At HealthLink we pride ourselves on our support for – and our adherence to – standards. But how do standards actually help in the delivery of solutions? More practically – how does the use of standards improve clinical outcomes?
Recently at HINZ, I presented an endorsement of the standards-based approach to developing solutions that span multiple systems. The case study that supports my proposition is Auckland eReferral under the CareConnect brand. The standard in question – “the standard” in the rest of this presentation – is HISO 10014.2 Online Forms Architecture Technical Specification.
Standards based solutions have been good for Auckland eReferral, good for vendors and good for the sector as a whole.
The CareConnect project was a challenging one, spanning many different systems, many different vendors, 300 odd general practices in Auckland and three of New Zealand’s largest district health boards – Auckland, Counties Manukau and Waitemata. Between them, these DHBs send almost a million referrals annually, faxed in manually. Key problems we needed to address using eReferral were lost and duplicated referrals. Having physical printed referrals also meant there was no “single source of truth”. A referral has a life after it is faxed, with information added or changed, other documents clipped-on or stapled and notes scrawled on it by clinicians . With multiple copies these additions and amendments could be across numerous documents and could easily contradict each other.
To address these challenges we wanted to take the work done on standards and use it to clear benefit in a real project. Furthermore, we knew that the eReferrals solution involved tying data from Primary Care into clinical workflows that took place in Secondary care. So, working in collaboration, HealthLink and Orion set up the “Open Health Consortium” so we could jointly propose a standards-based solution for eReferrals in the Auckland region. The Open Health Consortium combined HealthLink’s long experience and broad presence in Primary care with Orion’s known expertise in Secondary care.
As we learnt, the success of a standard is dependent on adoption and uptake. It needs to support clinical outcomes and be used in a meaningful way. Pragmatism always trumps dogmatism in the application of standards.
View the video of my HINZ conference presentation below to learn:
- Why standards are great for facilitating generic, extensible, reusable integration in a multi-system solution
- Why HealthLink decided to take the standards-based approach with CareConnect
- Six key problems the standard solves: multiple disparate coding systems, hard coded business rules, data quality issues, high cost of change to the proprietary interfaces, low pace of change and rogue forms that bypass the subscribing systems.
- How standards were designed and implemented specifically for Auckland eReferral (CareConnect)
- How eReferral has gone – an evaluation of the application of the HISO standard and the lessons we learnt
The video is 29 minutes long and follows the full length of my presentation.
View my presentation slides on Slideshare.
Your Feedback Helps Us Improve, We’d Love to Hear From You!
Auckland eReferral supplied as part of CareConnect is going into production as I write. However, this is a living project so we welcome feedback from those in General Practice for consideration in the next phase of this programme.
- What information do you want to receive about a referral after it’s made? Status Update messages in the inbox? A status summary that appears when you re-open the eReferral? A web portal you can login to that shows all the referrals – active and historical – that you or others at your site have made?
- The HISO standard supports the submission of eReferrals but once it’s implemented in a practice management system the addition of other forms is a relatively trivial matter – what other forms do you complete that could benefit from pre-population and online submission using the HISO standard?
- CareConnect eReferral will be available under the most recent releases of MedTech and My Practice – what other practice management systems do you use where you might need to raise eReferrals?
- We want eReferrals to mesh cleanly with practitioners’ existing workflows – what other steps could we take that would make eReferrals fit more seamlessly into your processes? For example, is there value in us requesting a daily reminder when you “Park” an eReferral? How about initiating an invoice?
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