Towards integrated care in Belgium · Missing link : The Value of Medical Data (1/2) y. page 11...

Towards integrated care in Belgium

Opportunities and challenges

“We need a comprehensive, integrated approach to service

delivery. We need to fight fragmentation.” WHO Director-General, 2007

Prof.R Van de Velde

Functions

Lab results &

Medical Images

History ->SumEHR

Medication (Recipe)

Online advce & guidelines

Letters Referrals

Electronic Prescriptions

(TTS)

eHBox

Transaction

Consent

Therap-Link

Hospital A

EMR

HC Actor

5 Hubs 98% hospitals have signed the 2012 protocol

Population 1O million

5 Factors to maximize the results obtained with integrated Care

• Connected Patients

• Connected HC practice

• Connected Analytics

• Workflow & CDSS

1. Connected Patients

• Integrated care achieves best results when patients take responsibility for their own care

20/04/2015

4 Questions Every Patient Should Ask

1. Can I Have my results?

2. What are my options?

3. What Next?

4. What does this mean?

R. Van de Velde

Medical Data

Should be

represented

Human Friendly

Challenge : The User Interface

Medical Data Should be Human Friendly

2. Connected Clinical Practice

• Communicate electronically & secure with collaegues (eHBox)

• Easy access/ update clinical data by different HC organisations (Hub/MetaHUB)

• Order requests (TTS)

• Security issues: Therapeutic relation

• IT infrastrucure “ Registry”

20/04/2015

Market Fragmentation

20/04/2015 Common vision Himms Level

1. Siemens 2. Chipsoft 3. Mims 4. Experthis 5. InfoHos 6. Cerner 7. NexUzHealth 8. Cegeka 9. Epic 10.In house

Time 20/04/2015

Technical Interoperability Actual Situation: exchange information

Challenge : Real Data Usability

Missing link : The Value of Medical Data (1/2) In

tegra

tion level &

Reusability

Aggregating is Just the First Step

Clinical Systems

Ambulatory EMRs

In-Patient EMRs

ADT System

HIS, LIS, RIS…

Pharmacies

…..just couriers, bringing our records from one doctor to another without understanding what’s in them…..

Time

Inte

gra

tion level &

Reusability

20/04/2015

Future:

Ability to exchange information

and to use information

that has been exchanged.

Missing link : The Value of Medical Data (2/2)

Technical Interoperability Actual Situation: exchange information

TSUNAMI FORECAST: Big data ahead in healthcare

• Lots of:

• data going on-line

• genetic data coming

• personal data

Challenge :More Data Doesn't Always Mean Better Care

• Capture and analyze care data and use this to identify needs for improvement in clinical care protocols and clinical outcomes across the organization

• Generating data to assess and compare performance that ensure transparency in system performance and help drive quality improvements

• Public health agencies use system-wide clinical data for population health reporting, allowing them to carry out analysis to monitor

• trends and manage disease in the population

We look forward to a future in which health information systems help physicians learn from every patient at every visit and close the feedback loop for clinical decision making in real time

3. Connected to Analytics …

Challenge : The secondary use of Data

Develop improved practice Deploy improved practice

RETROSPECTIVE Real Time

Information

Knowledge Data

Analytial Systems

Population Level

Analytical models Ad hoc query tools Q-improvement

Home Point –of care

Systems

Patient Level

Clinical observations, assessment, plan Orders Reminders

DATA WAREHOUSES TRANSACTION SYSTEMS MEDICAL DATA

Improve

Practice

Analytical systems are essential for integration & transformatiom

Hospital

Home Care

GP

• Profesional IT team • Security aware • Uptime & continuity

• Moderate security • No guaranteed

uptime

• Part of an organistion • It independant nurse support

PATHWAYS: Crossing Boundaries

16 When … Merging CP’s

4. From workflow to shared careflow

20/04/2015

Closing the loop by mining careflows

• Workflow Management (WFM) widely applied in administrative processes but not in healthcare. • Increasingly, clinical decisions need to be based on scientific evidence, social-ethical values and economic factors. • Evidence-based care requires transparency, justification, and accountability. • Careflow processes need to be supported, controlled, and monitored.

Collect, distribute,

share Information

Think, decide Reason

Plan, schedule,

act, collaborate

QUALITY

ACCESS

COST

Framework for Continuity of Care

CDSS, EMR & clinical workflow systems individually not adequate to facilitate quality

Challenge : No CP without Workflow

5. Barriers hindering ….

• Funding – Current investment capacity too limited

• Legislation : Lack of appropriate reimbursement

• eHealth programs are major transformations and require engagement and support by all. Workforce shortages - Limited time in clinic

• Governance is critical – government must walk a fine line between control and delegation.

• Important to address privacy and consent issues early with broad input.

• Do not underestimate the importance of change management. Education and training cannot be overemphasized to align human factors for success.

• Adopt data exchange standards early in the program to ensure interoperability & integrate mHealth.

We need systems that are …

• Dynamic : status of tasks

• Personalized: for patients

• Understandable: user friendly

• Holistic: show us all data

Towards integrated care in Belgium · Missing link : The Value of Medical Data (1/2) y. page 11...

Documents

Transcript of Towards integrated care in Belgium · Missing link : The Value of Medical Data (1/2) y. page 11...