Gordon Inkson HealthLink (Friday, 11.00, General 2) Online forms have the potential to greatly improve the consistency, reliability and usefulness of information exchanged in the health sector. However, the success of these forms is dependent on uptake by clinicians. So, for clinicians, there must be compelling reasons to choose the online form over any alternatives. In short, using the online form has to be both easier and more effective than not using it. The CareConnect project was faced with precisely this challenge when making online eReferrals available to over 300 General Practitioners across three of New Zealand’s largest District Health Boards. The challenge was met by vendors collaborating together to implement the solution using the Health Information Standards Organisation (HISO) Standard 10014.2 for online forms.

1. CareConnect:
Implementation of a
Standards-based Solution
by Gordon Inkson
(Solution Architect: HealthLink)
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2. The Standards Proposition
(What to take away from this session)
STANDARDS are great for facilitating
generic, extensible, re-usable
integration in a multi-system
solution …
… BUT that success is dependent on
adoption and uptake …
… AND standards are a means to an
ends – not an end in themselves …
… SO pragmatism must always trump
dogmatism
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3. My argument (in a nutshell)
 Auckland eReferrals provided a challenge and
an opportunity – successful implementation of
online forms
 Open Health Consortium’s Response?
“Implement a Standard“
 What? HISO 10014 Online Forms
 Why? Clinical Benefits
 How? Design & Implementation
 What happened? Evaluation and Lessons
Learned
 Conclusion – Standards-based Forms have
been good for Auckland eReferrals, good for
Vendors and good for the Sector (Questions at
the End)
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4. Before we start …
 “the Standard “ or “the HISO Standard“ =
HISO 10014.2 Online Forms Architecture
Technical Specification
(the full name’s a bit of a mouthful)
 Although this is a Case Study on Auckland
eReferrals the focus is on the Standard – not
the Project.
(That’s a whole other presentation – probably
two or three other presentations)
 Consider me an “Interested Observer“
 I’m new to the Health Sector and New to
the Project and New to the Standard
 Real credit rests with the pionees – Prof.
Jim Warren from HISO, Peter Sergent from
MedTech, Aswin Patel from My Practice and
HealthLink’s own Edwin Ng
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5. The Challenge
Three Very Large DHBs …
… lots of paper-forms …
… leading to obvious problems.
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6. A Proposed Solution
+
Open Health Consortoum
HISO 10014
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7. Why a Standard?
It’s all about integration …
… standards support integration
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8. Overview of HISO 10014.2
Goal of the Standard?
Overcome the problems of online forms
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9. Overview of HISO 10014.2
User Application
(EMR/PMS)
Forms Engine Forms Manager
Submission Recipient
Gateway Systems
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10. Components
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11. Process
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12. Clinical Benefits – Online Forms
Online Forms vs. Manual Forms
Form Characteristic Online Manual
Machine-readable

Pre-population

Consistent Forms

Up-to-date Forms

Interactive Guidance

Auditing Use

Active Reporting

Not Readily Falsifiable

Universally Available

Highly Robust Technology
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13. Clinical Benefits - Standards
But obtaining these benefits requires:
• Seamless integration of Form into
Business Process
• Data Pre-
populated
• Balance of
tight UI/
UX vs
Loosely-
coupled
Systems
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14. Design & Implementation
The Practicalities of Applying the Standard
Phase Forms Collaboration User
Components Tools Applications
Design Discussion, Documentation, Consensus-seeking
Governance Processes
Refining the Understanding of the Business Problem
Implementation Forms Implementation Guide Concept
Manager resolution
Concepts Spreadsheet Engine
Forms Engine
Vendor Validation Tool HISO Service
Submission
Gateway Vendor Testing
Vendor Assistance
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15. Evaluation
Early days ,,,
… but looking
excellent
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16. Lessons Learned
Bottom Line …
• Standards live or die by their usefulness
and widespread/universal adoption. Do
what’s needed to achieve this.
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17. What really matters
Standards will be a success for Auckland
eReferrals because …
1. Integration beats “rip-and-replace“
2. Extensibility
3. Promote Participation
4. Level playine field
5. Technology neutral
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18. Questions
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