IBM Healthcare Roadshow Enablers for E-health. Stephen Burmester - Program Manager: Identity & Authentication May 2010

Transcription

1 IBM Healthcare Roadshow Enablers for E-health Stephen Burmester - Program Manager: Identity & Authentication May 2010

2 NEHTA s Mission Lead the uptake of e-health systems of national significance; and coordinate the progression and accelerate the adoption of e-health by delivering urgently needed integration infrastructure and standards for health information. - Set up and funded by Federal, State and Territory Governments as a separate entity - Board comprises heads of health departments in all jurisdictions - Independent Chair - David Gonski

3 National E-Health Strategy: Vision statement E-health will enable a safer, higher quality, more equitable and sustainable health system for all Australians by transforming the way information is used to plan, manage and deliver health care services. Source: National E-Health Strategy, (September 2008) The National E-Health Strategy was outlined in a document tabled at the Australian Health Ministers Conference in December There are multiple organisations and committees involved in the progression of this strategy in collaboration with NEHTA such as Department of Health and Ageing (DOHA), State Health Departments, National Health and Hospital Reform Commission (NHHRC), Australian Health Ministers Advisory Council (AHMAC), industry organisations, standards organisations and the private health sector. The National E-Health Strategy documented some key recommendations for e-health progression in Australia, and specifically NEHTA s role going forward.

4 Delivery within the context of the NEHTA Strategic Plan Mission Statement NEHTA is the lead organisation supporting the national vision for e-health in Australia working openly, constructively and collaboratively with consumers, providers, funders, policy makers and the broader healthcare industry to enable safer, higher quality, equitable, efficient and sustainable healthcare system Strategic Priorities 1. Urgently develop the essential foundations required to enable e-health 2. Coordinate the progression of the priority e- health processes 1.1 Contribute to the establishment and adoption of e-health Standards in collaboration with the relevant standards communities 3. Accelerate the adoption of e- health 4. Lead the progression of e- health in Australia Strategic Initiatives 1.2 Deliver the national Healthcare Identifiers Service 1.3 Deliver enablers for secure information exchange; including secure messaging and NASH Included in NIS Responsibility

5 NIS Mission Statement What is the aim of National Infrastructure? Mission Statement: As a key part of the National Vision for e-health, National Infrastructure (NIS) is responsible for the developmentand ongoing management of the e-health information infrastructure services which form the backbone of Australia s e-health system.

6 NIS Components Underpin and Enable ehealth Who provided the service? (Healthcare Provider Individual) Where the service was provided? (Healthcare Provider Organisation) ereferral epathology Who received the service? (Healthcare Individual) edischarge Healthcare event Messaging Authentication Identification Data Security emedication What medications or medical products were prescribed or used (National Product Catalogue)

7 National e-health Infrastructure Components National ehealth Infrastructure Operations Developing the NIS operational capability required to service NIS products. Enabling Technology Technology Products developed by NIS to underpin e-health Includes: Healthcare Identifiers Nash - Authentication Secure Messaging ELS Supply Chain National Product Catalogue and E-procurement Regulatory Framework Standards Delivery Enablers Frameworks, Guidelines and Enablers to ensure that NIS products can be used effectively at a Federal and National level. Includes: Health Identifiers Legislation Standards recognised by Standards Australia Partners enabling delivery (Medicare Australia, AHPRA, Department of Veteran Affairs) Physical entities Standards, Guidelines & Policy

8 National e-health Infrastructure Components National ehealth Infrastructure Operations Direct online interface (approved users) Certifying Authority (issue certificates) Web Portal Participation arrangements Governance Arrangements Call Centre (Medicare Australia) Front Office (Medicare Australia) Inbound/ outbound mail (post) Training HI Service Operator Enabling Technology HI Service NASH - National Authentication for Health Secure Messaging Supply Chain Individual (IHI) R2&3 Healthcare identifiers HPI-I Provider (HPI) R2&3 HPI-O Identifiers & Access Healthcare Provider Directory Web standards Digital Credentials Organisation Individual Tokens HPI-I IHI Public Key Infrastructure (PKI) and Smart Cards Endpoint Locator (ELS) Version 2 Interoperability National Product Catalogue Medications E-procurement Regulatory Framework Standards Delivery Enablers HI Service Enabling Legislation Supporting Regulations (Commonwealth, State & Territory) Draft issued for Consultation Future National Privacy Framework Commonwealth State & Territory Legislation Standards platform Existing Standards NehtaDeveloped Standards Standards Australia Publishing Authority for NEHTA Medicare Australia Department of Veterans affairs Department of Defence IHI Australian Healthcare Practitioner Registration Agency (AHPRA) Other (as agreed) HPI-I Trusted Data Sources Under review HPI-O Compliance, conformance & accreditation Accreditation Physical entities Standards, Guidelines & Policy

9 HI Health Identifiers Service

10 What Identifiers Do Allow healthcare information to be shared among authorised providers only Enable consistent identification of an individual in healthcare settings, no matter how many providers they see or how many times they change address Will assist in reducing the risk of: information being sent to the wrong healthcare provider or assigned to the wrong patient medication errors incorrect surgical interventions diagnostic testing errors

11 The Patient Journey - Identification across boundaries Healthcare Identifiers underpin the patient journey through the healthcare system IHI Discharge summary IHI GP HPI-O referral HPI-O Specialist referral Hospital HPI-O Patient HPI-I HPI-I HPI-I Prescribing Ordering & results HPI-O Pharmacist HPI-O Pathology, Radiology HPI-I HPI-I

12 Model Healthcare Community (MHC) & R1 Delivered December 15, 2009 MHC moved & launched at Royal Australian College of General Practitioners (RACGP) April Medicare launches vendor engagement March 1st, 2010 Medicare Vendor Workshop to be held June 2010 Medicare completed HI Service R2 and promoted to pre-production April 2, 2010 HI Service Enabling Legislation & Regulations HI Bill Tabled Feb 2010 HI Draft Regulations/Consultation Complete April 9, 2010 HI Regulations Endorsed by Ministers 10 May, 2010 HI Bill adjourned by Senate till June 2010 sitting HI Regulations Enacted to support service operations July 1, 2010 HI Service Introduction July 1, 2010* Australian Health Practitioner Regulation Agency Providers loaded to HI Service July, 2010* * Subject to Legislation and Regulations enacted Key Outcomes and Milestones

13 NASH National Authentication Service for Health

14 National Authentication Service for Health (NASH) The National Authentication for Health (NASH) provides the required strong authentication of healthcare providers and organisations, and is an important foundation service in the developing e-health community.* Delivery of NASH will: Establish a national supply of trusted digital credentials available to all entities in the health sector, allowing the traceability of e-health transactions to trusted identities Allow healthcare communities to issue and manage authentication credentials locally, supported by national infrastructure Provide a governance approach that would allow health sector participation in the operational policies and services NASH would develop Support software vendors to transition their products to use nationally-recognised digital certificates Provide sufficient flexibility to leverage investment from organisations such as Medicare Australia Encompass the current use of PKI by Medicare and in the future National Individual credentials. * 2009, NASH Solution Blueprint, NEHTA, Medicare Australia, IBM Global

15 End to end map

16 NASH Conceptual Model UHI

17 Key principles for NASH Must have local issuance capability Must be able to use card as flexible container Must have HPI-I/-O numbers inside certificates Must have good software vendor support Service must have improved usability

18 NASH & Trusted Identity Solutions Enrolment Management TDS TDS HI Credential Issuance & Management NASH Governance Business policy, practices, guidance and contract management Certificate Management Token Management Credential Usage e-health Local Local HPOS Medicare Australia Other Local CoI Local Catalogue Credential Management Directory Exposed NASH Business Secure Messaging Physical Access Logical Access Local Token Management Systems HI = Health Identifier HPOS = Health Professional Online

19 National Authentication Service for Health (NASH) Planning & 1 Analysis Enrolment Management TDS TDS HI Medicare Australia Other Local CoI Local Credential Issuance & Management Certificate Management NASH Governance Business policy, practices, guidance and contract management Catalogue Local Token Management Systems Token Management Credential Management Directory Exposed NASH Business Credential Usage Local e-health Local HPOS Secure Messaging Physical Access Logical Access HI = Health Identifier HPOS = Health Professional Online NASH Business Requirements NASH Functional Requirements NASH Technical Requirements Medicare Current State Solution NASH Solution Blueprint NASH Transition Plan Design & 2 Build NEHTA Board Approval Credential Requests Policy, Practices, Governance Catalogue Directory Interface Order Store Directory / Order Credential Management Orchestration Engine Certificate Management N.CP Validate Local Issuance Central Production Token Management O.CP J.CP Fulfillment Deliver Report & Audit Reporting and Billing Help Desk Help Requests N.CP = National Certificate Policy O.CP = Organisational Certificate Policy Detailed specifications & services Publishing of Interfaces Support for Early Adopters Collaboration with Stakeholders Contract Negotiations NASH Service Build 3Deploy & Operate Individuals Healthcare Healthcare Provider Organisations Operators of E-Health Providers support services Nominated Authorised Users Local Systems Responsible Officers Health Record/ Provider Connectivity Document Directories Secure Messaging Nationally Available Service Channels Web Business Office By Telephone Web Portal Kiosk Provider TDS HPI-I Records RDS Certificate & Token Management HPI-O Records HI Service Provider CDMS Directory Individual TDS IHI Records National Authentication NASH Trusted & Directories Reference Data Sources Healthcare Identifiers Service NASH Nationally Operated Infrastructure Release 1 Establishment of Governance Detailed Specifications Service Catalogue Support for existing PKI Certificates Release 2 Enablement of Token Initiatives Limited Availability of PKI Certs. Release 3 Full Operational Capacity Full Help Desk Full Integration with HI National Credential & Token Delivery as per NASH Blueprint

20 NASH Conceptual Architecture Directory Interface Local Issuance Reporting and Billing Order Store Central Production Directory / Order Token Management Report & Audit Credential Requests Credential Management Orchestration Engine Policy, Practices, Governance Certificate Management Fulfillment Help Desk N.CP O.CP J.CP Catalogue Validate Deliver Help Requests

21 Bringing it Together Urgently developing the essential foundations required to enable e-health

22 National e-health Infrastructure Solution Overview

23 In Summary Accurate identification will mean improved continuity of care and health outcomes for consumers. Better management of chronic disease arising from accurate identification will mean fewer unplanned hospitalisations. Establishing trust and securely transferring health related information between care providers Less time spent by clinicians in seeking and tracking information will mean more available time with patients.

24 Model Healthcare Community opens

25 Staged National Rollout NORTHERN TERRITORY Early Adopter: Sec. Msg. WESTERN AUSTRALIA Fast Follower: IHI, HPI, NASH, Discharge Summary, ereferral QUEENSLAND Early Adopter: NASH Fast Follower: Sec. Msg., SNOMED, AMT, IHI, HPI, NASH, AMT SOUTH AUSTRALIA Early Adopter: Sec. Msg. Fast Follower: IHI, HPI, AMT ACT Early Adopter: IHI, HPI Fast Follower: NASH, CDA, SNOMED Fast Follower: IHI, HPI, NASH, Discharge Summary, ereferral NEW SOUTH WALES Early Adopter: IHI Fast Follower: SNOMED VICTORIA TASMANIA Fast Follower: IHI, HPI, Sec. Msg Early Adopter: HPI, NASH, AMT Fast Follower: IHI

26 Further Information