Primary Care IT

Primary Care IT

Context for Electronic Health Record

Background

A national Electronic Health Record (EHR) has been identified by HSE National Directors and clinical leaders as a key capability requirement for the future delivery of healthcare. While technology solutions are a key component, there will be a primary focus on how clinicians and administrative staff work with this technology in a way that closely aligns with and underpins the ambition for Integrated Care and other national healthcare reform priorities. The national EHR programme represents a significant transformation in the use of technology and data to underpin effective and efficient care. This document acts as a foundation document for the definition of the national EHR Programme and for subsequent strategies, plans and business cases once the overall roadmap is defined.

ICT within healthcare reform

ICT will be an increasingly critical element in healthcare reform. Ireland is set on an ambitious journey in the reform of healthcare in recognition of the need to radically transform healthcare provision to meet the challenge of delivering sustainable high quality care for the entire population. Information and knowledge are a core asset of our health systems and the creation and use of this asset in an effective manner is critical to improving performance across the system. The ability to record and share key information on patients’ and service users’ interaction across organisations and care settings is a key component of eHealth and will provide benefits to patients, service users, carers, health and social care professionals and wider stakeholders in the health system. The programme aims to exploit the capability of ICT to be more consistent in our delivery of safer, better and increasingly, personalised care.

EHR as cornerstone of eHealth Strategy

An EHR for Ireland is the cornerstone of the eHealth Strategy. A national EHR is a comprehensive and combined solution that supports the creation and sharing of key patient information. The national EHR will consist of core operational solutions (with functions such as ePrescribing and Case Management), along with the ability to aggregate data from these systems into a comprehensive national record, accessible to health and social care professionals, and also to patients, service users and carers. The opportunity afforded by a national EHR is to create a future environment that is information rich, supporting improvements in care, and making a step change in the availability of patient information across the various organisations within the remit of the HSE. As part of the Knowledge and Information Strategy of the Office of the CIO, the national EHR has been identified as a core capability.

- See more at: http://www.ehealth.ptoolstest.com/Strategic-Programmes/Electronic-Health-Record-EHR-/#sthash.B7u1AD63.dpuf

Context for Electronic Health Record

Background

A national Electronic Health Record (EHR) has been identified by HSE National Directors and clinical leaders as a key capability requirement for the future delivery of healthcare. While technology solutions are a key component, there will be a primary focus on how clinicians and administrative staff work with this technology in a way that closely aligns with and underpins the ambition for Integrated Care and other national healthcare reform priorities. The national EHR programme represents a significant transformation in the use of technology and data to underpin effective and efficient care. This document acts as a foundation document for the definition of the national EHR Programme and for subsequent strategies, plans and business cases once the overall roadmap is defined.

ICT within healthcare reform

ICT will be an increasingly critical element in healthcare reform. Ireland is set on an ambitious journey in the reform of healthcare in recognition of the need to radically transform healthcare provision to meet the challenge of delivering sustainable high quality care for the entire population. Information and knowledge are a core asset of our health systems and the creation and use of this asset in an effective manner is critical to improving performance across the system. The ability to record and share key information on patients’ and service users’ interaction across organisations and care settings is a key component of eHealth and will provide benefits to patients, service users, carers, health and social care professionals and wider stakeholders in the health system. The programme aims to exploit the capability of ICT to be more consistent in our delivery of safer, better and increasingly, personalised care.

EHR as cornerstone of eHealth Strategy

An EHR for Ireland is the cornerstone of the eHealth Strategy. A national EHR is a comprehensive and combined solution that supports the creation and sharing of key patient information. The national EHR will consist of core operational solutions (with functions such as ePrescribing and Case Management), along with the ability to aggregate data from these systems into a comprehensive national record, accessible to health and social care professionals, and also to patients, service users and carers. The opportunity afforded by a national EHR is to create a future environment that is information rich, supporting improvements in care, and making a step change in the availability of patient information across the various organisations within the remit of the HSE. As part of the Knowledge and Information Strategy of the Office of the CIO, the national EHR has been identified as a core capability.

- See more at: http://www.ehealth.ptoolstest.com/Strategic-Programmes/Electronic-Health-Record-EHR-/#sthash.B7u1AD63.dpuf

Context for Electronic Health Record

Background

A national Electronic Health Record (EHR) has been identified by HSE National Directors and clinical leaders as a key capability requirement for the future delivery of healthcare. While technology solutions are a key component, there will be a primary focus on how clinicians and administrative staff work with this technology in a way that closely aligns with and underpins the ambition for Integrated Care and other national healthcare reform priorities. The national EHR programme represents a significant transformation in the use of technology and data to underpin effective and efficient care. This document acts as a foundation document for the definition of the national EHR Programme and for subsequent strategies, plans and business cases once the overall roadmap is defined.

ICT within healthcare reform

ICT will be an increasingly critical element in healthcare reform. Ireland is set on an ambitious journey in the reform of healthcare in recognition of the need to radically transform healthcare provision to meet the challenge of delivering sustainable high quality care for the entire population. Information and knowledge are a core asset of our health systems and the creation and use of this asset in an effective manner is critical to improving performance across the system. The ability to record and share key information on patients’ and service users’ interaction across organisations and care settings is a key component of eHealth and will provide benefits to patients, service users, carers, health and social care professionals and wider stakeholders in the health system. The programme aims to exploit the capability of ICT to be more consistent in our delivery of safer, better and increasingly, personalised care.

EHR as cornerstone of eHealth Strategy

An EHR for Ireland is the cornerstone of the eHealth Strategy. A national EHR is a comprehensive and combined solution that supports the creation and sharing of key patient information. The national EHR will consist of core operational solutions (with functions such as ePrescribing and Case Management), along with the ability to aggregate data from these systems into a comprehensive national record, accessible to health and social care professionals, and also to patients, service users and carers. The opportunity afforded by a national EHR is to create a future environment that is information rich, supporting improvements in care, and making a step change in the availability of patient information across the various organisations within the remit of the HSE. As part of the Knowledge and Information Strategy of the Office of the CIO, the national EHR has been identified as a core capability.

- See more at: http://www.ehealth.ptoolstest.com/Strategic-Programmes/Electronic-Health-Record-EHR-/#sthash.B7u1AD63.dpuf

Background

Enhanced IT for Primary Care has been identified by HSE National Directors and Clinical Leaders as a key capability requirement for the future delivery of healthcare. While technology solutions are a key component, we must also focus on how clinicians and administrative staff work with this technology in a way that closely aligns with and underpins the ambition for Integrated Care and other national healthcare reform priorities. The national IT for Primary Care programme represents a significant transformation in the use of technology and data to underpin effective and efficient care.

The Role of IT for Primary Care in Healthcare Reform

ICT is a critical element in healthcare reform. Ireland is set on an ambitious journey in the reform of healthcare in recognition of the need to radically transform healthcare provision to meet the challenge of delivering sustainable high quality care for the entire population. Information and knowledge are a core asset of our health systems and the creation and use of this asset in an effective manner is critical to improving performance across the system. The ability to record and share key information on patients’ and service users’ interaction across organisations and care settings is a key component of eHealth and will provide benefits to patients, service users, carers, health and social care professionals and wider stakeholders in the health system. The programme aims to exploit the capability of ICT to be more consistent in our delivery of safer, better and increasingly, personalised care.

Current areas of Activity

We are currently focussed on the rollout of the 'e-Referrals' solution nationally. This follows the success of the Electronic Referrals (e-referrals) pilot team who developed and deployed e-Referrals successfully across all the major hospitals in the South/ South West Health Group.

We are busy promoting the widespread adoption and use of of the new 'Healthmail' service by all clinicians, nationally.

We continue to work very closely as part of the National GPIT team, a collaboration of the HSE (Office of the CIO and Primary Care Division), Dept of Health, Irsh College of GPs and GP's with a specific interest in IT, in the practice, to promote further developments in this area for the benefit of patients and all stakeholders.

Next Steps

In August 2015, we will launch an IT strategy for Primary Care. This will focus especially on IT enabled solutions that can make a meaningful difference for patients who transition between the Primary and Secondary Care settings. With the introduction of the national Individual Health Identifier, there is massive potential to ensure that the data required for the safe treatement of patients who transition between these settings is available to the clinicians when and where it is required. This will improve continuity of care, reduce the risk of repeating tests unnecessarily and ultimately lead to safer environment and better service for patients.

Electronic Referrals 

In January 2011, a National Electronic General GP Referral Pilot Project was established to achieve an electronic referral pathway between GPs and seven pilot hospitals. The Cork and Kerry Reconfiguration Team managed the pilot on behalf of the Clinical Programmes and Strategy Directorate (CPSD) Primary Care Programme. The Adelaide and Meath Hospital, incorporating the National Children’s Hospital (now Tallaght Hospital, Dublin) was included in the pilot, along with the six acute hospitals in Cork and Kerry.

The objective of the project was to put in place an electronic general referral solution that is accessible, transparent, measurable, robust, scalable and ensures its own sustainability.

Using the e-referral solution, a GP can submit a referral electronically directly from their practice management system to the hospital in question using the HIQA approved referral form and immediately receive an acknowledgement confirming receipt of same. Later phases in the project will also ensure that the GP practice system also received a response message once the patient has been triaged.

Over the next 12 months the OoCIO via the Primary Care IT Delivery team, will roll out the eReferrals solution to all sites nationally.

Healthmail

Healthmail is a service of the Health Service Executive Primary Care Directorate. Launched in November 2014, it has grown rapidly and how has over 1,000 registered GPs and support staff and over 30 connected health agencies (hospitals etc.).

Although GPs used structured electronic messages for many years to get laboratory and radiology results from hospitals and send electronic referrals to cancer services, they did not have a secure clinical email service. The limitations of normal email meant they could not include patient identifiable clinical information in their communications with clinicians such as public health nurses and hospital consultants. This limited the interactions with their clinical colleagues to face-to-face, phone, fax or letter.

Healthmail solves this problem by provising a solution that supports the secure exchange of clinical information at the point of care. It is a private, bounded, secure email service based in the Mater Hospital data centre. GPs can access their Healthmail accounts on desktops, laptops, tablets and smartphones and can easily share patient data. GPs get an @healthmail.ie account and the Healthmail servers are securely connected, using Transport Layer Security (TLS) with mail servers in the HSE and Voluntary Hospitals. It is not necessary for clinicians working in hositals to register separately for Healthmail. They can use their @hse or @vol_hospital.ie email address to communicate safely with GPs and others registered with the @healthmail.ie service. All they need to know is the email address of the clinician they wish to communicate with. So far over 30 health agencies are securely connected to Healthmail, creating a private bounded secure trusted network of clinicians.

General Practice Software Management Systems

There has been significant investment by general practitioners in information systems over the last 20 years. As a result, over 90% of the 1,300 general practices in Ireland are computerised, using GP practice software management systems. Approximately 95% of the computerised practices use accredited software systems.

Healthcare is complex and chaotic. It involves lots of clinicians, information from different sources and rapid changes in health and illness over short time spans. Trying to manage health records on paper does not work. GPs were quick to realise this and to adopt and implement software systems to manage the clinical care of their patients.

GP Practice Software Management Systems are complex information systems that:

  • Manage patient registration and demographic information
  • Record and code diseases and allergies
  • Record, track and support recall for immunisations
  • Manage medication and generate electronic prescriptions
  • Create and track electronic referrals
  • Import laboratory and radiology results into individual patient records
  • Allow analysis and audit of clinical conditions and processes
  • Provide a summary care record
  • Support the exchange of a patient’s electronic health record when they move practice

There are currently four accredited GP Practice Software Systems in the Irish market. They are HealthOne, Helix Practice Manager, Socrates and Complete GP.