# Presentation: 131015

## An Australian National Health Infostructure

**Dr Branko Cesnik MBBS, MD, FACHI**
**(standing in for David Rowlands)**

## BACKGROUND

**In July 2003 Australian Health Ministers agreed for the Australian Health Information**
**Council (AHIC) and the National Health Information Group (NHIG) to jointly develop the**
**national strategic plan for health IM&ICT, that builds on *****Health Online: A Health Information***
***Action Plan for Australia, September 2001*****.**

**The national health IM&ICT strategic plan will:**
**•****	****identify national strategic reform issues**
**•****	****set long term reform directions**
**•****	****advise on how IM&ICT effort can be harnessed to address current and emerging needs in health care delivery, management and planning**
**•****	****recommend national guiding principles for investment in and use of IM&ICT.**

## THE OPERATING ENVIRONMENT FOR THE NEXT 5 – 15 YEARS

** ****Quality and Safety imperative**
** ‘****Cost’ of burden of disease**
** ****A focus on ‘wellness’ and not**
**  ‘****illness’ – prevention is key**
**   ****imperative**
**link health promotion**
**risk factors**

**SCENARIOS**

** ****External threat e.g. biosecurity**
** ****Intergenerational issues**
** ****Population growth and age distribution**
**Size of the workforce**
**Health as % of GDP**

**THE OPERATING ENVIRONMENT FOR THE NEXT 5 – 15 YEARS**

**IM&ICT IMPLICATIONS**
** ****Broadband system that supports all**
** ****Standards-based**

## THE OPERATING ENVIRONMENT

** ****Cost of health/burden of disease**
** ****Federated system and dysfunctions**
** ****Demands for wellness - reach larger **
**   ****population**
** ****Pressures for safety and quality**
** ****Consumer and community will expect  **
**   ****to be more actively involved**
** ****Workforce will be under pressure to **
**   ****work differently – evidence based **
**   ****medicine**
** ****Assume Australians want national  **
**   ****health care system**

**THE OPERATING ENVIRONMENT**

## STRATEGIC ANALYSIS

**STRATEGIC ANALYSIS**

## GOALS FOR THE NEXT THREE YEARS

**Develop a 15 year strategy that includes strong change management**
**Set directions that are realistic, achievable, articulated and communicated to its stakeholders**
**Establish the robust national building blocks of an electronically enabled health care system that ensures congruence as the IM&ICT systems are developed and implemented**

## KEY FACTORS OF SUCCESS FOR HEALTH IM&ICT 2004-08

** ****Develop a coordinated national approach**
**  ****Fund partnerships****	****	****	****- Understand the need**
**  ****Establish the proposed Entity****	****	****- Interoperability**
**  ****Clear and shared vision**
** ****Design and implement projects/initiatives**
**  ****Improve safety and quality of care**
**  ****Harness efficiencies**
** ****Build infrastructure and capacity**
** ****Technical****	****	****	****	****-  Human skills**
** ****Cultural/attitudinal change****	****	****-  Research**
** ****Ensure effective incentives and investment**
** ****Advocate and communicate the need for health IM&ICT reform**
**Craft the ‘compelling story’****	****	****-  Champions/leaders**

**KEY FACTORS OF SUCCESS FOR HEALTH IM&ICT 2004-08**

## BROAD STRATEGIES FOR HEALTH IM&ICT 2004-07 (I)

** ****Design and implement projects/initiatives**
** ****Build infrastructure and capacity**

**BROAD STRATEGIES FOR HEALTH IM&ICT 2004-07 (I)**

**Strategies**

**Determine what ‘delivery system’ is needed in future.**
**Identify where and how to do things differently (key concepts, opportunities)**
**- innovation, collaboration e.g. childhood vaccination**
**- consumer focused/medicines**
**Ensure ‘national priorities’ in place**
**Develop initiatives for short term impact (prerequisites)**
**e.g. Discharge event summaries, eSignatures**
***Technical******	******	*****Undertake national stocktake of current infrastructure and ****	****	****	****capacity of systems, link funding to interoperability**
***Human******	******	*****Education Strategy for IM&ICT at range of levels**
**	****	****- Senior managers, clinicians, community, IT industry**
***Research******	******	*****Secure IT research investment and research vehicle**
***Change******	******	*****Communicate the need for change to key audiences (decision-****	****	****	****makers/Clinicians)**
***Governance******	******	*****Establish entity with sufficient funding for effective ****	****	****	****governance**

## Historic Fragmentation of (often) Voluntary Activity

**Multiple Committees**
**Standards**
**EHR developments**
**Guideline Producers / Disseminators**
**Quality and Safety**
**Prescribing**
**Multiple Departments**
**Commonwealth**
**States and Territory**
**Local Government**
**Professional Bodies**
**Colleges**
**Academia**
**Multiple Trials**
**Communications**
**Incentive Programs**

## TIMEFRAME AND KEY MILESTONES

**TIMEFRAME AND KEY MILESTONES**

**Week Ending**

**NHIG & AHIC members confirmed for the Strategic Plan Editorial Advisory Panel (EDP)**

**AHIC**
**National Strategy**
**Workshop**

**NHIG Meeting**

**AHMAC Meeting**

**AHMC Meeting**

**AHIC Meeting**

**NHIG Meeting**

**Public release of the National Strategy at the National Health Information Summit 6-7 December 2004**

**Period for intensive development of the strategic plan:**
**Directions from the EDP**
**AHIC-NHIG Secretariat drafting team**
**Approximately six weeks**

**AHIC to endorse the final draft of the strategic plan**

**NHIG to endorse the final strategy and provide to AHMAC (21/10) and AHMC (19/11)**

## Two Major Groups created to Govern Rationalisation

**Australian Health Information Council - AHIC**
**Experts**
**Conceptual Direction**
**Task Specific Activities**
**National Health Information Group - NHIG**
**Bring together fragmented committees**
**Operationalise AHIC direction**
**Draw together Cross Jurisdictional efforts**
**States / Territory**
**Researchers**
**Financials (Health Insurance Commission)**

## National Priorities Areas = eHealth Building Blocks

**National Priorities Areas = eHealth Building Blocks**

**Supply Chain Procurement Standards**

**Secure Messaging & Information Transfer**

**Technical Integration Standards**

**Clinical Data Standards**

**Consent Models**

**Directories for unique ID of patients, providers and products**

**Identification Standards**

**Hospitals and Other Providers**

**Clinicians**

**Consumers and the Longituidinal Health Record**

**Researchers**

## Governance Arrangements for National eHealth Authority

**Governance Arrangements for National eHealth Authority**

**AHMC**

**NEHTA Advisory Committee**

**NHIG**

**AHIC**

**AHMAC**

**AHMAC IM&ICT Working Group**

**NEHTA CEO**

**AHMAC IM&ICT Working Group**

**Clinical Data Standards**

**ID Standards**

**Directories****Patient****Provider****Product**

**National Consent Models**

**Technical Integration Standards**

**Secure Messaging & Info Transfer**

**Secure Messaging & Info Transfer**

**Core Transition Team**

**Work Program Manager**
**Technical Expert**
**Finance Officer**
**Business Analyst**
**Administrative Support**

**Reporting**

**Consultation / Advice**

## The Key Activities for a ‘New’ Agency(early hits)

**Clinical Data Standards**
**Event Summaries / Records**
**Clinical Coding Areas**
**Base Level Clinical Terminologies**
**Identification Standards**
**Provider (with delegated ‘authority’)**
**Products (Medicines, Consumables, Equipment)**
**Patient (Tasmanian Smartcard trial)**
**Directories**
**Patient – National Health Identifier Solution end 2004)**
**Providers – Business case development in Technical and operational specs)**
**Product – National Formulary**

## The Key Activities for a ‘New’ Agency(early hits)

**Supply Chain Procurement**
**Consent Models in place**
**Technical Integration Standards**
**Priorities for development (eg recent HL7 acceptance Nationally)**
**Actually Develop priority Standards (IT14)**
**Consistent Implementation Documentation**
**Secure Messaging and Information Transfer**

## Specific Australian Infostructure Activities

**Implementation of the National Broadband Strategy****. **
**Specific targets for Healthcare (GP, State based)**
**Benefits realisation via Demand Aggregation (critical at Community Level)**
**Optimise Financials, Investigative communications**
**Cross sectorial Integration (Discharge, Referral etc)**
**Develop a planned approach to Workforce Capacity Development**
**Training / Education**
**Competency Standards**
**Facilitate fragmented and poorly resourced programs**
**Advancing work to date regarding Electronic Decision Support**
**Order Entry benefits**
**Guideline Creation, Representation and Delivery**
**Evaluation models to demonstrate perceived benefits**

## NEHTA Contact Details

**David Rowlands****	**_**[David_Rowlands@health.qld.gov.au](mailto:David_Rowlands@health.qld.gov.au)**_
**Scott Thistlethwaite****	**_**[Scott.Thistlethwaite@dhs.vic.gov.au](mailto:Scott.Thistlethwaite@dhs.vic.gov.au)**_
**Elise Wherry****	**_**[Elise.Wherry@dhs.vic.gov.au](mailto:Elise.Wherry@dhs.vic.gov.au)**_
**National Health Information Summit, Melbourne, Victoria, December 6,7**