Understanding shared challenges · •Architecture, hardware and software that physically enables...

Understanding shared challenges

For Health Information Exchange across the States

Proteus Duxbury

10th September 2010

© PA Knowledge Limited 2009. PPT US presentation template V2-0.ppt

We are a leading technology, systems, and management consulting firm

Employs 2600 experienced people in over 25 countries

65 years of corporate experience

Annual revenue in excess of $700m

Provides consultancy support to successful, multi-national organisations

Delivers long-term, sustainable benefits

From ‘Insight to Implementation’

Consistent venture success

At PA Consulting Group, we deliver a visible difference by helping transform the performance of organizations.

Clients call on us when they want:

- An innovative solution: leading edge thinking and groundbreaking solutions

- A highly responsive approach: we listen, and then we act decisively and quickly

- Delivery of hard results: we get the job done, often trouble-shooting where previous initiatives have failed. Complex programme

delivery

Strategic

management

Innovation &

technology

Operational

improvement

Information

technology

People &

organisational

change

Equipped to deliver any kind of business transforma tion


PA is a leading contributor to the eHealth revolution

Integrated Asset Management System – A one stop shop portal for managing engineering assets including hydrants, extensions, plans and taps. Implemented using ASP.NET and SQL Server

Infostream Intranet – Internal company wide Intranet. Deployed using MS Sharepoint and includes employee directory

Systems Integration - Built a service oriented framework using BizTalk Server to integrate field operation systems with customer billing systems. This resulted in significant efficiency gains and cost reduction.

Workflow Automation – Implemented a solution using WWF to automate back office manual processes. The improvements resulted in 50% cost reduction in non-value adding tasks.

Technical assurance

Challenging project delivery

eHealth strategy

eProcurement

● Existing system compliance

● NHS spine Assurance team

● Electronic transmission of prescriptions

● Picture archiving and communications

● Record transfer Integration and Test Lead

● Assistive Technology Programme

● Auto ID Procurement

● Electronic transfer of prescriptions

● Data Standards Review

● Summary Care Record

● Bowel Cancer Screening Programme

● Clinicians Portal

● HealthSpace

● Clinical Spine Application

● General Practice Administration System

● e-Health Strategy for the State of Qatar

● Bed Strategy, Republic of Ireland

● Strategy Dubai Health Authority

● eProcurement strategy,Republic of Ireland

● eProcurement benefit assessment, Germany


• We met with leads from a diverse set of states including New York, Pennsylvania, Florida, Alabama, Nevada and Michigan

• States started from different points

• On the whole good progress is being made

• Most states cited similar challenges across the five domains defined by ONC


• Creating trust and consensus with stakeholders, and providing oversight and accountability

• Key challenge - ensuring the right level of engagement with stakeholders. In particular patient advocacy groups

• UK tells us that effective engagement of patient organizations and representatives is critical

• Avoid using one group as a proxy for another

• Active involvement of patient advocacy groups important for developing a trusted approach to consent and data sharing

• One state specializes in survey development, and uses this as a means to understand the consumer view

• Others engaging with organizations such as AARP and organizations like Patient Privacy Rights (Dr. Catherine Peel)

Governance


• Identification and management of necessary financial resources

• Sustainability is critical and was the #1 one program challenge cited by all states

• Stimulus funding from ONC is one-time only – models needed that include: who will fund HIE, what their individual incentives are, and a mechanism for apportioning cost between them

• Several states have issued RFPs to assist with the creation of models

• A utility service approach (pay per click) – but this can create barriers to adoption

• Tax on payers has been investigated – surcharge on transactions and a 0.1 cent claims tax

• Participation and investment from stakeholders in the development of HIE infrastructure

• States reporting that engaging the larger providers / payers is an ongoing challenge

• Approach needed that focuses on benefit and value to these groups for example the OneHealthPort PPP in Washington State ( http://www.onehealthport.com )

The governance domain focuses on creatingtrust and consensus with stakeholders, as well

as providing oversight and accountability.

GovernanceFinance


• Architecture, hardware and software that physically enables the technical services

• HIE must integrate successfully with local EHR/EMR solutions – complex task

• Ensuring balanced progress of both local solutions and overall architecture is essential

• Multiple interfaces into individual providers will be expensive across a region

• Regional Extension Centers (RECs) will drive successful adoption and a consistent approach to EHR product selection and architecture development

• States also performing HIT and connectivity assessments for providers

• States should exploit existing solutions and Regional Health Information Organizations (RHIOs)

• Integrating existing IT using trusted platforms for interchange can reduce the costs and complexity of adoption while accelerating time-to-benefit delivery

Technical Infrastructure


• Identifying requirements, process design, project management, program evaluation and reporting

• Overcoming the people change implications of implementing HIE was key challenge cited

• View as a business change challenge not a technology one

• Identify change agents early

• Some states performing change readiness assessments

• Some are working with clinician associations to explain meaningfull use etc

• RECs can help to drive change

• Reporting mechanisms and metrics not fully thought out

• Some using ONC metrics to build on others funding academia to assist

• Central storage of data by a trusted organization is critical to measure outcomes

Business and technical operations


• legal / policy barriers and enablers, policy frameworks, privacy, data sharing agreements and laws

• Secure, central repository for secondary use is critical

• Mass will build a system based on a federated model, but may store data in a centralized repository when absolutely necessary to support specific uses

• Patient consent a big area of concern

• Engaging and educating patient groups is critical to iron these issues out

• UK experience suggests that there are important limits on ‘opt-in’ solutions

• Effective policing requires a strong central infrastructure to facilitate audit

Legal/policy


Thanks you for your time

For more information, contact:

Proteus DuxburyManaging Consultant100 Overlook Center 2nd FloorPrincetonNew Jersey08540Cell: 610 772 0124E-mail: [email protected]

Ghost (signpost) – current chapter title...

Understanding shared challenges · •Architecture, hardware and software that physically enables...

Documents

Transcript of Understanding shared challenges · •Architecture, hardware and software that physically enables...