ehealth kate gunn balance healthcare
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TRANSCRIPT
GP Super Clinics – Using IT to Address Chronic Disease in Primary
Healthcare
May 2010
Agenda
• What is a GP Super Clinic?• Who is Balance! Healthcare?• The IT challenge• Fixing standards for EHRS in new
communities• Engaging Key Stakeholders• Privacy Risks• Measuring Outcomes
Background
A key element of the Reform Plan, $275 million over 4 years to establish GP Super Clinics in 36 locations across Australia. Another 23 GP Super Clinics announced in the 2010 budget.
The GP Super Clinic• Different processes are used to select the organisation
that will operate the GP Super Clinic, depending on the situation at each of the 36 locations. These include:
– A Commonwealth led Invitation to Apply process, following local consultations. Where appropriate, the Invitation to Apply will detail the contribution being made by the State or Territory Government in that locality;
– A process administered jointly by the Commonwealth and the relevant State or Territory Government; or
– A directly funded process where the recipient has already been identified.
• $5 million funding for the Blue Mountains and Cairns GP Super Clinics was decided through an Invitation to Apply Process.
Balance! Healthcare• Private organisation• Strong Board• Experienced Management• Hub & Spoke Model• Out of Area GPs• Local GPs• Local Nurses• Local Allied Health• Local Specialists• Property Experience
Specialist Centre, Katoomba
Medical Practice Spokes
Allied Health Spokes
GP Super Clinic Hub, Springwood
Future shared service spoke
All sites will be networked through an independent secure wide area network.
Cairns GP Super Clinic
= Medical and Allied Health Services
= Allied Health Services
= Community Health Programs
= Cairns Suburbs
Education
• Partnership with UNSW/JCU• Research partnership with UNSW• ARC and NHMRC grants• Registrar Training Practice• Place medical students – UNSW, UWS, USYD,
JCU• Place nursing students – UWS/JCU• Place allied health students
Work Force
• Increasing GP numbers• Recruiting GPs who embrace our
philosophy and approach• Overseas trained GPs• Registrars/medical students: increase in
the total number of training practices and training places for the Blue Mountains and Cairns
• Committed to increasing the nursing, allied health and specialists numbers
Work Force• General Practitioners• Nurses• Physiotherapy• Exercise Physiology• Occupational Therapy• Speech Pathology• Osteopathy• Chiropractic• Psychology• Counselling
• Pathology• Radiology• Pharmacy• Dietician• Podiatry• Audiology• Gynecologist• Obstetrician• Pediatrician• Other Specialists
What we offer• Well integrated multidisciplinary patient centred care• Responsive to local community needs and priorities including
Aboriginal & Torres Strait Islander people• Accessible, culturally appropriate and affordable care• Support for preventive care• Working environment and conditions which attract and retain
the workforce• High quality best practice evidence based care• Operate with viable, sustainable and efficient business
models• Support the future primary care workforce• Integrate with local programs and initiatives• Efficient and effective use of information technology
Benefits - shared e-health record
• Patient does not have to repeat story• Practitioners do not need to repeat
tests• Holistic clinical view of the patient• Increased efficiency and productivity
Balance! Healthcare
Where did we start?
• Install servers• Pilot location
– Connect pathology, x-ray, EDS, secure messaging
• Write privacy project brief• Modify our software• Roll out “spokes” within the GP Super Clinic• Connect to other providers and the
community
What did we learn
• Not that easy for vendors as we imagined• Got stuck on modifying the software• Many clinical software packages not
patient centred enough or focused enough on health outcomes
• Decided we need a new approach• Be more self reliant• Start again!
Where do we go now?• Servers installed• Select new clinical software (no modifications)• Defined privacy project brief – look for basic
functionality in clinical software• Focus on chronic disease indicators• Focus on new business model requirements• Pilot locations• Roll out “spokes” within the GP Super Clinic• Connect to other providers and the community
Fixing Standards for EHRS
Fixing Standards for EHRS
Data Repository/ExchangeAdopting an incremental and distributed approach allows different care provider networks to progress towards the establishment of IEHR repositories at different rates based on the extent to which infrastructure foundations and key information flows are in place. Distributed repositories will most likely be developed across geographic regions by large care provider organisations and care provider networks.
The key challenge associated with a distributed IEHR strategy is ensuring that the health information contained in these repositories is consistently secure, private and accurate and can be found, shared, transferred and reported on across multiple national repositories. Accordingly all IEHR repositories must be based on consistent national data standards and fully comply with data protection legislative requirements.
National E-Health Strategic Summary, Dec 2008
e-health information standards• Unique Health Identifier (UHI) – 2011• PKI for providers and locations• Messaging – full web services• HL7• SNOMED• Providers Directories• Data Exchanges
Engaging Key Stakeholders
• CHIP– Centre for Health Innovation Partnerships
• CHIC– Connecting Healthcare in Communities
• Wuchoppern
Engaging Key Stakeholders• Cairns - Local Workshop
– Division of GPs– Area Health Service
• Working Groups• Pilot
– Avoidable Admissions Project
Engaging Key Stakeholders
• Local Solutions– Practice Software– Messaging Communities
• Regional Solutions– Data Repositories
• Regional/National Solutions– Data Exchange
Privacy Risks
• Looked at many examples• Best cases – allow the patient to be
in control• Health vs Banking• Practitioner communicates with
patient• Opt out not opt in
Measuring Outcomes
• IT must support clinical indicators• Baseline important• Improvement over time• Research projects
Thank you
