Health Informatics Primer. Liz Schoff Chair, HINZ LinkedIn Twitter: city4liz

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1 Health Informatics Primer 2015 Liz Schoff Chair, HINZ LinkedIn Twitter: city4liz

2 Why are we here? Hillary All Blacks

3 Overview for workshop What is health informatics? Why is health informatics important? What does health informatics mean for me? What does health informatics include?

4 Theory, practice, discipline, knowledge Friedman CP. What informatics is and isn't. JAMIA. 2012;20:224-6.

5 Information lifecycle Collect, Identify Maintain Archive, Dispose Organise, Store

6 What is health informatics? Why is health informatics important? What does health informatics mean for me? What does health informatics include?

7 Triple aim for quality in health

8 50% health care dollars are wasted in inefficient processes 82% health care providers said electronic prescribing saves time and reduces errors 85+% medical records contain errors 1 in 3 adults do online health research and half of these consulted a health professional with their online findings

9 The National Health IT Plan First published for with focus on national and regional initiatives, and integration of IT systems Particular commitment to patient portal Update in July 2014 focused on: electronic medication management national clinical solutions regional information platforms community-based integrated care initiatives

10 What is HIGEAG? HIGEAG is the Health Information Governance Expert Advisory Group It reports to and advises the National Health IT Board It was established to develop a Health Information Governance Framework for the New Zealand Health sector

11 The Health Information Governance Framework will cover: Maintaining Quality and Trust support information sharing so that health practitioners have all relevant information at point of care and consumers feel confident that their personal health information is held securely and treated confidentially Upholding Consumer Rights and Maintaining Transparency consumers privacy rights in regard to their personal health information and health agency obligations around maintaining transparency in their use of that personal health information Appropriate Disclosure and Sharing rules around information sharing and disclosure Ensuring Security and Protection of Personal Health Information link to Health Information Security Framework which sets out the technical and procedural requirements for protecting personal health information

12 Health Informatics supports education and research

13 What is health informatics? Why is health informatics important? What does health informatics mean for me? What does health informatics include?

14 Health informatics domains 4 Core principles and methods Information & Communications Technology Health and Biomedical Sciences Information Sciences Management Sciences 10 5 Human and Social Context Competencies in health informatics, CHIA

15 Understanding the basics Information systems Key concepts What s hard what s cool

16 Information systems Electronic Health Records Clinical Decision Support Systems E-health applications and solutions Participatory health solutions Architectures of health information systems

17 Electronic health records What are EHRs? Pros/Cons Examples

18 Some examples Orion Health Medtech Epic Systems OpenMRS

19 Clinical Decision Support Systems Dr. Dawn Dowding, PhD, RN

20 E*health applications and solutions

21 Participatory health solutions

22 Architectures of information systems Federated Centralised

23 Key concepts Knowledge representation Standards and interoperability Interfacing and patient identification Value of information systems and adoption

24 Computers are dumb They don t learn They can t tell what you mean They don t get bored

25 Data Information - Knowledge Vocabulary Semantics Baby Blood Pressure Context Values

26 Standards and interoperability Humans are flexible and expressive, computers are rigid and formal 1 Coding - Diagnostic related groups (DRGS) ICD 10, Read, Snomed-CT, FHIR Vocabularies to standardise terms, shared meanings Pre-eclampsia, PE, Toxaemia, PET, Gestational Proteinuric Hypertension, GPH 1. Prof. Alan Rector, U of Manchester

27 Interfacing and patient identification AVC4323 AWS2204

28 Value of IS and adoption Reducing occurrence of rheumatic fever by increasing compliance of secondary prophylaxis with a mobile app Whanau Ora and approach.

29 Problem solving A man moved to a new city and both his electronic and his paper medical records were transferred from GP A to GP B. Soon after the transfer, the man died. A medical incident review noted the electronic record was incomplete, however it was determined GP B overlooked important information in the paper record, resulting in the man s death. What concerns would you have for electronic records? What concerns would you have for paper records?

30 What s hard, What s cool Integration of clinical data and associated risks Ethics, privacy and security New data sources Emerging technologies

31 Integration of clinical data associated risks Errors in data Missing data Wrong data Too much data

32 Ethics, privacy, security Professional codes of conduct, ethics Privacy Act & Health Information Privacy Code Privacy is the interest that individuals have in sustaining a 'personal space', free from interference by other people and organisations Security Confidentiality: right people, right information Integrity: trustworthy, accurate, complete Availability: right time, right place

33 Keep data and hardware secure

34 New data sources & big data Volume 90% world s data generated in the last 2 years temperatures, physical locations, geocodes, call details, weather conditions, medical biosensor readings, automobile and driver operational data, equipment status. Variety Veracity Velocity real-time sensors in smart buildings and homes, phones and tablets, security cameras, watches and personal fitness monitors, automobiles, appliances, smart clothing

35 Emerging Technologies & Trends

36 Categories of health information Shahid Shah, healthcareguy.com

37 What is health informatics? Why is health informatics important? What does health informatics mean for me? What does health informatics include?

38 What do HI professionals do? Ensure patient records are complete, accurate and easily available to medical professionals Devise, implement and maintain systems to capture, store and organise medical data Compile and analyse medical data for better quality care, research and cost control Troubleshoot and improve all the technologies and workflows that are used in the delivery of healthcare

39 What roles do HI professionals have? Clinical Records Managers Health Systems Analysts Research, Funding and Policy Analysts Health Service Designers Nurses, Doctors, Health Administrators, Health Practitioners, Allied Health Providers, Health Educators

40 How computer literate should health professionals be? What basic information literacy skills should health professionals possess? Where and how should they get the education for this? To what extent should health professionals be trained in IT to enable them to work with health information systems?

41 Health informatics skills provide for: lifelong learning career development critical thinking ability communication skills information literacy Follow Up: Personal assessment and plan Opportunities to learn more about health informatics

42 Useful information sources HINZ National Health IT Board Ministry of Health IMIA Health IT cluster Health Quality & Safety Commission

43 Useful evidence Liz Schoff Chair, HINZ LinkedIn Twitter: city4liz

44 Questions? What is health informatics? Why is health informatics important? What does health informatics mean for me? What does health informatics include?