health it priorities - global health care · • the app assessment process has been developed by a...

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Hosted by Tim KelseyTelstra Health, Australia

Moderated by Julie SchneiderUS Department of Health and Human Services

Health IT Priorities















Kasi McMickingPublic Health Agency of Canada

Indi SinghNational Health Service (England)

Nir KaidarIsrael Ministry of Health

Gayatri JayaramanCentre for Chronic Disease Prevention (Canada)

Paul MaddenAustralian Ministry of Health

Panelists

Beverly BryantNational Health Service (England)

Helen Caton-PetersOffice of the National Coordinator (US)















SESSION GOALS• Share information about a variety of exciting Health

IT initiatives in Australia, the United Kingdom, Israel and Canada

• Identify opportunities to share lessons learned, success stories and case studies

• Identify potential opportunities for collaboration















PRESENTATIONS• My Health Record – Paul Madden, Department of Health,

Australia• Digital Health Tool Assessment – Helen Caton-Peters, HHS and

Beverly Bryant, National Health Service (NHS), England• Interoperability – Indi Singh, NHS England• Digital Health and the Challenge of the Aging Population in

Israel – Nir Kaidar, Ministry of Health, Israel• Advancing Healthy Weights – Kasi McMicking and Gayatri

Jayaraman, Public Health Agency of Canada

My Health Record May 2016

Paul MaddenDeputy Secretary/Special AdviserStrategic Health Systems and Information Management

Individuals managing and sharing their health information electronically will lead to:

•Increased availability and quality of health information

•Less occurrences of adverse medication events•Decreases in the number of duplicated tests•Better coordination and quality of healthcare

Ultimately, better health outcomes for Australians.

•

My Health Record Why are we doing this?

• Implemented as the Personally Controlled eHealth Record – July 2012

• As an opt‐in system• Slow individual take‐up• Low healthcare provider uptake• Long term return on investment• Review late 2013• Suggestions on accelerating real benefits

including opt‐out• Governance

My Health Record ‐

Background

A new direction for digital health records in Australia:

•Rename as My Health Record•Improve usability and continued operations •Trial opt-out arrangements•Legislation to support opt-out arrangements and strengthened privacy •Targeted GP and other provider education and training•Revised GP Incentives for use of the system•A single agency accountable for national digital health services

•

My Health Record ‐

forward programme

•Opening the platform for mobile access •Open innovation•Trials of chronic disease management coordination •Secondary data usage

•

My Health Record Linked Policies

International Health IT Policy PrioritiesDigital Health Tool Assessment

Helen Caton‐Peters, MSN, RN, Office of the National Coordinator, HHSLinda M. Harris, PhD, Office of Disease Prevention and Health Promotion, HHS

HHS Education & Guidance for Developers of Mobile Health Apps

• Explain regulatory environment

• Tools for developers

Mobile Health Apps Interactive Tool

11

https://www.ftc.gov/tips‐advice/business‐center/guidance/mobile‐health‐apps‐interactive‐tool

https://www.ftc.gov/tips-advice/business-center/guidance/mobile-health-apps-interactive-tool



Health Literacy Online: A Guide for Simplifying the User Experience

• Synthesizes lessons learned from HHS’s original research with

more than 700 web users with limited literacy skills

• Incorporates best practices from the literature on cognitive

processing and the online behavior of adults with limited

literacy skills

• Builds and expands on principles of web usability described in

the Research‐Based Web Design and Usability Guidelines

•Health Literacy Online ‐

health.gov

12http://health.gov/healthliteracyonline/

http://health.gov/healthliteracyonline/

UK National Information Board app assessment process

• The app assessment process has been developed by a

cross organisation delivery team led by PHE and NICE.

• The app assessment process will be designed to identify

and promote the best apps for a specific disease or

condition.

• The assessment process will not be a regulatory process

and will not provide nor take away permission to market

apps to patients or the NHS.

• The assessment process will set a benchmark for quality.

Developers will be able to improve their product as they

follow the guidance which underpins the assessment

process

• The assessment process will support the objectives of the

Accelerated Access Review as it relates to the adoption of

digital health products.

Providing citizens with access to an assessed set of NHS and social care ‘apps’

Stage One: Self‐assessment questionnaireTo identify those apps that meet the minimum

required standards. Online self assessment which

will follow a structured set of questions organised

against key quality dimensions.

Stage Two: Community validationDesigned to use the wisdom of an engaged

community of professionals, commissioners and

end users to evaluate and support the better apps

emerging from self assessment. Apps will be

promoted after this stage.

Stage Three: App providers undertake evidence based

gathering exercise to identify value of their app to

patients and health services.

Stage Four: Independent assessmentFor a subset of the apps, NICE will undertake an

independent evaluation of the evidence in line

with stakeholder needs especially payers.

App assessment process

Outcome of Collaboration: Incorporation of HHS Usability Research

Stage One: Self‐assessment questionnaire

Comparing self assessment questions against HLO usability criteria in areas such as:

•How the app provides for persons of limited cognitive or sensory

skills, low health

literacy levels and other disability considerations

•Provision of written interaction design documentation

•Inclusion of visual design stage, involving feedback from final end users, to ensure the

App is aesthetically pleasing and follows good practice

•Provision of usability evaluation exercise involving real end users with the findings

having been incorporated into the App design

Stage Two: Community validation

Considering the inclusion of HLO criteria into the community validation stages of the

app assessment process as appropriate.

14

@ONC_HealthIT @HHSONC

Contact Details

Helen Caton‐Peters (Helen.Caton‐[email protected])

Linda Harris ([email protected])

Diarmaid Crean ([email protected])

Alexia Tonnel ([email protected])

mailto:[email protected]




Interoperability- UK perspectiveIndi SinghHead of Enterprise Architecture, NHS England

The development of an open environment for information sharing supporting emerging models of care based on open interfaces and open standards.

No v

20 15

March

‘16

National

Information

Board

Interoperabilit

y Strategy

published

Over 95% of

hospitals using

NHS Number in

clinical

correspondence

Launch

Interoperability

Community

bringing together

localities,

vendors and

national

organisations

Over 70% of

hospitals sharing

discharges

electronically

Use of

FHIR APIs

for

workflow

and

accessing

record

starts

Discharges

shared using

professionally

endorsed clinical

structure

Key APIs Transfers of CarePrimary IdentifierFocus on key priorities

Change the dynamic

Nov‘15

Jan‘15

Nov‘14

Sept‘16

Dec‘16

AppointmentsManage appointments in

order to co-ordinate access to care

Access RecordAccess a patient’s care record for the purpose of direct care

Tasks Manage tasks in order to work effectively across care settings

eDischargeDischarges from inpatient care back to the general

practitioner

A&E eDischargeInformation sent to the

general practitioner from an A&E attendance

Emerging needs

Data group Argonaut Cerner Epic UK

Patient

Encounter

Allergies *

Medications *

Diagnosis *

Problem

Observation

Family History

Diagnostic Report

Immunisation

Procedure

Vital Signs*

Smoking Status*

Care team

Care plan

Device

Document reference

End of life

Key flags

Creating a common and open set of APIs to support information sharing across health and care

Defining the key clinical information sharing needs.

Prioritising the key APIs.

Group members e.g. CCIOs, CIOs, Vanguard, Pioneers, PMCFs, NHS England.

Outlining the accreditation approach for APIs.

Group members e.g. TechUK, CIOs, suppliers, HSCIC.

Defining the key underpinning components and policies, e.g. security and authentication.

Group members e.g. HSCIC, suppliers, CIOs, TechUK, NHS England.

Establishing and creating the required APIs based on clinical information sharing needs.

Group members e.g. suppliers, innovators, CCIOs, CIOs, NHS England, HSCIC.

Made up of the above organisations, the Project Boardis responsible for the assurance and governance process.

Links to existing communities and

signposts tools and products.

DIGITAL HEALTHAND

THE CHALLENGE OF AGING POPULATIONIN

ISRAEL

NIR KAIDARSENIOR DEPUTY DIRECTOR GENERAL FOR STRATEGIC AND ECONOMIC [email protected]

Males life expectancyat birth ‐

2013

Infant mortality rate

2013

Health

expenditure

% of GDP ‐

2013

OECD Health

Care Quality

Reviews of

Israel, 2012,

states:“Israel has

established

one of the

most enviable

healthcare

systems

among OECD

countries”

THE ISRAELI HEALTH SYSTEM

100% insured

with wide

public

insurance

80% purchase

supplementary

insurance

Health disparitiesLong waiting times for

surgeries

Rapid growth in population

and aging

challenges

ISRAEL OECD

AGING IN ISRAEL

CASE STUDIES IN A NUTSHELL

Health IT Policy Priorities

Advancing Healthy Weights

Health Datapalooza, May 2016

Setting the Context

1.

Healthy Living as a Policy Priority

2.

Ecology of Innovation: Behaviours and Environments Dashboard

3.

Innovation Case Study -

BikeMaps & Food Purchasing

29

Healthy Weights as a Policy Priority

30

The Canadian Context and Agency Mandate

31

1974 Now

Data Innovation Priorities

The Challenge:

•“Traditional” health administrative data challenges‐ declining survey response rates, timeliness challenges, missing behavioural risk factors and negative health tracking limitations

Improving Health Outcomes: A Paradigm Shift

Our Priorities for Evidence Generation: Leverage the use existing data and nontraditional data sources to assess modifiable risk and protective factors;Improving timely access to data through publicfacing platforms; Experimenting with data visualization and interactive techniques;Identifying alternate and innovative ways to collect, integrate and disseminate information.

32

Indicators Dashboard

33

The BikeMaps Project – Crowdsourcing data collection

34

Acknowledgement: W. Vanlaar, Traffic Injury Research Foundation

• Types of data accessible

– Representative, store‐

based purchasing

– Household, longitudinal,

loyalty card based

• Public Health uses

– Estimate healthiness of

food environment at the

neighborhood scale

– Understand impact of

interventions

3. Nutrition data linked

1. Food scanned in store

4. Healthiness metrics calculated

2. Scanner data aggregatedFood Purchasing Data – Use of Loyalty Cards

Acknowledgement: D. Buckeridge, McGill University

Data Innovation Priorities Some Final Observations

Continued IT and Innovation Priorities:

•Utilize new public health surveillance methods and complementary non‐traditional data sources:

– Syndromic surveillance – Geospatial data– Social media data (data streams from Instagram, Twitter, Facebook, etc.)– Fitness technologies (Smartphones, Wearables)

•New tools, channels and partnerships‐ timely data in/out, innovative IT platforms, emerging dissemination channels

• Utilisation and Exploration of Data Challenge Concepts

36

Questions:

Dr. Gaya JayaramanGayatri.Jayaraman@phacaspc.gc.ca

@JayaramanGaya

Kasi McMicking Kasi.Mcmicking.@phacaspc.gc.ca

@healthdatadiva

For More Info: www.phacaspc.gc.ca

www.phacaspc.gc.ca/fofc/loi2015eng.phpwww.bikemaps.org

37



http://www.phac-aspc.gc.ca/

http://www.phac-aspc.gc.ca/fo-fc/loi-2015-eng.php

http://www.bikemaps.org/

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