Better Sooner More Convenient Primary Care - New Zealand Doctor

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Year one Primary secondary create link to Heath Views for community pharmacies develop link into MedTech for outpatients, wards and hospital pharmacy. Within IFHC Develop specifications for new system and fund implementation. Work with the current health centre that does not currently use MedTech to determine the barriers and facilitators for change. Review current referral systems, considering potential role of Care Link, and change to within system request for assistance/booking. Monitor workload and waiting times and develop new priority and entry criteria as required. Telemedicine Review the Canterbury Initiative Telemedicine plan and implement proof of concept plan for telemedicine links from IFHCs, likely to include: o Increased number of outpatient clinics done at a distance using telemedicine (reducing patient travel and so making services availability better, sooner and more convenient) o Increase in the use of the medical telemetry system to share diagnostic information with Greymouth Hospital reducing patient travel and so making services availability better, sooner and more convenient Web based support for providers (see health pathways work plan). Year two extend MedTech across all health centers and for all community nursing and allied health develop link into MedTech for community pharmacy work with the private practice on Profile to overcome barriers to the use of MedTech, and assist with migration to MedTech ensure all Coast lab results are in the same database. Year three (to be developed) 7 Capability and capacity There will be training requirements for new providers to use MedTech32 for consultations. Training in the use of telemedicine will also be required to ensure this methodology is used safely and appropriately. Business case appendices V12 AC 25Feb2010 Page 136
8 Effect on inequalities The increased use of telemedicine will benefit those who have difficulties with the expense of traveling from rural areas to Greymouth. 9 Evidence for this initiative This plan follows the Better, Sooner, More Convenient Primary Health Care Business Case Development Process Information Pack principles: • Prioritisation and access to services (shared scheduling of primary care, community nursing and allied health appointments) • Information sharing (shared electronic clinical record, sharing electonricni information with pharmacy and between primary and secondary care) • Quality and performance (HealthPathways, patient access to web support, i.e. Health Navigator) The changes proposed will result in a more patent/whanau centred approach since with all primary and community health providers using the same electronic medical record there will be less need to repeat their same story to multiple providers and for unnecessary repeated assessments. 10 Risk analysis Risk Probability Impact Contingency plan Increased risk of privacy breaches with move to more providers using the same electronic health record Low High Ensure patients understand how their information is stored and shared. Ensure all health providers understand privacy requirements Provide training in how to hide sensitive consultation notes. New users find MedTech32 difficult Moderate Moderate Provide adequate training. Use enthusiastic peers to support and motivate. Larger numbers of providers using the same electronic medical record making it difficult for different types of providers to follow the flow of their consultations Moderate Moderate Review how other places have dealt with this situation, such as coding consultations according to types of provider Business case appendices V12 AC 25Feb2010 Page 137
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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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Identify patients that would benefi
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 and 204: 4 Objectives: To implement c
Page 205: Security An individual‟s health i
Page 209: Appendix Fifteen: Project advisory
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Better Sooner More Convenient Primary Care - New Zealand Doctor

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