This document summarizes Dr. John Heavens' presentation on addressing Scotland's eHealth goals. The presentation reviewed Scotland's eHealth strategy and goals, Orion Health's global experience with eHealth solutions, and provided perspectives on achieving success. Scotland's eHealth goals are to use information and technology to maximize efficiency, support self-management, shift the balance of care, improve information for healthcare workers, and improve medication management. Orion Health has experience with integrated electronic health records, clinical portals, patient portals, clinical workflows, and business intelligence tools to support new care models of coordinated, community-based care. The presentation recommends taking a phased, clinically-driven approach starting with integration and a single patient record view to achieve

1. Addressing Scotland’s eHealth Goals NHS Scotland, August 2011 Dr John Heavens

2. Session Goal Within the context of the new Scottish eHealth Strategy, to provide some perspectives on a way forward to achieving success, based on Orion Health’s global eHealth experience

3. Agenda Review Scottish eHealth Approach Orion Health’s Global Experience Our perspectives

4. Scottish e-health approach

5. Scotland’s eHealth Scotland’s eHealth Strategy Policy Context: The Healthcare Quality Strategy for NHSScotland(May 2010) – the 3 Quality Ambitions: Effective (Evidence based) Right care at the right time in the right place Eradication of variation Person-centred Safe Health & Social Care Collaboration & Integration Financial

6. Scotland’s Scotland’s eHealth Strategic Goals To use information and technology to: Maximise efficient working practices, minimise wasteful variation, bring about savings and ensure value for money Support people to manage their own health and wellbeing, and to become more active participants in the care and services they receive Contribute to shifting the balance of care and support people to self manage, and to provide appropriate information for people with long term conditions and mental health problems Improve the availability of appropriate information for healthcare workers and the tools to use and communicate that information effectively to improve quality Improve medication management as an essential part of peoples’ care

7. Orion health’s experience

8. Globally Globally - A Changing “Burden of Disease” Traditional Burden of Disease Young Infectious Diseases & Injuries Traditional Care Model Acute hospital based Curative Speciality orientated Episodic Current Burden of Disease Elderly With LTCs & related: Mental Health problems Socio-economic problems Significant cost escalation New Care Models Community based Prevention focussed MDT orientated Continuous care and review Use of assistive technologies Behaviour modification

9. New Care New Care Models - 1 Integrated H&S care delivery through: Multidisciplinary Teams (MDTs) Working in an interdisciplinary way Across care boundaries Focussing on: Community based care Patient and care giver involvement

10. New Care New Care Models - 2 Continuous care and review with a preventative focus, which may include: Evidence based, disease focussed, programs of care Case Management principles ‘Virtual Ward’ approaches Call centre support, which may include: Behaviour modification Use of Assistive Technologies Video Conferencing Telehealth – Physiological monitoring Telecare – Environmental monitoring

11. Mechanisms Mechanisms Mechanisms to deal with these changes include: Workflow re-engineering eHealth support

12. Orion Health Orion Health A global provider of eHealth solutions Our Mission - To create innovative, world-leading health technology solutions that improve peoples' lives Provide clinical systems, designed by clinicians for clinicians ‘Tools’ based approach

13. eHealth Support eHealth Support - 1 Delivery of coordinated, cross boundary, evidence based, community orientated, MDT quality care with patient and care giver involvement requires: Systems interoperability – Integration Engine An integrated, single view of Patient Records accessible by: Health & Social Care providers – Clinical Portal Patients and Care Givers – Patient Portal

14. eHealth Support - 2 eHealth Support - 2 Process support tools – Problem Lists, Medicines Reconciliation, Orders, Discharge Letters, etc. Clinical Workflow tools – Disease & Case Management tools Outcome measures – Business Intelligence tools

15. Orion Health Orion Health - History Healthcare Professionals Patients Access – Patient EHR Clinical Process/Workflow Integration & Decision Support National & Regional Systems Clinical Data Repositories Telehealth & Telecare Currentsystems Hospital, GP, SS Other Systems Application Integration

17. Message routing & delivery

19. Secure Authentication/Authorities, CCOW enabled SSO (Single Sign-On) to multiple systems with RBAC (Role Based Access) & LR (Legitimate Relationships) capabilities

20. CDV (Clinical Document Viewer) - including results, sign-off and charting

21. DPS (Dynamic Patient Summary) – windowlets of any electronically available data

24. Secure messaging

25. Notifications

28. Medicine Reconciliation

29. Order Entry

30. Disease Management:

31. Forms designer

32. Rules Engine

33. Program Builder

34. Role based Task List management

37. Data Mining and Analysis

39. Our Perspectives

40. Mechanisms How do you start? Mechanisms: Workflow re-engineering eHealth support Requirements: Clinically driven but with Informatics & Management involvement Done jointly Think: ‘Delivery of coordinated, cross boundary, evidence based, community orientated, MDT quality care with patient and care giver involvement. ‘

41. Mechanisms Where do you start? With the foundations: Integration Engine Clinical Portal Understand local health & social care priorities Take a phased approach to delivery Know the importance of Change Management

42. Orion eHealth Maturity Model Patients Professionals Maturity Level V Health Management Co-responsibility Active Patient Involvement Patient & Carer Integration Patient Portal Coordinated Quality Care MDT Workflow & Decision Support Workflow Integration Disease & Case Management IV Process Integration OE / Med. Rec. / Prescribing Process Automation and Standardisation Improved Quality of Care III Information Integration Clinical Portal – EPR / EHR / HIE Shared Single View of Patient Data Shared Information II Resource Optimization Application Integration Integration Engine & Standards Quality Data I Cross Boundary Integration Business Intelligence Capability

43. Orion Health – eHealth Architecture

44. Orion Health Orion Health Support Orion Health are here to support you with: eHealth solutions Professional Services: Clinical Technical

45. Discussion? Discussion?

46. www.orionhealth.com