This is a keynote presentation given to HIMSS Asia Pac 2010

1. The Future of Health is in Our HandsIntelligent Health Steven C. Boyages Copyright Not for Reproduction 2010

2. Summary We are on the verge of a great era of transformation in health care through health IT Intelligent Investment The future will be spearheaded by a better understanding of workflow Intelligent Work Better access to real time information about patient care and health system performance underpinned by sustained investment in technology Business Intelligence Systems This transformation will lead to a sustainable, flexible and safer health system where the patient is at the center of care as an active participant Intelligent Health Care

3. Intelligent Investment Copyright Not for Reproduction 2010

4. Challenges to the health system Rising demand Growing & ageing population Chronic illness rising High levels smoking, obesity, stress High consumer expectations Constrained capacity Patient Safety Workforce shortages and attitudes Manage demand within finite resources Cost vsinvestment NSW spends about 28% of budget on health care 1.3 million dollars per hour 4

5. Investing In Health IT Benefits Improved automation Improved productivity Reduced duplication Improved safety Improved patient and staff experience Improved reach of information and service Risks Financial investment not realised Poor connectivity Lack of common standards Increased risk to patients Increased staff frustration and lower morale Staff expectations not realised 5

6. Investing in Health IT Transformation steps Build the case for Why? Build the case for What and in what order (sequence)? But most importantly: Build the case for How? Value proposition Patients, payers, providers, places of care (4Ps) Execution is the key Evolution as opposed to revolution Engagement with key staff in design Integration with key legacy systems Understand complexity and complex systems Copyright Not for Reproduction 2010

7. Health is a complex business Copyright Not for Reproduction 2008 The organisational goals fundamental to Sydney West Area Health Service are clearly outlined in CAREFirst1, to: Provide accessible and appropriate clinical services Design safe, effective and innovative models of care Invest in services that are value for money Advocate a culturally appropriate model of service and community participation Promote a culture of knowledge through teaching and research Develop a highly skilled workforce.

8. Sydney West delivers On a typical day in Sydney West… 2,334 people receive inpatient care 546 people are seen in emergency departments 8,753 out-patient services are provided 1,488 primary care and community health occasions of service are provided, with 129 new referrals 266 occasions of service are provided by community mental health teams.

9. Health Operating System-HOS Complex and Connected 9

10. Current Strategy

11. Background

12. InfrastructureComplexity

13. Intelligent Work Copyright Not for Reproduction 2010

14. How do we evolve and adapt? Copyright Not for Reproduction 2008

15. Evolution In biology, evolution is the process of change in the inherited traits of a population of organisms from one generation to the next Natural selection, adaptations Genetic drift, random The concept of evolution may be applied to an organisation Traits are the genetic code or constants in health, patient care Adapting to external environmental factors Copyright Not for Reproduction 2010

16. Evolution Copyright Not for Reproduction 2008

17. The Process of Adaptation Models of Care Safety Redesign Information and Innovation Technology Investment Team First Understanding the way we deliver care at the level of the “cellular unit”, what, how and who Strong focus at the ward level Copyright Not for Reproduction 2010

18. Something old Constants of health Copyright Not for Reproduction 2010 Patient Centred care History, physical, investigations Teams of health care workers Care in the Home Hospital Setting

19. Team First Copyright Not for Reproduction 2008 WARD

20. COMPASS Professional Specialist Teams Redesign FIT BIT ReFIT Audio-video Recording Roles SOPs Policy Vertical Process Horizontal Process Generalist Teams Team First Social Networking Wiki, Blogs Collaborative Teams WARD Collaboration Tools RSS, Sharepoint, Groove Technology PlatformsSurface Computing, Bedside WAND Display Copyright Not for Reproduction 2010

22. LOS

23. EUR

25. Hospital Avoidance

26. Load Management

27. Hospital Bypass

28. Dashboard

29. Referrals to HealthOne & GPCare Navigation Unit Patient Flow Manager Copyright Not for Reproduction 2010

30. How do we evolve and adapt?Something new Copyright Not for Reproduction 2008

31. Business Intelligence Systems Copyright Not for Reproduction 2010

32. Health IT systems Clinical Corporate Integrated BI systems Copyright Not for Reproduction 2010

33. Layers of information

34. Clinical Systems Patient Administration Systems Electronic Medical Records Electronic Records PACS/RIS Pathology Systems These are key building blocks or genetic code Copyright Not for Reproduction 2010

35. Current Applications Orders (Order Entry)

36. Current Applications PowerChart (Flow Sheet)

37. Current Applications Respiratory

38. Current Applications Discharge Summary (eDRS)

39. Layers of information

40. Copyright Not for Reproduction 2008

41. Copyright Not for Reproduction 2008

42. Layers of information

44. Links to hundreds of pre-populated Business Objects Reports (no performance issues)(a) Patient Care (b) Performance Mgmt 35

45. (b) Performance Mgmt Enterprise Level 36

48. SQL Server Reporting / Analytic ServicesPublished / Static Reports Operational / Subject Area Dashboards and Drilldowns 37

49. Bed Board 38

50. (a) Patient Care 39

51. Real Time Health Systems Definition Responsive Agile Available Flexible Timely Real time Near Real time Capability Patient Care Safety Decision support Outcomes Research Patient Logistics Performance Management State Area based Hospital/cluster/network Modality (scheduling) Bedside 40

52. Unified | …To Data FUSION Labs Cardiology Procedure Documentation Medication Administration Electronic Medical Record OR Management Emergency Department Pathology Imaging Hemodynamics CPOE Pharmacy Dictation Medication Dispensing PACS Charting Clinical Notes Orders VIEWERS FUNCTIONS DATA CORE Mobile Data ICU/Critical Care Advanced Analytics Image Distribution RIS Nursing Workflow/ Documentation Amalga Amalga Amalga Contract Management Revenue Management Bed Management Financial/ERP Enterprise Scheduling Business Decision Support Inventory Document Imaging Physician Practice Claims Management Registration Staff/Nurse Scheduling Outcomes Management Transcription Purchasing Access Management Medical RecordsCoding Call Management Microsoft Amalga is the new way to capture, consolidate, store, access and quickly present data in meaningful ways

53. Business Intelligence Systems Allows leveraging of existing investment in legacy systems Integrates patient level and performance level information Allows Flexibility and Agility Real Time Rapid development Culture Governance Copyright Not for Reproduction 2010

54. Intelligent Health Care Copyright Not for Reproduction 2010

55. Patient Experience Copyright Not for Reproduction 2008

56. Evolutionary Pressures Copyright Not for Reproduction 2010 Patients as partners in health Health information and navigation Personal health records Greater expectations of citizens

57. Improving Staff Experience Desktop Thin Client Telephone Vocera Mobile Computer On Wheels (COW)

58. Intranet, tablets, blogs and wikis Copyright Not for Reproduction 2010

59. Improving Staff Experience Lithgow Hospital Wireless LAN

60. Summary We on the verge of a great era of transformation in health care through health IT Intelligent Investment The future will be spearheaded by a better understanding of workflow Intelligent Work Better access to real time information about patient care and health system performance underpinned by sustained investment in technology Business Intelligence Systems This transformation will lead to a sustainable, flexible and safer health system where the patient is at the center of care as an active participant Intelligent Health Care

61. Future Health Care Understanding the way we do our work Technology simplifying work flow Improving patient experience Assuring patient safety Copyright Not for Reproduction 2010

62. Copyright Not for Reproduction 2010