Stuart MacKinnon Analysis One Ltd (Wednesday, Interoperability Workshop)

1. HEALTH INFORMATION EXCHANGE
Trial Implementation Options
Stuart MacKinnon
Analysis One Limited

2. Acknowledgements
• Ministry of Health
• healthAlliance
• Aseem Agarwal
• Michael Tapp

3. Why ‘Health Information Exchange’?
Why Not an
• ‘R-CDR’ using
• ‘IHE XDS.b’,
• ‘CDA’ and
• ‘OpenEHR’?

4. HIE - Working Definition
• A united collection of a number of individual CDRs.
• Each CDR is a single database storing some particular
kind of health information - e.g. lab results or medications
lists or care plans - while the Health Information
Exchange is a virtual database, which has the purpose of
providing an index to the overall content of its component
CDRs, via a registry.

5. But this is what we are talking about

6. RISP 10-20 (2009)

7. eHealth Vision
To achieve high-quality healthcare and improve patient
safety, by 2014 New Zealanders will have a core set of
personal health information available electronically to them
and their treatment providers regardless of the setting as
they access health services.
National Health IT Plan, 2010 (p.5)

8. HISO 10040 - CDR Utility Services
Health Information Exchange
Virtual Repository Registry
Patient ABC1234
1. eDischarge, Middlemore
Hospital, 23/6/12
2. Care Plan, CMDHB Home
Health Care, 24/6/12
3. Health Status Summary,
2 South Health IFHC, 15/7/12
1 3
4
Document
Document
Consumer
Publisher

9. HISO 10040 - Structured Documents

10. HISO 10040 - Content Model
Generic CDA Structure OpenEHR Archetype
<ClinicalDocument>
for Blood Pressure
... CDA Header ...
<structuredBody>
<section>
<text>...</text>
<observation>...</observation>
<substanceAdministration>
<supply>...</supply>
</substanceAdministration>
<observation>
</observation>
</section>
<section>
<section>...</section>
</section>
</structuredBody>
</ClinicalDocument>
OpenEHR Archetypes can be used to standardise the content of the CDA-structured documents.

11. HISO 10040 Benefits
• Supports a core electronic
health record
• Supports information being
Clinical Benefits available wherever the patient
is
• Supports integrated care
• Reduced interfacing costs
Technical • Incorporates multiple data
sources
Benefits • Platform for data sharing
across regions
HISO • Defines Information Transport
Interoperability • Defines Information Structure
• Defines Information Content
Standards

12. The Big Picture

13. A Core Set of Personal Health Information

14. Trial Implementation Success Criteria
• Align with one or more DHB-funded projects in the region
• Demonstrate something new and important for the sector
• Demonstrate key features of the HISO interoperability
standards
• Have potential to engage successfully with health system
vendors
• Provide a model for national HIE adoption

15. Sharing InterRAI Assessments

16. Sharing Discharge Summaries

17. Sharing Primary Care Summaries

18. Options Compared (For Arguments Sake)
Share Primary Care Summaries
with After Hours and Emergency
Health Services
Potential Difficulty
Share Hospital Discharge
Summaries with After Hours and
Emergency Health Services
Share InterRAI Reports
with Community
Pharmacists
Potential Value

19. Privacy

20. Next Steps
• MoH and healthAlliance to provide feedback on options
• Select Trial Implementation option(s)
• Confirm funding
• Develop project plan(s)

21. Questions/Comments?