Better Sooner More Convenient Primary Care - New Zealand Doctor

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separate databases. functions to Med Tech delineated. Outcome measures Indicator Baseline Target – Yr 1 Year 2 Year 3 Numbers of remote outpatient TBC consultations per quarter/year Number of times medical telemetry system used to share diagnostic information with Greymouth Hospital , per quarter/year TBC 6 Deliverables / activities One of the aims of the IFHC is to provide an integrated health information system that allows clinical information to be available at each point of care that a patient connects with, so that patient specific information relevant to an episode of care follows the patient from carer to carer across the entire network of integrated health services. The aim is to support an integrated model of care, whilst minimizing waste and duplication, and whist safeguarding patient privacy. One way of achieving this involves moving services that are similar in nature to the same shared information system. A logical choice for this would be MedTech 32 for all providers working in IFHCs, probably provided over the West Coast DHB developed PrISM system, as it is already well established on the West Coast. The system needn‟t be owned and hosted by the DHB; it has been developed in a way that allows it to be transferred to another provider such as the PHO or an IFHC in the future. Complete Population To be of the greatest benefit, an electronic health record needs to include all health activity provided by all health providers. With this in mind, plans have been developed to make the West Coast DHB PrISM system available to other providers, so that all relevant health information can be available when and where it is required for patient care. Self Service Access A logical next step beyond developing an integrated electronic health record is to provide access for people to see their own health information and so that they can provide updates for changes of address or provide any new health information, (such as diabetes patients entering home blood tests). Business case appendices V12 AC 25Feb2010 Page 134
Security An individual‟s health information is a taonga – it has great value and is sacred to them. It is therefore essential to ensure that health information is secure and that a patient's wishes are adhered to regarding its availability. Resilient Health Information Systems need to be resilient to external factors such as a localised disaster, so that critical information is available to those who legitimately need it wherever and whenever it is required, regardless of the challenges involved in ensuring its availability. Improving Data Quality Health information systems are large complex IT systems with numerous users and complex information flows. Data needs to be accurate and reliable as incorrect data can dramatically impact on a patients wellbeing. Continuous quality improvement philosophies need to be applied in order to ensure that the risk of error is minimized. Implementation plan: to June 30 Within primary/community care Begin the process of identifying the requirements for sharing clinical notes on MedTech in a single clinical file used by all health providers in the IFHC. Understand and, as necessary, re-negotiate reporting requirements for community nursing & allied health. Between primary and secondary Establish access for all medical centres to HealthViews, through the DHB's PRiSM system. Co-ordination with ED acute care install a copy of MedTech on a computer in ED change patient registration form/casualty sheet on arrival to include consent for access to their MedTech notes for that hospital visit ensure privacy considerations are met obtain agreement from practices create link into DHB practice server. Patient access to information Publicise Health Navigator patient self management website – for providers and community, eg. pamphlet in prescription bags for (see also LTC workstream) Create link to Community & Public Health website on PHO website, (see also Keeping people healthy workstream). Business case appendices V12 AC 25Feb2010 Page 135
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Business Case Better, Sooner, More
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1 Caveats/status This business case
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Current situation By three years Wa
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staffed on a capacity model - in wh
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support from DHBs, specialist clini
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10.4 Key milestones................
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Annual government health funding pe
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Ambulatory Sensitive Hospitalisatio
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The base populations of the three d
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Māori/Pacific Not Māori/Pacific D
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4.7 West Coast region service deliv
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5 Future model of care 5.1 The desi
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support them. Help with understandi
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LEVERS VISION Better, sooner, more
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providing the majority of care). Th
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The Community Health System Deliver
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To better integrate the support pro
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5.5 Enablers A key aspect of this b
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Two rounds of meetings with front l
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While doctor-nurse substitution has
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Nick Goodwin, Kings Fund 14 , in hi
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Quality domains Each new initiative
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Preventative Acute LTC management R
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Preventative Acute LTC management R
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The core services are provided or p
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Total required FTEs for the Grey IF
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7 Governance, Ownership & Managemen
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Option D: PHO/DHB jointly owned Pri
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The IFHS will need the ability to b
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Of note, a large proportion of the
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The DHB delegates decision making o
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Limited integration of community se
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10.4 Key milestones The table below
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Expanded pharmacy roles Improving a
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Devolved community based services w
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Appendices Appendix One: Health Equ
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ongoing GP shortage creating an env
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10. What are the unintended consequ
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It is common for people with an acu
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Outcome measures Indicator Baseline
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determine ratio of nurses and GPs t
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C. Extended role for pharmacists:
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11 Engagement Working group who dev
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Appendix B: Acutely unwell adult pa
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4 Objectives to implement nur
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Review Buller after hours arrangeme
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Year three Community education camp
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13 Costs Budget considerations:
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established. This group now oversee
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Output measures Tobacco control / s
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Improving immunisation coverage - h
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Year three Continued joint plan
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extending health promotion activiti
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Immunisation Coverage Funder Provid
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The Community Health System Deliver
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Clinical care Practice self managem
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and increases in the numbers of pat
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Ambulatory Sensitive Hospitalisatio
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% CVD on lipid lowering drugs, beta
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Health navigators/ kaiawhina: chan
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Committee‟s objectives 41 of prov
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- lack of consistency of care betwe
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qualifications and skills. Where ca
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6 Deliverables / activities Impleme
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“With an aging population and an
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Differences between revenue generat
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Appendix Seven: Integration - Healt
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It is expected that HealthPathways
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Year two implement the process to
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Low uptake by primary and secondary
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Appendix Eight: Improved access to
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to easily access by telephone). Oth
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Year One - July 2010 to June 2011 T
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LECG 50 evaluated whether “the im
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Appendix Nine: Referred services 1.
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them by technical errors or lack of
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Page 155 and 156: • Provision of patient specific m
Page 157 and 158: 12 Organisational accountabilities
Page 159 and 160: emain under the care and management
Page 161 and 162: Service user pathways in an optimal
Page 163 and 164: Model for shared care pathways deve
Page 165 and 166: Implementation plan: to June 30 Dev
Page 167 and 168: Year two Review progress, outcome m
Page 169 and 170: 10 Risk analysis Risk Probability I
Page 171 and 172: Appendix Eleven: Frail older people
Page 173 and 174: ehab and treatment programmes that
Page 175 and 176: Year one: Maintain and continue the
Page 177 and 178: Māori have a higher incidence of m
Page 179 and 180: 11 Organisational accountabilities
Page 181 and 182: There are often vacancies for allie
Page 183 and 184: 6 Deliverables / activities Program
Page 185 and 186: Professional development: Provide
Page 187 and 188: Mainstream arguments are concerned
Page 189 and 190: Appendix Thirteen: IFHCs - Faciliti
Page 191 and 192: A key possibility is that land at t
Page 193 and 194: This option is effectively a Greenf
Page 195 and 196: 7 Westland IFHC Facilities options
Page 197 and 198: Year two Substantive-IFHC in Greymo
Page 199 and 200: 12 Costs Capital costs Greymouth IF
Page 201 and 202: utilize MedTech, but via their own
Page 203: 4 Objectives: To implement c
Page 207 and 208: 8 Effect on inequalities The increa
Page 209: Appendix Fifteen: Project advisory
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