Telehealth Quality Planning Guidelines and their relevance to Architecture, Maturity Models, and Implementation

Transcription

1 Telehealth Quality Planning Guidelines and their relevance to Architecture, Maturity Models, and Implementation Alan Taylor CEng MIEE Flinders University & edevelopment Solutions

2 Planning for Success? Implementation Architecture Maturity Modelling Guidelines 12/3/2015 2

3 The Journey Guidelines What you want. ISO/TS 13131:, Health informatics Telehealth services Quality planning guidelines Architecture How the parts fit. Maturity Model Are you ready? ISO/TR :2014 Health informatics -- Capacitybased ehealth architecture roadmap -- Part 2: Architectural components and maturity model Implementation How to do it! 12/3/2015 3

4 Why have guidelines? Add credibility Decrease risks 12/3/2015 4

5 Using guidelines? Starting a new program Training staff Quality and safety assurance 12/3/2015 5

6 Best guidelines Simple, clear, obvious Adaptable to organization / culture Support improvements, change, innovation 12/3/2015 6

7 The scope of ISO/TS Quality and safety management Quality characteristics for telehealth services. Quality objectives and procedures

8 Telehealth quality characteristics For Telehealth services that aim to improve: Quality of life Quality of care 12/3/2015 8

9 Examples of quality characteristics Transparency, accountability, efficiency Accessibility Inclusivity 12/3/2015 9

10 Examples of quality characteristics Usability Effectiveness Safety 12/3/

11 Quality & safety in healthcare ISO 31000:2009, Risk management ISO 9000:2005, Quality management systems Health Safety Standards 12/3/

12 Quality & safety in telehealth ISO 31000:2009, Risk management ISO 9000:2005, ISO 9004: 2009 Quality management systems ISO/TS 13131:Telehealth guidelines 12/3/

13 Risk areas for telehealth 1. Financial management for sustainable telehealth delivery 2. Facilities management to provide an appropriate environment 3. Technology management to underpin telehealth service delivery 4. Information management to safeguard information privacy, security and health information. 12/3/

14 Application of guidelines quality management financial management service planning workforce planning healthcare planning healthcare responsibilities facilities management technology management information management 12/3/

15 Financial management Have a business case and implement a financial plan Analyze costs, benefit, affordability & sustainability Grow services to reduce unit costs 12/3/

16 Service planning Accessible, appropriate and inclusive telehealth services Service levels Service design 12/3/

17 Workforce planning Workforce competency and inclusion Right qualifications, skills to provide safe, high quality healthcare Workforce involvement and consultation 12/3/

18 Healthcare planning Efficient, effective, safe and appropriate healthcare Plans, guidelines, protocols When technology fails 12/3/

19 Healthcare responsibilities Accountable, appropriate, transparent healthcare Does patient fully understands healthcare plan Ensure patient competence to use telehealth devices 12/3/

20 Facilities management Facilities that are appropriate, effective and safe healthcare workers patients and family 12/3/

21 Technology management Technology that is dependable, efficient and usable Information Technology Infrastructure Library (ITIL ) Service delivery is not about operation of equipment. Technical support is not just about fixing faults 12/3/

22 Technology management includes Service Support Service Delivery Infrastructure Deployment Operations Technical Support Incidents, problems, changes, releases Agreements, capacity, availability, continuity Interoperable, usable and meets needs Design, build, test, install, remove Backup. monitor, configure Research, evaluate, pilot, advise, document 12/3/

23 Information management Information is confidential, dependable and safe Privacy, identity management, security and record management The quality of telehealth data must safely support healthcare 12/3/

24 Discussion Do guidelines help build architectures for Telehealth Do guidelines help assess maturity and capacity to implement Telehealth? Should implementation strategies worry about guidelines for Telehealth? Do any of these tools guarantee success? Trying to answer some of these questions led to a Telehealth Architectural Model (THAM) 12/3/

25 Applying Guidelines - Architecture ISO/TR Components and Standards of a Health Information System International Experiences Health information systems rely on health indicators, data sources, data management and information products Draws on international ehealth experiences from Australia, Brazil, Canada, India, Kenya 12/3/

26 Example Primary Healthcare ICT capacity Low Capacity No records or paper records Medium Capacity Paper or electronic silos of information using mobile, personal computers at clinics High Capacity Broad interoperability across electronic health information systems. Patient data is not aggregated into public health collections. Landline, smart phone or minimal data connectivity Some information retrieval for reporting and public health Connectivity with sufficient bandwidth to support videoconferencing and data transfer Unique patient identifiers used across the system Enhanced telemedicine, video conferencing, capabilities at clinics, and hospitals 12/3/

27 Applying Guidelines Maturity Model ISO/TR Levels of capacity (or maturity) have been defined for each of the ehealth architecture components Describes ehealth services, processes, components, policies Enables organized approach to investments in ICT Guides planning, using common principles, policies and specifications 12/3/

28 Example A Telehealth Architecture 12/3/

29 Applying Guidelines - Implementation ISO/IEC : Service management & Information Technology Infrastructure Library (ITIL ) Technology providers Healthcare Organisations Service management includes Technology Design Service Strategy Health Service Design Service Transition Service Operations Service Improvement 12/3/

30 Example - Implementation 12/3/

31 Discussion Do guidelines help build architectures for Telehealth Do guidelines help assess maturity and capacity to implement Telehealth? Should implementation strategies worry about guidelines for Telehealth? Do any of these tools guarantee success? See for more resources 12/3/