U-IHIS Initial Steering Committee Meeting Project Office, Belgrade, 3 July 2012 www.eu-ihis.rs
U-IHIS Project Inception Phase Inception report Dr. ng. Branko Marović Project Manager www.eu-ihis.rs
Activities performed during Project Inception Phase (February-June2012) -1/3 1. Recruitment of Project Staff 2. Project Office establishment 3. The review of legislative framework and relevant documents Laws related to the IHIS development and implementation; Reports of related national and international projects. 3
Activities performed during Project Inception Phase (February-June2012) -2/3 4. Organization of meetings, communication and consultation with key stakeholders MOH, DU, NHIF, IPHS, representative of the urorec institute, international consultants, representatives of vendor organizations. 5. Obtaining the HIS and HR software Source code and documentation of the HIS software provided, including changes made during SHP pilot implementation in 4 hospitals. IPH Serbia delivered HR software and relevant documents on CDs. Reports submitted to U were received from the DU. 4
Activities performed during Project Inception Phase (February-June2012) -3/3 6. Assessment of 19 hospitals2012, based on two surveys IPHS October-November 2011. U-IHIS project, June 2012. 7. Preparation of detailed Work Plan 8. Training plan and software deployment plan 9. Organization of the initial PSC meeting 10. Writing the Inception Report 5
Background- findings lections and appointment of the government The Rulebook on Detailed Contents of Technological and Functional Requirements for Implementation of Integrated Healthcare Information System HIS1 andhis2and 8 other software were certified in primary healthcare domain. Certification for secondary healthcare is expected. Change of legislative is necessary in order to effectively introduce HR and enable use of HIS Necessary to have MoH support IPH Serbia has submitted the draft Law on Records in Health Care two years ago 6
IPH Dr Milan Jovanovic Batut Strong interest for improvement of public health information Clear attitude towards necessary legislative modification and improvement HR project equipment transferred to the NHIF Software,documentation and data submitted to the Project Important coding systems are published by CIS 7
National Health Insurance Fund Need to expand theis to all levels of healthcare and health institutions Master record of insured persons Publication of codes and classifications is important for NHIF HR servers are placed in the NHIF data center Developing infrastructure that will enable creation of digital certificates for patients and health workers Important interests in the Project mpowering hospitals in quality data collecting and analysis, reporting and invoicing through introduction of HIS Prerequisite for transition to the DRG (diagnosis related groups) nabling access to medical data to a larger number of legitimate users reduces unnecessary costs and facilitates abuses detection 8
Beneficiary Hospitals Project will be implemented in 19 hospitals selected by the MoH. 3 clinical hospital centers 12 general hospitals 4 institutes All beneficiary hospitals have infrastructure set up through IPA 2008 Project LAN IT equipment 9
Baseline assessment of 19 hospitals U-IHIS Project will be implemented In 31 locations Approximately 172 buildings More than 4.000 PCs All hospitals have operational LAN. About60% hospitals have mutually disconnected LANs. One third of hospitals have partially networked PCs. All hospitals have IT staff. 10
Mode of introduction IterativelyF Initially in admission and outpatient facilities According to vertical specialties Introduction of HR operability The Project does not envisage introduction of Additional systems(lis, RIS, PACS, internal finances and bookkeeping..) Non-standard functionalities Hospitals may independently contract additional features. Additional possibilities may come through future projectsf 11
Role of hospitals Management support and commitment to the HIS introduction Involvement of professionals Health workers IT sector Harmonization, not suspension, of initiatives that are underway. Commitment to sustainability once the project is finalized. Other initiatives and own/additional resources are an asset. Project does not provide equipment, network, internet, infrastructure or software maintenance. Balance during introduction in various institutions 12
HIS Fully introduced in 4 SHP hospitals, initial maintenance in about 20 SHP-AF hospitals Now Adjustment to hospitals processes and needs Data migration from systems that are being abolished Integration with HIS subsystems that are in use If a hospital wants to keep the existing solution Not to integrate HIS with other subsystems: laboratory, PACS, RISF Only standardized HR interface Important aspect is the improvement of access security with access to HR data from other hospitals Sustainability after the Project s end 13
HR Sustainability, patient identity management, content Old system was never in real use In the meantime new resources are developed: MOP, CISF Standardization in the field of HR data exchange in urope epsos project Ability to temporally monitor data and its sources Develop monitoring scenarios for specific conditions that will demonstrate HR benefits: diabetes, heart attack, strokef HR Minimal Data Set from the previous project Define clear interfaces for integration Usage of existing classifications, registers and classifications 14
Introduction and training 1-4: Installation and adaptation, initial training, expansion, fine tuning 5: HR training, overcoming the problems identified in the meantime Project Timeline - Training Related Activities Related to Deployment and Training Year 1 Year 1 Year 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 F M A M J J A S O N D J F M A M J J A S O N D J F M A M J J A S O N D J IT Development Pilot Testing Full Implementation Health Informatics Unit 2012 2013 2014 15 HIS Deployment and Training Team 1 1 Hospital 1 1 Team 2 2 Hospital 2 2 Team 3 3 Hospital 3 1 Team 4 4 Hospital 4 3 HR/Follow-up Hospital 5 2 Summer Hospital 6 4 Hospital 7 1 Hospital 8 3 Hospital 9 2 Hospital 10 4 Hospital 11 1 Hospital 12 3 Hospital 13 2 Hospital 14 4 Hospital 15 1 Hospital 16 Hospital 17 Hospital 18 Hospital 19 3 2 4 1 15
Licences MS SQL licence from theipa2008 HIS in MoH There are licenses for obsolete products for HR, their annual maintenance expired in May 2008 Now it would be approximately 300.000 /USD Use only necessary components Purchase only when they enter into production Ask for discount, previously purchased licenses have never been really used Include into the budget of the organization responsible for the HR 16
General risks lections, governmental support, general stability Relationships and cooperation of main participants Cooperation of hospitals and users technical committee? quipment and infrastructure properly align procurement, phases and locations HIS and HR documentation HRteam is no longer available HIS software updated on monthly bases close coordination required Preconditions for training must be performed mainly in hospitals, on present equipment, in alignment with availability of health professionals New: Fragmentation of HIS platforms and work due to many diverse and specific requirements 17
Risk related to HR Initially specified Patient identification Institution identification Health information meaning and data exchange Sharing and using data in accordance with participant's roles and privacy New The legal framework consistent with the use of HR and allowing data exchange and collection Accidental security and data disclosure incidents may jeopardize the project Inadequate stewardship over various registries, classifier and coding systems Funding source for HR connectivity Need for a large-scale identity management infrastructure 18
Key modifications of the original project plan Delayed start of the Project Inception Phase Need for consultations and assistance in the legal field arlier introduction of HIS into hospitals Adaptations for the existing solutions and data in hospitals, but within clear constraints Probable HR re-implementation 19
xpected results Significant improvement of previously developed HIS and HR solutions, their development, integration and adaptation in order to achieve integrated healthcare IS. Installation and use of IHIS in 19 hospitals. IT staff trained for administration and support in 19 hospitals. Trained user (doctors, nurses, pharmacists, hospital administration and support staff) in 19 hospitals. HR connection to the HIS already introduced in over 20 hospitals and ability of connection with other systems. Support to the MoHto strengthen capacities and set up appropriate institutional framework for operation and development of health informatics. 20