HIMSS ASIAPAC 11 CONFERENCE & LEADERSHIP SUMMIT SEPTEMBER 2011 MELBOURNE, AUSTRALIA

Transcription

1 HIMSS ASIAPAC 11 CONFERENCE & LEADERSHIP SUMMIT SEPTEMBER 2011 MELBOURNE, AUSTRALIA

2 Exciting developments for digitized health records standards Leanne Holmes Health Information Manager (CHIM) Drafting Lead AS2828 Project Standards Australia IT Health Concept Representation

3 My experience of document scanning Once upon a time over 20 years ago John Hunter Hospital a new teaching hospital in Newcastle, NSW week Optical Disc scanning pilot study at Mater Misericordiae Hospital in Newcastle.

4 The objectives of this pilot 1.To evaluate the scanning application including hardware and software. 2.To evaluate user acceptance. 3.To assess its capacity to interface effectively with the HOSPAS patient management system and VAX Radiology and Pathology orders/results.

5 What was achieved during the pilot All paediatric patients seen in Emergency had their doctors notes & referral letters scanned prior to admission to ward. ED doctors tested Wang stylist and tablet to write notes using Freestyle with moderate success. Ward retrieved information from scanned record Ward experimented with entering TPR and fluid balance observations directly to electronic charts Outpatient clinics- viewing scanned record

6 Wang freestyle demo on YouTube For a Wang freestyle demonstration you can view a 8 minute demonstration by Wang Laboratories. Go to You tube and type in: Wang Freestyle Demo (Part 2)

7 Equipment and technology is Hewlett-Packard M-O Jukeboxes consistently changing Based on a 9.1GB Optical platter, Hewlett-Packard Magneto- Optical jukeboxes offer near-line storage for small companies, departmental workgroups, or Enterprise applications requiring storage capacities that range from 290GB to 2.2TB of archival data in a single library. The Workgroup family of Hewlett-Packard M-O jukeboxes include the 300mx, 600mx, and 700mx, and offer storage capacities that range from 290GB to 690GB in floor-standing configurations. The Enterprise family of Hewlett-Packard M-O jukeboxes include the 1200mx and 2200mx, and offer storage capacities of 1.2TB and 2.2TB, respectively. For future scalability, the 1200mx library can be upgraded in the field to a 2200mx library, as well as supporting a maximum drive count of 10 for high-production environments.

8 What is happening today! Over 20 individual hospitals/healthcare networks have implemented a digitized health record (DMR) system in Australia Another 20 health services are at evaluation / implementation phase of introducing a digitized health record system Various jurisdictions are planning Area or State-wide implementations i.e. NSW Health & Queensland Health.

9 Transition to the EHR Implementing a scanned health record system should not be solving a paper storage dilemma only Digitized record systems have the capacity to progressively replace the scanned paper, with screen based data capture thereby converting the record incrementally from a picture based capture format which is not computable to a fully digitized format. Each data element shall be able to be accessed and queried, thereby supporting the progressive move towards electronic decision support, and a more integrated approach to patient information exchange and care.

10 Why develop this standard? Current situation in Australia Many healthcare organisations have implemented a scanned medical record without standards or benchmarking capabilities. Existing products/ systems are very diverse Lack of standards specific to scanned health records Technology is changing very rapidly Federal government e-health reform agenda is progressing swiftly To ensure uniformity in language

11 Definitions and Language Adopt common language Digitized medical records (DMR) rather than scanned medical records (SMR) Difference between definitions: Digital medical record (DMR) Electronic health record ( EHR) Personal health record (PHR) Scanned medical record (SMR) Definitions have been incorporated into this work

12 Standards Australia IT-014 Health Informatics Committee This committee develops Australian Standards, Technical Specifications & Reports that support the communication of information across the health sector. IT-014 align with and influence global e-health developments. IT-014 s vision is that standards are implemented widely across Australia e-health applications

13 IT Health Concept Representation work group IT is a sub committee of IT 014 This group has developed a revision of AS2828 (1999) and a final draft of the first digitized health record systems technical specifications. Extensive consultation and input from all members, stakeholders including statewide Medical Record Forms committees, the HIMAA Scanning Special Interest Group and vendors.

14 Australia Standard & ATS This body of work is referred to as AS2828 and is a multi -part set which incorporates paper based health records, hybrid records and digitized (scanned) health records. Part 1: A revision of AS Paper based healthcare records standard: specifies physical aspects of health records such as size, quality, layout, bar-coding, colour, order of filing etc. Part 2: Technical Specifications this part has been developed to assist those who have or will be implementing digitized health record systems

15 Part 1 - Features of AS Paper based health record revision Revising paper forms for the 21 st century Forms considers new technologies: coloured NCR, recycled paper, form identification Discusses positioning of bar-codes on forms Colour coding Use of coloured ball point pens

16 Part 2 Features of the Technical Specification Adopts robust and consistent definitions Defines what is a scanning system? Discusses the relationship & benefits between clinical information systems and digitized medical record systems Identifies Indexing/Metadata requirements Provides guidelines on conversion and document capture requirements

17 Part 2 Features of the Technical Specification. (cont) Considers scanning functional requirements Hardware fit for purpose Recommendations re: Bar codes and OCR technologies Identifies impact on workflows Change management considerations Legal and retention principles Backup and risk contingencies

18 Standard Standards Australia process document, established by consensus and approved by a recognized body, that provides, for common and repeated use, rules, guidelines or characteristics for activities or their results, aimed at the achievement of the optimum degree of order in a given context NOTE Standards should be based on the consolidated results of science, technology and experience, and aimed at the promotion of optimum community benefits.

19 Difference between Standard & a Technical Specification Technical specification normative document which has been subject to a limited form of transparency but does not have the backing of the full consensus process normally associated with an Australian Standard. A technical specification may be prepared in a noncontentious field where the subject matter is undergoing rapid technical development where speed of delivery, rather than full consensus, is of paramount importance

20 Public comment On 29th June 2011 Standards Australia announced that the AS2828 Part 1 & 2 was out for public comment. Stakeholders had the opportunity to view the drafts on the Standards Australia HUB website and add comment until 31 August Final comments will be circulated to committee members in preparation for the next IT meeting on 27th September This meeting has been specifically set to resolve the comments received for the documents.

21

22 Final editing and publication Once the comments have been addressed, the documents will be given to the drafting lead to make the appropriate changes in track changes. Then the documents will be surrendered to Standards Australia to begin the 2 stage editing process for publication. They will then be sent to IT-014 for ballot via the Standards Australia HUB. Since ATS is part of a pair it may also go to ballot even though it is a technical specification. After ballot the document will be finalised for publication; hopefully before the end of the year.

23 Conclusion Standards development is an ongoing challenge which encourages product development and improvement continuously. As technology evolves so will the standards, this document will then need replacement but you have to start somewhere..

24 THANK YOU Leanne Holmes Mobile /22/ Healthcare Information and Management Systems Society 24