@NathanK: This has now been made a Poll for us to vote on; you each get 3 votes
At our next CiLN meeting we have a break-out session to discuss topics of most interest to members, this is a starter list of potential topics but we’re looking for contributions.
Once we have a final list we’ll do a survey so you can rank them in importance and the top 4-5 will be worked on on the day, with notes written up and shared on this forum.
Linking up primary/community care, secondary care, and the regions.
Effective clinical input / oversight / prioritisation of IT stuff
What are NZ clinicians looking for from digital clinical tools / systems / ecosystems?
What clinical informatics skills and roles do we need?
Navigating funding issues and barriers (for clinical systems)
Support and education for clinical informatics workforce and professional development
How do we better make use of existing data?
Access and connectivity - sorting out poor WiFi, multiple logins, poor UIs, etc
Engaging patients in the process of digital transformation
Hi Rebecca, thanks for the list. I don’t have anything to add other than to ask, do you mean “5. Support and education for clinical
IT – workforce (not workplace) development”? or we could have both workplace and workforce development because they are interrelated.
I think that looks like a robust list. Are we thinking of running break out sessions for the various topics or will they be all group sessions.? I am just not sure we could get through it all?
1 and 6 are two arms of a single larger issue of linking.
not sure how to word this topic for discussion, but I felt that at HINZ there was a lot of talk about data by MoH but I don’t see a vision of where we are going as a country and I’d like our group to be able to form a vision for a national and regional direction and lobby/advocate for it to be a cross-party “thing” and championed by MoH (or at least not interfered with), so that the next government doesn’t override whatever good comes out of it.
Hi All-I am just getting into this list serve and will be meeting a number of you for the first time at the meeting in 2 weeks. As somewhat of a newcomer to the IT Clinical lead role and as a pretty much sole participant in all related matters at my DHB, I will be a sponge for advice on all the topics above. Two of my primary areas to discuss are related to my current activities around the Midland Clinical Portal Project and how we from this region can learn from others who have already implemented their systems. In our meetings I often ask “Who has done this before? How did they manage it and what lessons were learned?” This is in regards to all topics such as discharge summaries, progress notes, med management, etc. We all seem to be using Orion so why does it seem like we are working in silos at times?
My other area for discussion is how do you get clinician engagement with your CIRG? What does your TOR look like and what does your agenda look like? What authority does the CIRG have amongst the decisions required for regional projects? How do you align meeting times with requests for endorsement on papers from other projects? For example, with our MCP project we will get requests for decisions every two weeks to endorse a paper. There is no agile way to discuss this with a CIRG or clinicians. How do others approach this? We only have about 50 clinicians(doctors) at Gisborne Hospital and maybe 2-3 will turn up for a CIRG meeting so I struggle with all of this but I feel regional integration is so important for our communities.
Look forward to seeing you all.
Sari
I’ve been doing a bit of that too, happy to share. I feel a decision grid coming on
I reckon that CIRGs can work really well as working groups but I have my doubts as decision making bodies. We need to make sure we bring all of our clinical leads with us on the journey and that means infiltrating decision making groups rather than necessarily making new ones. If you have a really functional decision making clinical group that may work better for you than establishing a new group. Especially in a small place…
Stella Ward from CHCH is the lead CIO on “linking regional portals” now- and a bit of work has gone into considering options, landing on one, and having a project manager within Stella’s team put together a high level plan. We will be meeting on the Tuesday evening to continue the discussion. I could do a quick presentation of the options as suggested by Orion - some interesting points (would be really weird presenting for Orion!!!) would come out though in terms of principles - and that would be useful for all me thinks
I agree - do not underestimate the value a good IT person who has spent years with clinicians - they often have more insight and a broader range of insight than many doctors - but you do need a clinical lead who is prepared to get down and dirty with the nitty gritty insanity of how this all fits together, is prepared to make decision and then stand by them (but with enough humility that they do laugh at themeselves and will change their mind when it needs to change!)
Linking the regional portals - is the wider topic how do you make information more accessible and usable than it is now? Linking existing portals is a solution that could improve that, and there are others (do we know what they are?) that may be complementary or even better. Should/would CiLN support pilots of alternative solutions?
I agree with @eras that item 6 is another aspect of this same topic - we need to remove barriers to information access across all agencies and geographies.
2 What are NZ clinicians looking for from the EHR market? The term EHR can get too restrictive. Is the topic about the functional capabilities of clinical tools (the work @nick.baker has done on this may be a useful input) , how they improve clinician experience and workflow, what the current pain points are, what solutions are out there but not widely known or adopted? A possible extension of this is whether current tools support cross agency collaboration and a mobile clinical workforce.
3 What is a clinical informatics role and who should fill them? Putting the job title aside a topic focused on what skills/roles are needed to drive value from use of data and digital tools would be useful. That would link into point 5?
4 Funding issues – where should digital health sit within funding projects - agree that a discussion on funding barriers would be useful from a CiLN perspective. Also expend to include other investment and commercial barriers (procurement, business cases, capital vs operating funding) and opportunities (shift to consumption based commercial models)
5 Support and education for clinical IT– workforce and workplace development. A strong link to point 3, consider everything from lifting digital literacy to professional development for clinicians in a data or digital role?
6 Linking primary and community care with tertiary care - I see this as an aspect of accessible information in item 1.
Another few topics to consider:
7 Data insights and analytics - how do we get more value out of the data we already collect whether through big data analytics, real time decision support, AI etc… I see this as the other side of accessible information and a key part of moving from a “view” to a “do” world. What are the barriers and opportunities? How do we apply them across agencies and geographies.
Access and connectivity - where do we have barriers to access whether poor mobile connectivity, multiple logins, lack of devices, poor WiFi within our facilities, poorly designed UI, restrictive organisational policy?
Consumer engagement - how does consumer experience and engagement (whether telehealth, access to information, supporting patient choice of engagement channels etc…) inform how we invest in digital tools?
As I can’t be there at the workshop I do have a request for CiLN that could maybe be discussed
We are intending to progress to the next stage of the business case for the national Health Information Platform - which is about transforming access and use of data through incremental delivery rather than a specific technology solution - and I have proposed that CiLN is a key clinical engagement group to inform that process. You collectively have more expertise in this space than most!
I’ll connect back in when we have a clear timeline for the business case development but I’m interested in CiLN thoughts on how to engage effectively.
Certainly it would be my hope that through CILN we may develop a more formal body through which the network can communicate. The trick as always is to have as broad a membership as possible and still be able to make decisions. It’s very exciting to have this opportunity and great to have Ministry and HiNZ support.
Thanks @amscroggins yes each group will discuss one topic. The first half of the meeting will focus on CiLN itself, it’s purpose and structure and what it wants to achieve, then the second half will focus on some key topics you want to discuss.
We’re up to 53 attendees so I’m sure we’ll get some great results!
Linking regional portals will indeed be a big way forward and we have done this with HealthOne (H1) but in addition to hospital systems tying it all together by incorporating primary health will be key to assisting in the patient journey. Most citizens spent 99.9% of their time not in hospitals so the hospital part of their record may or may not be critical around presentation. Its not the HIE nature of H1 that is unique. Instead it is the privacy framework that it sits on that is hard to find elsewhere.
Darren, you make excellent points. The one that sticks for me is your note about the EHR. As I talk to people all over the country,
I’ve noted that there doesn’t appear to be a shared definition of what an EHR is. In the research literature there have been several attempts to define the concept ‘electronic health record’ (a Google Scholar search this morning reveals over 50,000 results).
In 2008 this article reviewed the literature and came up with some good ideas but didn’t settle on a single definition:
Häyrinen K, Saranto K, Nykänen P. Definition, structure, content, use and impacts of electronic health records: a review of the research literature.
International journal of medical informatics. 2008 May 1;77(5):291-304.
Comments in our network discussion also reveal differences in what constitutes an EHR and then there are ideas around ‘an EHR that works for one
speciality doesn’t work for another speciality’ plus ‘we use the same software from DHB to DHB so why does it feel like we’re not?’.
I’m wondering if we could gain a shared understanding of what we mean when we refer to EHRs in general so that conversations about issues, risks,
opportunities, gaps, challenges, and future work can be more productive.
The only thing I would like to add is getting clinicians on board with IT and providing the right equipment, mid you that could come under support and education.
