roadmapto interoperability 2018-2020 - ministry of health nz · roadmapto interoperability...

Roadmap tointeroperability2018-2020PracticalstepstointeroperabilityThis3-year roadmapoutlinespracticalstepstorealinteroperabilityinthedigitalhealthecosystem,forbetterpatientanduserexperience.InteroperabilityTheGlobalDigitalHealthPartnershipdefinesinteroperabilityastheabilityofasystemorproducttotransfermeaningofinformationwithinandbetweensystemsorproductswithoutspecialeffortbytheuser.Interoperabilityensuresthathealthinformationcanbeaccessedbyclinicians,patients,theircarersandwhānauanywhere,anytimeandanyhow. InteroperabilityisessentialtoadigitalhealthecosystemthatenablestheVisionforHealthTechnologyandNZHealthStrategy.DependenciesRelatedDigitalHealthStrategyinitiativesestablish(a)digitalidentityforallpatients, providersandhealthservices,(b)secureconnectivityaroundallservices,and(c)asecurity,privacy and trustmodel.

PrinciplesforinteroperabilityConsumertrust:Consumerscantrustthequality,securityandprivacyoftheirhealthdata. Consumerscanaccesstheirownhealthdata,createnewdataaspartoftheirhealthrecord,andseewhohasaccessedtheirdata,whathasbeenaccessed,whenandwhy.Noblocking: Wearecustodiansofhealthdataandwillmakeitavailabletootherswheneverconsistentwiththeotherprinciplesandpermittedbylaw. Wewillnotunreasonablyblockorhinderaccesstohealthdata.Datasharing: Healthdatawillbesharedacrossthehealthandsocialcarecontinuum,withappropriateuserauthorisation,tosupportclinicaldecisionmakingandenabletheprovisionoftherightcare,intherightplace,attherighttime,bytherightpeople.Standards: Wewillimplementagreednationalinteroperabilitystandardsandpoliciesandadoptrecognisedpracticesrelatedtohealthdataincludingprivacy,security,informationgovernanceandservicemanagement.Commoncapabilities: Wewilluseagreednationalinformationcommoncapabilitiessuchasprovide identity,directoryandhealthrecordservices.

StandardsforinteroperabilitySNOMEDcontentstandardforalle-healthrecords

HL7FHIRinteroperabilitystandardforRESTfulAPIs

LOINClabtestcodesetstandard(tobecontained)

GS1standards forproductandentityidentifiers

HISOnational standardsforinteroperability

Subjectarea 2018/19milestones 2019/20 milestones 2020/21 milestones Userexperience

MedicinesanddevicesinformationFurtherdevelopNZUniversalListofMedicinesandNZFormularyasinteroperableclinicaldecisionsupportresourcesusedbyclinicalandpersonalhealthapps. Extendtheseresourcestomedicaldevices.

• NZULMmaptoSNOMEDmedicinalproducts• NZULMdata,APIanddisplaystandards• Codedapprovedindicationsstandard• Prescribingdata standard

• NZULMintegrationinprimarycareandhospitalsystemscomplete• RealtimeNZULMAPI• Medicines anddevicesdatastandardsintherapeuticproductregulations

• Medicaldeviceterminology• Universallistoftherapeuticproducts• Codedapprovedproductslist• Fullydigitalformularyandfundinginformation

Patientisfullyinformedaboutprescribedmedicines,theirbestuseandpossiblesideeffectsHealthprovidersaresafelyandeffectivelyguidedinprescribingandadministeringalltherapeuticproducts

Pathways,referralsandcarecoordinationImplement commone-referralstandardsaroundthecountrytocreateinteroperability.Createthestandardsforinteroperableclinicaldecisionsupportandcarecoordinationtools.

• E-referralande-transferofcare standardsandresources

• Interconnectede-referralsystems• Pathwaysinteroperablewithe-referralsystems

• SNOMEDcodedhealthpathways

Patient hasadigitalhealthpathwaytheycanusetotrackandscheduletheirinteractionsHealthprovidershavestandardisedtoolstoselecttherightpathwayandtocoordinatecareforthepatient

PersonalhealthinformationandsharedcareplansDataandinterfacestandardsareneededforthecorepersonalhealthinformationthatisneededineverysettingforsafeandeffectivecareandselfmanagement.Standardised sharedcareplansarealsoneeded.

• Datastandardsforallcorepersonalhealthinformation

• NationalImmunisationRegister(NIR)andMedicalWarningSystem(MWS)APIs• Interoperablesharedcareplan• Standardisedadversereactionreporting

• InteroperableMyListofMedicines• Genomicdataaddedtopersonalhealthinformation

PatienthasstandardisedpersonalhealthinformationthattellstheirhealthandwellnessstoryHealthproviders havethemostimportantinformationavailabletothemwhentheyseepatients

Patientportals andpersonalhealthappsanddevicesPromotethedevelopmentofpatientportalAPIsasthetrustedaccesspointtopersonalhealthinformationandservicesintheecosystem.Patientscanuploadinformationfromwearablesandhomemonitorstothepatientportalandcommunicatewithhealthproviders.

• Patientportals extendedtoonlineconsultationsandmorecontent• ProofofconceptforpatientportalqueryandextractAPIlikeBlueButton

• StandardisedpatientportalAPIs

• Appstoreandformularyforpersonalhealthapps• FHIR-basedAPIsfornationaldigitalservices• NationaldigitalservicessecurelyavailableonInternet

Patient cancommunicatewithprovidersandusewearables,monitorsandappsthatconnecttotheecosystemHealthproviderscancommunicatewithandmonitorpatientsviadigitalchannels

SNOMEDimplementationinprimaryandacutecareLeadthemovefromReadCodestoSNOMEDinprimarycare.EnableSNOMEDimplementationingeneralpractice,healthcare

• SNOMED implementationmaturitymodel• PersonalinjuryclaimandmedicalcertificateAPIs• SNOMEDreferencesetsforprimaryandacutecare

• SupportforPHOreportingandprimarycaredataservice• Patient friendlyterms• SNOMEDinNationalCollectionforEDvisits• EDearlyadopters

• SNOMEDin allEDs• AllDHBand PHOprocessesmovedfromReadCodestoSNOMED

Patient receivesthebestevidence-based carewhenqualityinformationisusedHealth providershavethepreciseandstandardiseddataneededforclinicaldecisionsupportandnewmodelsofcare

SNOMEDimplementation in secondarycareEnsureSNOMEDimplementationoccurswithallnewinvestmentinclinicalinformationsystems.EstablishnationalclinicalgovernanceofSNOMEDmaterialsforallservices.FurtherdevelopSNOMEDnationalreleasecentrecapability.

• Early adopterDHBsimplementNationalPatientFlowreferencesetsforreferralsandassessments

• AllDHBsimplementNationalPatientFlow referencesets• SNOMEDusedinclinicalportalforproblemlist

• SNOMEDandCurrentProceduralTerminology(CPT)proofofconcept

Patientbenefitsfrom moretimelyandequitableaccesstosecondaryservicesHealthprovidersareenabledtomakeobjectivedecisionsaboutaccesstosecondaryservices

Laboratorye-ordersandresultsEnhancepathologyandlabinformationstandardstoimproveclinicalworkflowandpatientengagement.Extendthestandardstomicrobiology,cancerreportingandgenomicsusingSNOMED.MovetoFHIRAPIsandfullySNOMEDbasedstandardsin4-yeartimeframe.

• NZPOCSandmessagingstandardadoptionbyalllabsandDHBs• Standardmicroorganismcodingforinfectioncontrol• Draftstandardsfore-orders• ContainLOINCtopresentuse

• Structuredpathologyreportingfor bowelcancerandothercancers• Partner inselectedRCPAcodesetdevelopmentanduse• PartnerwithNHSDigitalonSNOMEDforlabtestschedule

• MovetoRESTfule-ordersandresultsAPIs• Fully digitallabtestscheduleandAPI• LOINCtoSNOMEDmigrationtoolkitavailable

PatienthasmoreconvenienceinthetestprocessandcantrackresultsagainsttargetsHealthproviderscaneasilyselectandordertests,reviewresultsandeffectivelycommunicatethem

Radiology e-orders,imagesandreportsStandardisethewaydiagnosticradiologytestsareorderedandreported,includinghowimagesareshared.Supportforteleradiologyisimportant.Introducestandardsformedicalimagemanagementgenerally.

• Clinicaldocument metadatastandard• Standardsforradiologye-orders

• Standards formedical imagemanagement

• Virtualnationalimagerepository

Patient hasmorecontrolovertheprocessandhasaccesstoimagesandreportsHealth providershavestreamlinedprocessesaroundradiologyandconvenientaccesstoimages

SupplychainandproductinformationImplementGlobalTradeItemNumber(GTIN) productidentificationstandardandotherGS1automaticidentificationanddatacapture(AIDC)standardsforinteroperabilityinsupplychainandclinicalprocesses.ImplementNational ProductCatalogue(NPC).

• Plan DHBadoptionofGTINandother GS1AIDCstandards• PlanforandrolloutGTINsinNZULMby productclass• PlanmovefromPharmacodetoGTINincommunitypharmacy

• ImplementGTINintherapeuticproductregulations• Supportinternationaluniquedeviceidentifier(UDI)standardisation• InterfaceNationalProductCatalogueandNZULM

• CompletemovefromPharmacode toGTINincommunitypharmacy

Patienthas accessto widevarietyofhealthandwellnessproductsandcanorderthemonlineHealth providershaveefficientsupplychain,accesstoglobalhealthtechnologymarketandenhancedpatientsafetyprocesses

IntegratedhealthandsocialservicesContinuetoinvestinintegrated healthandsocialdigitalserviceslikeSmartStart andTe Hokinga āWairuaEnd ofLifeinpartnershipwithotheragencies.

• DeathDocs• Lifeeventservicesenhancements

• Codedchildhealthassessment• Codedmedicalcertificateofcauseofdeath• Maternity andchildhealthpathways

• SupportforLifeEventsAPIs Patienthasconvenientaccesstojoined-updigitalhealthandsocialservicesHealthproviderscanshareconsentedinformationwithotheragenciestoprovide seamlesspublicservices

CorestandardsandcommoncapabilitiesImplementfoundational dataandAPIstandardsandnationaldigitalservices.

• SNOMEDmanagedservice• FHIRprofilesforcoreresources• FHIRregistry• Onlinestandardsresourcecentre

• Conformancetest, certificationandadoptionframework• Nationalsystemsallusestandardcodesets• SNOMEDterminologyservices• ImplementNZBN

• Recordlocator service• Commonidentity,demographicandeligibilitycodesetsimplementedin allsectorsystems• EnhancedNHIandHPIwithFHIRAPIs

Patientexperiencesasmartandinterconnected healthsystemthatembracesnewtechnologyHealthprovidersandtheirindustrypartnersofferplug-and-playsolutionsonpopularplatforms