Clinical champion for digital change reflection on 30 years HIC - - PowerPoint PPT Presentation

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Clinical champion for digital change – reflection on 30 years

Dr Richard Ashby Chief Executive / Chief Information Officer eHealth Queensland

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HIC 2017

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First there was the green screen

1980s Queensland Health Information System

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Hospital Based Corporate Information System (HBCIS)

• McDonnell Douglas
• Pick operating system
• Comprehensive suite

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HBCIS – outcome!

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SOFTWARE HARDWARE VS

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1990s

+ Hundreds of small, bespoke systems and applications

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Various speciality systems

EDIS ORMIS ICU CARDIOLOGY GE PAC/RIS TELEHEALTH OSIM AUSLAB MOSAIQ ELMS

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2000-2005

• Build system with small

Australian company

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ieMR 2

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2007

• “Best of breed”
• Interoperability
• Data warehouse
• Local build

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EMR 3 ($243m)

OERR ICU CCU ED OR etc. Interoperability Data warehouse

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ieMR – part of the eHealth agenda

Focus of international agendas

2003 – United Nations World Summit on the Information Society 2005 – World Health Assembly 2005 – WHO Global Observatory for eHealth (GOe) established 2005 – European Commission eEurope action plan released 2006 – World Summit on the Information Society 2009 – Obama Health Reform (‘meaningful use’)

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eHealth – a global focus…

National agendas

• Canada Infoway
• Scottish Care Information (SCI)
• NHS Connecting for Health (2003-2011)
• Veterans Health Administration USA
• Making IT work – UK NHS (2016)
• US Department of Defense (2016)
• US Veterans Health Administration (2017)

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Digital Hospital – part of the eHealth agenda

2003 Victoria invests in HealthSMART ($232m) 2004 eHealth Western Australia program ($334m) 2005 NeHTA established 2005 HealthConnect South Australia begins 2007 Queensland ieMR Project ($243m) 2008 Australian eHealth Research Centre opened in Brisbane (CSIRO/QH) 2009 Queensland ieMR (v2) commenced 2012 PCEHR (My Health Record) launched ($628m) 2014 First L6 HIMSS hospital – St Stephen’s 2015 First large scale digital hospital – PAH

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eHealth in Australia

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2009-2011

NSW strategy and procurement

• Off the shelf
• Proven product
• 90:10 rule

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“Best of breed” ($1.5B cost estimate)

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2012-2014

R1 R2 R3 R4

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July 2014

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“Digital Exemplar” model

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November 2015

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Princess Alexandra Hospital go-live

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April 2017

Medication management Anaesthesia Research

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Digital disruption and healthcare

• Health record always available
• Evidence based care pathways
• Structured documents with voice analysis
• Active and passive decision support
• Monitoring device and ECG integration
• Early warning systems
• Electronic order entry and results
• RFID tracking – patients, staff, equipment
• P2P communication/location
• Business intelligence and analytics

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The Digital Hospital

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Internet of Things (IoT)

• Definition
• Scale – 24 billion devices by 2020
• Ubiquitous sensing and monitoring
• Automation, robots etc.
• Smart Homes, Smart Cities, Smart Hospitals (?)

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“The biggest threat to the future of the internet is legacy IT systems”

Thomas Frey, DaVinci Institute

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Specialty systems

• Oncology
• ICU
• Mental Health
• etc.

2017-2020

• Patient Activity System
• Financial System
• Laboratory System
• Interoperability Engine
• Legacy network,

processing, storage

Replace

Digital Collaboration Platform

• Windows 10 / Office 365
• Smart Devices
• My Health Record
• Apps

Build Integrate

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Integrated Care

• eReferrals
• Clinical Pathways
• My Health Record
• Community
• Consumers – Apps, eConsultation,

eIAC, Citizen Science, Remote Monitoring, etc.

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Brisbane Diamantina Health Partners

Precision medicine exemplar - Melanoma

PRECISION TREATMENT

(QIMR Berghoffer) (MSH, MNH, UQ, QUT) (HSQ, QGHA) (QH, UQ, QUT, MSH, MNH) (QIMR Berghoffer)

TRIENNIAL 3D VECTOR IMAGING MELANOMA

(UQ)

IBM WATSON HYBRID IMAGING GENOMIC TESTING

Keytruda Opdivo Yervoy Zelboraf etc. SunSmart monitoring and behaviour app

WEARABLE TECH

UV Dosimetry BRAF Class 1, Class 2

SURGERY + - VACCINE

(AEHRC)

EVALUATION GENOMIC SCREENING EPIDEMIOLOGY AT RISK

CDKN2A (QUT)

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The High Reliability Healthcare Organisation

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Variation

“Can you predict the next

Zero Harm

Dave Roberts, Leadership Forum May 2017

harmful incident and prevent it?”

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The Intelligent Healthcare Enterprise

• Predictive, prescriptive, streaming analytics
• Cognitive Computing /Desktop

Learning/NSP/Augmented Intelligence

• Big Data/Small Data
• Visualisation/Virtualisation

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“Evidence into practice in a day, not a decade”

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Prediction: Changes to healthcare in the next 30 years, caused or enabled by digital technology, will be an order of magnitude greater than in the past 30 years!

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30 year digital journey

• The road is long and hard!
• Be persistent, consistent and resilient
• Focus on superordinate goals
• Beware of political cycles, toxic

cultures and ethical challenges

• Stay in the race…………………………..

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Travel tips

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