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

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

3. 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

4. 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

5. 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

6. 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

7. Australian Institute of Health and Welfare Existing data standards: example

8. 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

9. 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

10. 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

11. 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

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

13. Australian Institute of Health and Welfare Useful concepts for secondary use

14. 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

15. Thank you