Department of Health is a Smoke Free Workplace

eHealth Standards and Best Practice Models

Michelle McGuirk

Manager TeleHealth NTRegistered Nurse, Master of Public Health

Email: michelle.mcgurik@nt.gov.au

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Overview

My eHealth Record

Digital Regions Project

&

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Overarching Structures in Health Informatics

Department of Health is a Smoke Free Workplace

My eHealth Record - Journey

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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

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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

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Jun-2005 Jun-2006 Jun-2007 Jun-2008 Jun-2009 Jun-2010 Jun-2011 Jun-2012 Jun-2013 Feb-20140

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100000

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My eHealth Record growth June 2005 - February 2014

Registered Consumers Clinician updates to patient records (monthly) Clinician views of patient records (monthly)

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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

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Access to Services in Remote NT

Photo Western McDonald Rangers courtesy of Greg Simon, Alice Springs

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Digital Regions InitiativeHealth eTowns Program

Infrastructure upgrades 17 major Territory Growth Towns

TeleHealth Network Advanced Shared

electronic Care Plan (ASeCP)

eLearning Framework

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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

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Infrastructure Upgrades

Increased bandwidth

Wireless mesh networks implemented

Multiagency approach

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Digital Regions: TeleHealth Project

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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

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Equipment – Desktop VC

Flexibility within the Video conferencing network

Easily installed Enables access for

services with minimum outlay

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Equipment : IP Emergency Monitors

Easy to operate on the ground Real time Video accessed by

clinicians External access

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TeleHealth Strategic VisionTeleHealth 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

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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.

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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

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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?

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Tele-Specialist Services

Ambulatory care services provide 3 key service models Specialist

Outreach Patient Travel TeleHealth

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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

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TeleHealth Converge

Web Interface; acts as directory with ‘click and connect’ functionality

Secure Access Model of CareAccess is so important when it comes to

any eHealth services. It needs to be easy and quick.

Developed initially for IP Emergency Cameras- Expanded in 2014 to include all other TeleHealth equipment.

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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

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Multiple components- not just Infrastructure and technology

Ryan 2011

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Implementing services

Governance Community engagement Clinical input Expert Health IT advice Supporting mobile workforce

frameworks Agile Resourcing

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Social Accountability Pentagram

WHO, 2010

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Thank you

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Special Thank You

Economic Times India Health Summit Organisers

NTG Department of Health

eHealth Operations Team

Greg Simon (Photos)

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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