Orion Health Slide Deck template · Taken from The Innovators Prescription, Clayton M Christensen...

Integrating the Patient into the Care Delivery Team Moving from passive recipient to being co-responsible for their health

Orion Health

David Hancock – Solution Director, UK, Europe and Middle East

The Need to be More Patient-Centric

Integrating the Patient into the Care Delivery Team

• Copyright © 2013 Orion Health™ group of companies • All rights reserved

Driving change in Healthcare Delivery in Turkey

Non Communicable

Disease

Patient Experience

Hospital Investment

• c70% of all mortality is caused by NCDs1

• Type 2 diabetes has doubled in little more than a decade2

• Obesity levels are increasing3

1. MoH and Baskent Univ 2004 2. TURDEP (Turkish Diabetes Epidemiology Studies 1997-98 and 2010) 3. Various (including the above)

• More than 95,000 new hospital beds are required by 2023

• Massive MoH Investment Programme including large PPP initiative

• High Expectations of Service

• Massive Internet Penetration

• False Boundaries in Healthcare (as in rest of world)


Supporting information following the patient - Typical Diabetic Patient’s Journey

Diabetes

Patient

HbA1c Check-Up and

Take Blood Sample

Create Plan for

Managing Lipids, BP.

Prescribe Drugs

Appointment, suspect

kidney failure Consultation

Review

Eye Check

Review &

Treatment

Review &

Treatment

Prescribe Drugs

GFR, Serum

Albumen,

HbA1c etc Review &

Treatment

Review &

Treatment

Ulcer Evaluation

Hypoglycemic

Event ( In Coma) Review

Lab Tester ER Doctor

Hosp 1

GP Primary

Care Nurse

Primary Care Org

1

Endocrinologist

Hosp 2 Hosp 2

Home

Health

Nurse

Community

Health 1

Psycho

logist

Provider 5

Nephrol

-ogist

Hosp 4

Opthalmol

-ogist

Hosp 3

Podiatrist

Hosp 3

Lab

Tester

Hosp 4

Review Consultation,

Prescribe Drugs Evaluation,

Revasculation and

Wound Mgt Review. Presentation of

Ulcer

Treatment in Hospital

CBT for Depression

CBT for Depression

CBT for Depression


Managing Long Term Conditions – Supporting Behavioral Change

Minimal Extensive Degree to which behaviour change is required

Mo

tiva

tion

to a

dh

ere

to b

est-k

no

wn

the

rap

y

WEAK Consequences are Delayed

STRONG Consequences are Immediate

Obesity

Type II Diabetes

Congestive Heart

Failure

COPD

Schizophrenia

Addictions

Coronary Artery

Disease

Cystic Fibrosis

Parkinson’s

Chronic Hepatitis

B

Hyperlipidemia

Hypertension

Diseases with Immediate Consequences

Diseases with Delayed Consequences

Be

ha

vio

ur D

ep

en

de

nt D

isea

ses

Tec

hn

olo

gy D

ep

en

de

nt D

isea

ses

Depression

Chronic Back Pain

Epilepsy

Multiple Sclerosis

Allergies

Psoriasis Crohn’s Disease

Sickle Cell Anemia

Type I Diabetes

Taken from The Innovators Prescription, Clayton M Christensen

40 percent of deaths are caused (in US) by modifiable behaviors, such as poor

nutrition, physical inactivity, and tobacco.

A Path to Healthcare Co-Responsibility between Patient and Care Delivery Team

HIMSS Continuity of Care Model


The Path to Healthcare Co-Responsibility

HIMSS Maturity Level Healthcare Capability Patient Centricity

7 Knowledge-Driven Engagement, Multi-vendor, Interconnected Healthcare Delivery Model

Multiple Care pathways using personalised clinical evidence (past patient performance, genomics etc.) Patient making informed decisions

Patient as Colleague

6 Closed Loop Care Coordination Multiple pathways mgmt with consistent, contextual use of best clinical evidence, integration to home devices and healthcare apps

Patient as Helper

5 Community Wide Patient Record, Patient Engagement Focus

Multiple condition pathway coordination, with patient as an actor – often in administrative processes

Patient as Consumer

4 Care Coordination w/ Actionable Data, Semantic Interoperable Care Record

Basic task coordination, rule-based alerts, single best view of patient record, structured

Patient Centric Care Pathway

3 Normalized Patient Record, Shared Care Plan, Structural Interoperability

Single best view of patient record, structured data

Structured Patient Centric Record

2 Patient Centred Clinical Data, System-to-System

XDS-style, federated exchange: document centric

Patient Folder

1 Basic Peer-to-Peer Data Exchange Basic interoperability between systems None

0 Limited/no e-Communication

Sustainable Foundations

Planning and Implementing for Success


Building a Business Case through a Platform

Don’t create more islands of information

Find Economies of Scale in utilising your investment

Focus on Admininstrative areas as well as Clinical

Drive Innovation in Applications


Clinical

Applications

Patient

Portal

Extensions

Clinician View

Appoint

ments

Messages Chart Health

Library

CDR

Authentication

Healthcare

Platform

Healthcare

Service Bus

SQL Server/

Oracle

SDK • Filter

• Comm

Points Data Connectors

HL7 v2, v3

IHE, NCPDP

X12, XML

HIPAA, SMTP

Web Services

Etc.

Devices Web Services

Identity and Relationships Auditing Security, Privacy

and Consent

RESTful APIs RESTful APIs

External

System

Technical interfaces and external systems

Key

Web Apps Web Apps Mobile

Clinicians

(Circle of Care)

Patients and

Caregivers

Shared

Files

Circle of

Care

Allergies

Problems

Diagnoses

Procedures

Immunizations

Encounters

Maternity

Medications

Lab, Rad

Documents

Patient View


NSW Health, electronic Blue Book, Australia

• Solution:

– A platform for new applications and services

– Electronic Blue Book for mothers and new-borns through a secure web portal + native iPhone and Android applications

• Implementation by an independent third party developer:

– Orion Health’s role was to provide the secure web portal views to the well-child record, designed to be managed and updated by the parents of new born children through to the age of five.

– The customer involved an independent organization with extensive iOS and Android development experience.


Summary

• We need to deliver Patient-Centric care Records that span the patient journey

• Vast majority of care is actually self care, we have to support change in Patient Behaviour and Patient Co-Responsibility

• The HIMSS Continuity of Care Model provides a framework to move towards Patient Co-Responsibility

– Patient as Consumer Patient as Colleague

• Successful Projects focus on overall business case

• Support Best of Breed devices and Apps on a standards based infrastructure


Q U E S T I O N S A N S W E R S

Orion Health Slide Deck template · Taken from The Innovators Prescription, Clayton M Christensen...

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