acts as directory with ‘click and connect’ functionality SSecure Access Model of Care AAccess is so important when it comes to any eHealth services. It needs to be easy and quick. DDeveloped initially for IP Emergency Cameras- Expanded in 2014 to include all other TeleHealth equipment.

24. 24 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

25. 25 Multiple components- not just Infrastructure and technology Ryan 2011

26. 26 Implementing services  Governance  Community engagement  Clinical input  Expert Health IT advice  Supporting mobile workforce frameworks  Agile Resourcing

27. 27 Social Accountability Pentagram WHO, 2010

28. 28 Thank you

29. 29 Special Thank You Economic Times India Health Summit Organisers NTG Department of Health eHealth Operations Team Greg Simon (Photos)

30. 30 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 http://whqlibdoc.who.int/publications/2010/9789241564144 _eng.pdf