1. World Class ICT Platform for Primary Care

2. How do we use next generation IT systems to improve quality outcomes?  Feedback loops  – OODA or Study act do, becomes real time and improves, situation awareness for individual and population health.  Actionable outcomes.  Improve presentation of data  Communications –  Async  Series of one way communications....– peer to peer communication can be very short but rich with implied knowledge  Sync  Peer to peer (knows the jargon)  Shared screen in web meetings – removes all integration issues  One of the most asked for features by GPs

4. Complex?  Hospital care  Small, acute, disease centred, concentrated,  Staff ?  Primary Care  Large, everything, patient centred, spreadout  Staff ?

5.  GP Web access to health care data  Patient access via web  Integration with common practice management and billing systems  Support of practice-based clinical research:  Audits  Costs, processes, outcomes  Just in time information  Knowledge Management

6. Do the same thing?  Massive increase in knowledge  Demand up, practitioner supply down?  - Do more with less and spend more time learning  (there is plenty of time between 2 and 4am)

7. Why  On look out for developments that may help GP  Doing nothing is like choosing the same thing  Unnecessary variation is HUGE pain.  Thin client not new concept.  Proposal to board – time is right  Found vendor – approval process..

8. Cloud????  System to provide private outsourced network and Servers etc, that are not locked to one piece of hardware and allows economies of scale while keeping... individual practice autonomy ” Question Is GP small fast adapting businesses?

9. Or stuck in the mud that is the Current ICT environment

10. Multiple vendors with multiple standards all have access to my server!!!!! Patient centered medicine Evidence based medicine Real time population health Personal medical Home

11. ICT Platform - Current  Almost all computers hosted locally at GP Practice (few exceptions)  Some Practices have power supply and data backup devices in place, many haven’t  PMS software, data security requirements and integration with other systems are becoming too complex for Practice staff to maintain properly  Next generations of PMS software require in most cases expensive hardware upgrades  Variability in Practice configurations and network connections is creating performance problems  Where needed, Practices have independently contracted IT companies and receive varying quality support

12. What I say to Practices  If brought a new server today  Will it cope with  Future Health net requirements  GP2GP, e prescribing, up grades, shared record, other?  Is it designed fit for purpose, fit for whole system  Do you lead it or it lead you?

13. ICT Platform - Current

14. ICT Platform - New

15. Cutting edge?  Wx  East Tamaki  Apollo  Rotorua IPA  Just as if local

18. Benefit  Consistent platform  More time on User centred design

19. Moving to the cloud the 2 Onion way  40 practices  100 000 enrolled, 120 GPs  Over next three years...  Importance of independence for PMS.  Feedback  Shared helpdesk

20. Future  HML nursing integration.  Shared care project.  PMS not geo locked  DHB  Real time case discussions  One log in for concerto/PMS?  All roll outs testing in 2 Onion environment first