nihi cap n opp

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Capabilities and Opportunities Prof Jim Warren Chair in Health Informatics The University of Auckland

National Institute forHealth Innovation (NIHI) – Purpose: 

National Institute for Health Innovation (NIHI) – Purpose Develop internationally competitive health technology Accelerate the uptake of technologies that improve health outcomes and reduce inequalities Improve the effectiveness and efficiency of health systems Develop the health innovation workforce Provide a forum for national and international collaboration

Our Foundation Members: 

Our Foundation Members 11 members providing $7.1M in support for the NIHI agenda Members group into several (not mutually-exclusive) types of support Established R&D relationships e.g., Phonak, Enigma Infrastructure for the Health Data Interoperability Laboratory (HDIL) e.g., Oracle, IBM Domain-specific applications e.g., Medtech, Houston Niche solution providers e.g., Telemessenger Solutions in voice services

Core Capabilities - UA: 

Core Capabilities - UA Health Informatics – multiD individuals Jim Warren, BSc in CompSci, PhD in InfoSys Martin Orr, specialist physician, Clinical Director of IT WDHB, completing doctorate in KM Karen Day, nurse, MPH, completing PhD in org change mngt Rekha Gaikwad, physician, MCompSci (Health Informatics) School of Population Health General Practice / Goodfellow Unit: Bruce Arroll, Ngaire Kerse, Tim Kenealy, et al. Clinical Trials Research Unit: Anthony Rodgers, Robyn Whittacker, Cliona Ni Mhurchu, et al. Epidemiology and Biostatistics: Rod Jackson, Susan Wells, et al. Audiology: Peter Thorne, Grant Searchfield, et al.

Core Capabilities – UA (contd.): 

Core Capabilities – UA (contd.) Also in the School of Population Health Health Systems (Paul Brown, et al.) Research methods (survey, qualitative – David Thomas, et al.) Health Promotion Pacific Health Department of Computer Science John Hosking (system architecture), John Grundy (software engineering), Clark Thomborson (security), Gill Dobbie (Database), Beryl Plimmer (HCI), John Corey (software innovation), et al. And there’s more… Social Simulation (Peter Davis), Geographic Information Systems, Business (Knowledge Management – Kenneth Husted, et al.), Embedded Systems (Zoran Salcic, et al.) The Bioengineering Institute And the rest of the Faculty of Medical & Health Sciences

Candidate Priorities: 

Candidate Priorities Achieving medication concordance Nutrition: how to reduce obesity? Improving the use of existing data collections Improving the quality of data collections (and usability of systems) Reduction of admissions/re-admissions while achieving better outcomes Learning from existing data; targeted patient education; understanding admission patterns from residential care Addressing health workforce Empowering patients and community groups Minimizing the impact of disability Prevention of hearing loss; better tracking and support for the mentally ill in the community; supporting mobility Making the healthcare system more responsive in times of crisis Better communication to health professionals

Consider just one: 

Consider just one Medication Concordance How can efficacy and use of medication be improved through: Measuring compliance? Achieving increased compliance? Understanding non-compliance reasons? A mechanism: reminders to patients based on GP prescribing E.g., to fill script (or why not); to return to GP when supply is exhausted Good set of Foundation Members to develop solutions in this space

Initial Areas of Activity: 

Initial Areas of Activity Continue the ongoing projects Reducing hearing loss (impact thereof), decision support to reduce risk, cell-phone based health promotion Clearly-defined new projects Oracle Health Transaction Database (HTB) demonstrator Medtech32 training facility ‘First key initiative’ – the Health Data Interoperability Laboratory (HDIL) Not ‘a’ project, but an enabler of projects and capabilities

What is HDIL?: 

What is HDIL? A ‘sandbox’ A convenient and safe environment to try things out What good is that? Training and Awareness – see the systems, learn to use the systems Documentation – nexus for expertise on documented APIs (and probably for writing the APIs) Evaluation – informal or formal; usability studies Development – create more audacious orchestrations of health IT services What should it have?...

Health Data Interoperability Laboratory (HDIL) Components: 

Health Data Interoperability Laboratory (HDIL) Components HDIL Server Infrastructure DBMS Suite Enterprise Software (e.g., workflow mgt, proj mgt) National Systems (MoH, ACC) NIHI Member Systems* Demon- stration Systems and Tools Systems/ Solutions Under Development and Test Develop- ment Tools Test Plans and Test Data Suites Training Packages Physical copies w/ test data Portals/ APIs to external test sites Lab Systems Data Repository Systems Primary Care Systems Secondary/Tertiary Front-end Systems Open Confi- dential Modelling Tools Documen- tation On-site Off-site HDIL Workstations Off-site Workstations HDIL Systems Staff Member/External Developers and Testers Clinical and Technical Academics Students and Trainees Off-site Industry, Academic and Government Users

Why Interoperability?: 

Why Interoperability? Walker et al (2005) define four levels of healthcare information exchange and interoperability (HIEI) Level 1 – mail, telephone Level 2 – machine transportable data (e.g., scanned image) Level 3 – structured messages with nonstandardized data Level 4 – machine-interpretable data Project US$77.8 billion/year savings from full level 4

NZ and Level 4: 

NZ and Level 4 This nirvana of level 4 is key to US and Australian (NeHTA) plans NZ is more advanced for demonstrating this Strong track record in health IT innovation Much stronger IT usage track record than US in General Practice Delivering level 4 is real stuff Reducing duplicate tests (key to financial rationale) Presenting relevant information at the right time Decision support that reduces errors, minimizes risks and maximizes benefits

The Road Ahead: 

The Road Ahead Setting priorities Establishing areas of enthusiasm for Foundation Members Considering further partnerships Formulating ‘knock-out’ projects (win-win-win… -win scenarios) Setting initial work plan Establishment Further recruitment and job definition, formalizing operations Forging HDIL: Design, hardware/software acquisition, installation, configuration Seeking further support