NI IN PACIFIC RIM

An aging population ● Increased complexity of need ● A greater incidence of long-term conditions

Government’s Health Policies need to address the increased demand for health services imposed by 3

Professor Fetter from Yale University

case mix program developed by

Australian Refined Diagnosis Related Group (AR-DRG)

standard is used nationally for costing and funding healthcare services in australia

International Statistical Classification of Diseases and Related Health Problems (10th Revision) , Australian Modification (ICD-10-AM) codes

2 under Relies on data obtained from individual patient records: in australia

2009- AR-DRG system generated approximately $4 billion per year

case mix economic impact

a. 1.5, 1, 15

b. increase

c. cardio diseases

funding

a. Australian taxpayers contribute a —% Medicare levy, with an additional —% for high-income earners without private health insurance. This contributed —% to the Australian Government;s total health funding for 2009-2010.

b. Taxpayer contributions to Medicare are projected to —to cover disability services

c. Spending on —was the highest, totaling $7.9 billion

Pharmaceutical Benefits Scheme (PBS):

jointly funded by the Australian government and non-government sources. accounts 14%

publicly funded hc, acc, private hc Pharmaceutical and Medical Device Regulation

4 under new zealand

The Ministry of Health

— allocates funds to 20 District Health Boards (DHBs) based on population, with DHBs both purchasing and providing healthcare services.

DHBs

collaborate to deliver cost-effective, efficient healthcare that meets national, regional, and local needs.

New Zealand Accident Compensation Corporation (ACC)

Provides comprehensive, no-fault personal injury coverage for all residents through a range of health benefits and subsidies to assist individuals in the event if an accident

injury prevention, early rehabilitation, and collects injury-related statis

ACC funds 3

levies on employers, employees, and vehicle registration

ACC funding comes from 3, processing over 1.5 million new claims annually.

aging population, increased demand, and limited public budgets

Private insurance-funded healthcare is on the rise, driven by 3

20

Private sector now accounts for nearly —% of h services

Pharmaceutical and Medical Device Regulation

All prescription medicines are regulate government through this; it offers subsidies o medicines, although only for a few options

Cloud services ○ Maturity of systems integration services ○ Proliferation of devices ○ Mobile Access to applications, enhanced capacity to collect

Major changes in technology give 5

a. Basic hardware has advanced into multiple input and output devices

b. overcoming phys and contraints

Embracing advances in technology 2

Personal Digital Assistants (PDAs)

Used for point information and clinical documentation for community a hospital nursing, hospital-based infection control, and/o management

Monitoring Devices

Being connected to information sys automated data entry

improved portability

Enabling technology use in more setting

PDAs and Tablets

Being used or trialled in the clinical settin

integrating care

is a priority; supported by technology-enabled information flow

Electronic health event summaries and lab and radiology data

are being transmitted between providers and across primary and secondary sectors

88

—% of New Zealanders use the Internet

Ultra-Fast Broadband and Rural Broadband Initiative

The government is working to improve broadband access through: —These 2 initiatives will bring faster broadband using fiber optic technology to 97.8% of homes, schools, businesses, and hospitals.

67.9, 3rd

New Zealand consumers found —% of participants used a computer to access health information ○ The internet was the — most popular source of Internet information, after doctor/health center and nurses.

health navigator, healthpoint, health topics A-Z, web health

4 Health Information Websites in NZ

Health Navigator:

Collates, coordinates, and identifies the most useful resources for primary and secondary prevention of long-term conditions

HealthPoint:

Provides local information about what to expect prior to, during, and following a referral

Health Topics A-Z:

Promotes healthy aging

Web Health

Aims to connect communities by providing a directory of health and social services

Provision of consumer information ○ Patient Portals ○ Shared Health Records

Important developments 3

“Single patient-centric” view

contextual view of data that is single log-on and browser-based; provided by the web environment and the use of powerful integration engines; placed over multiple health information systems

Horizon research- mar 2013

found more adults in New Zealand now use a smartphone than a standard mobile, which was a 13.6% rise over the previous nine months (Horizon Poll, 2013).

Bring Your Own Device (BYOD)

In secondary care health professionals may— for use in multidisciplinary team meetings.

mobile computing

has also increased with the use of tablets, including iPads.

Royal New Zealand Plunket Society

Is using tablets for point-of-care data entry in the area of well child health in the community setting

Social Media

Can be a platform in healthcare to promote and improve health and as a means of contact with and between consumers

thrive

A community-based support service for teen parents; use Facebook as their main communication tool ■ Service that provides support to families with mental health problems who are using an online forum to extend their service provision

Nursing Council of New Zealand in the Nurses Code of Conduct

Makes specific mention of the use of social media and electronic communication

Information Technology in New Zealand

behind dairy and tourism. ○ NZ government identified innovation as one of six priority areas to support. ■ Funding funneled into research and development in ICT.

a. 2008

b. drive greater synergies and high-performing systems, maximize synergies from shared systems

SINGAPORE: INTEGRATED HEALTH INFORMATION SYSTEMS (IHiS)

a. established yr

b. 2 goals

provie it services, oversee clinical business, cost effective hc

3 key function of ihis

singlehealth hospitals, singleHealth nurses pal

2 initiave under ihis

SingHealth Hospitals:

Launched a mobile app to pressure ulcers, prevent falls, and enhance m safety designed by and for nurses.

SingHealth Nurses Pal:

Features an IV drip rate and alarm function

health online, national e health strategy, National Broadband Network rollout, National eHealth Transition Authority (NeHTA)

AUSTRALIA E-HEALTH INITIATIVES 4

health online - 1999

Australia's first national strategic eHealth.

HealthConnect, MediConnect, HealthInsite, National chain initiative

followed by projects by the Australian Government: 4

National Hospitals and Health Reform Commission’s report

identified a number of gaps in safety and quali suboptimal information sharing, and propose informatics solutions that are expected to improvements

e health

“The transfer of health resources and healthcare by electron It encompasses three main areas (WHO, n.d.): ○ Delivery of health information, power of it and e commenrce, and e business

2008 National eHealth Strategy

Reinforced existing collaboration between Commonwealth, State, and Territory Government on the core foundations of a national eHealth system ● Identified priority areas ● Provided sufficient flexibility for Individual States and Territories, and the public and private health sectors

National Broadband Network rollout

Healthcare Identifiers Bill was passed by the Australian Federal Parliament

National eHealth Transition Authority (NeHTA)

Jointly funded by the Australian Government and all State and Territory Governments to facilitate the transition to a connected system where every Australian is at the center of healthcare

NZ National Health IT Plan:

Focus on ensuring electronic access to core health information for all New Zealanders. ○ Priorities include electronic medication management, national clinical solutions, and integrated care

telehealth

Increasing use to improve rural healthcare access through remote consultations and services. ○ Supported by the National IT Health Board and government broadband initiatives.

National Health Data Infrastructure, METeOR, Minimum Data Sets (MDS), data governance

info governance under australia 4

National Health Data Infrastructure

Established by national health information agreements and the National Health Data Dictionary (1993).

METeOR

A repository for national metadata standards, providing access to data definitions and tools

Community Nursing MDS, Palliative Care MDS, and Nurse Practitioner MDS.

australia 3 mds

National Health Information Standards and Statistics Committee (NHISSC)

Australia’s health data governance has evolved, with the

National Health Information Collections, NHI, health legislation

NZ info govt 3

national Minimum Data Set, National Non-Admitted Patient Collection, and the National Medical Warning System.

National Health Information Collections include 3

National Health Index (NHI)

A unique identifier for each healthcare consumer, used to track individuals across healthcare events.

Privacy Act (1993) and Health Information Code (1994),

health legislation governed by

50,060, 2005, 2013, 110

Nursing Workforce in NZ: — nurses providing care. The role of nurse practitioners was introduced in —, and by —, there were—nurse practitioners.

Asia eHealth Information Network (AeHIN) ● Spearheaded by: Dr. Alvin B. Marcelo

reginal deve: forum to improve healthcare through information and communication technology (ICT).

Dr. Alvin B. Marcelo, Bangkok in August 2012

(AeHIN) headed by and launched in

a. Medical Informatics Unit, University of the Philippines Manila.

b. 2011 Asia-Pacific HIS Country Ownership and Leadership Forum

c. eHealth, Health Information Systems (HIS), and civil registration/vital statistics (CRVS)

d. WHO ○ ITU ○ Rockefeller Foundation ○ Australia Aid ○ US Aid

AeHIN

a. secretariat based at

b. Resulted from the

c. open to 3

d. supported by major orgs 5

collab, strategic info, faci Global Observatory of eHealth

AeHIN 3 functions

advisory, management, scientific committees.

Governance structure includes 3

Enhancing leadership and governance ■ Capacity building ■ Peer assistance ■ interoperability

Five-year strategic implementation plan with fou objectives:

HEALTH INFORMATICS NEW ZEALAND (HINZ)

National non-profit organization focused on improving processes and patient care through IT

Nursing Informatics New Zealand (NINZ) ■ New Zealand Health Informatics Foundation (NZHIF)

HEALTH INFORMATICS NEW ZEALAND (HINZ) formed by merging 2

(NZHIF)

Holds annual conferenc collaborates with IT groups.

International Medical Informatics Association (IMIA)

● International Medical Informatics Association Nursing Informatics group (IMIA-NI)

● Health Information Management System

New Zealand participates in International Health Informatics 3 orgs

a. IMIA’s Working Group 8

b. 2nd group

c. Health Information Managers Association of Australia

d. Health Informatics Society of Australia (HISA)- Joan Edgecumbe

Informatics in Australia

a. has had a representative in the— (W 1984.

b. Nurses were the —of health professionals to or promoting health informatics

c.was established in 1949, though its informatics focus came

d. Nursing informatics is now a special interest grup wiith the—

COALITION OF NATIONAL NURSING ORGANIZATIONS (CONNO)

Developed a Position Statement on Nursing and eHealth under leadership of its NIA member (CoNNO, 2008). ● Meets twice a year to discuss key nursing profession issues.

difficult, No national-level consensus,

Challenges in Professionalization 2

IMPORTANCE OF HEALTH-RELATED INFORMATION SOURCES OF EVIDENCE-BASED PRACTICE

TRENDS IN HEALTH INFORMATICS RESEARCH

HI and NI res 3

Australian Health Informatics Education Council (AHIEC), Certified Health Informatician Australasia (CHIA)

In response to persistent skills shortages, initiatives such as the establishment of the— and launch of — cert program in 2013 were implemented

1- defining core health informatics competencies along with role-specific skills;

2- delivering accessible “Introduction to Health Informatics”

3- promoting inter-university cooperation

Health Informatics New Zealand (HINZ) Education Group 3 strat

a. raise awareness, educate professionals, disseminate knowledge

b.multiple depts, multidisciplinary nature of HI

c. nurses

a. Professional health, medical, and nursing organizations, along with educational providers and research centers, play a major role in: 3

b. The field is becoming increasingly complex due to:

c. the largest healthcare professional group, play a crucial role in leveraging informatics for better patient care.

Core competencies in Health informatics