Slide1: Capabilities and Opportunities
Prof Jim Warren Chair in Health Informatics The University of Auckland
National Institute for Health 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