Key y Issues for Successful E-Health Solutions

Prof. Nilmini Wickramasinghe, PhD MBA Epworth Chair Health Information Management RMIT University, School of Business IT and Logistics
Email: nilmini.work@gmail.com

Agenda
The healthcare challenge g Why e-health How to design, develop and implement successful solutions Summary

The Challenge
17

%GDP

15

13

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3 1970 OECD Netherlands Australia Norway 1990 France UnitedKingdom 2000 Germany UnitedStates
3

2008 Italy

AdaptedfromOECD2010a,bandHuber1999

The Challenge cont.

Demographics
Everyone is getting older and living to tell about it

Public Health
Increase in chronic diseases Focus F on prevention ti

Technology
Keeping everyone younger and in good health

Finance
Escalating g costs to treat everyone y with latest technologies g

Achieving effectiveness, efficiency and quality

Best practices in clinical, operational and administrative f functions ti

Healthcare Solutions
Key solutions from healthcare must address:
Access
Caring for anyone, anytime, anywhere Prevention and cure

Quality
World class care Integrated information

Value
Effectiveness Eff ti Efficiency

Why e-health
IS/IT in healthcare
Various technology solutions for healthcare contexts

e-health
Most countries focussing on design and development of e e-health health solutions

Pervasive e-health (mhealth) ( )

Driven by smart phone development with unlimited possibilities

T Technology h l is i great t at t processing i large l amounts t of f data and information, supporting monitoring, and management activities as well as providing decision support

How to Design, Develop and Implement Successful Solutions?

Examinepeople,process,technologyissues Embracetools,techniques,technologiesand tacticsofKM

Web of players
Payer

Healthcare organisation

Patient s

Regulator

Clinicians

Healthcare Delivery

Mostly Private Healthcare Systems (e.g. U.S.) The Australian Th A t li Healthcare System

Two-Tier Healthcare Systems

Mostly Public Healthcare Systems (e.g. U.K.) The German Th G Healthcare System

Source:Thehealthcaresystemcontinuum(adaptedfromZwickeretal.2012a)

Orthopaedic Continuum of Care Processes

Marketing Efforts Clinical Co Morbidity Evaluation Detection Revenue Event Maximize Recovery Maximize Function

Awareness Programs

Outpatient Clinic

Preop Evaluation

Day of Surgery

Post Op Inpatient

Post Op Rehab

Knee and Hip Arthroplasty Knowledge from each step

Best practices discovery Implementation Optimization to minimize variances, maximize output by surgeon Involve, align and empower employees Continuously improve in pursuit of perfection

Adapted from Schaffer and Wickramasinghe, 2012

Definition: Knowledge Management (KM)

Systematic y approach pp using g appropriate pp p tools, techniques and strategies to manage organizational g knowledge g for creating g value and generating a sustainable competitive advantage
Solvecurrentchallenges Increaseefficiencyandefficacyofcoreprocesses Mitigatefutureproblems Facilitatecontinuousinnovation

Adapted from Schaffer and Wickramasinghe, 2012

KMforhealthcare

Adapted from Bali and Wickramasinghe, 2010

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Intelligence Continuum Continuum

People HealthCareEvent/Process

Data

InformationSystem

ComputerTechnology

DataMart/Warehouse

?
Knowledge DataMining Management BusinessIntelligence/Analytics DataMining

Source: Schaffer and Wickramasinghe, Wickramasinghe 2006

Intelligence Continuum

IntelligenceContinuum
People HealthCareEvent/Process Data

InformationSystem

ComputerTechnology

DataMart/Warehouse

?
Knowledge DataMining Management BusinessIntelligence/Analytics DataMining

Source: Schaffer and Wickramasinghe, 2006

Boyds Boyd s OODA Loop Thinking

Observe
Unfolding Circumstances Implicit p Guidance & Control

Orient
Cultural

Decide
Implicit p Guidance & Control

Act

Traditions Genetic Heritage

Observations

Feed Forward

Analyses & Synthesis

Feed Forward

Decision (Hypothesis)

Feed Forward

Action (Test)
Unfolding I t Interaction ti With Environment

New Information

Outside Information Unfolding Interaction With Environment

Previous Experience

Feedback Feedback

Defense and the National Interest, http://www.d-n-i.net, 2006

Thinking About How It Really Works

Doctorsdontseeactivitiesas aprocess Provisionofhealthcareisa process, p ,asequence q of activities Mapouttheprocess Collectthedata Analyzethedata Lookforpatterns

Adapted from Schaffer and Wickramasinghe, 2012

Impact of the Intelligence Continuum

Current State

People
Future State

Process Technology Data

Diagnostic g Evaluation

Prescriptive Evaluation
Adapted from Schaffer and Wickramasinghe, Wickramasinghe 2012

Summary
Healthcare Information Technology
Canhelpmakeprocessesrunbetter Canhelpdistributeknowledgetohelppeoplefunctionsmartly Canhelpactualizeknowledgefromdata

Data structure needed to

Knowwhattoimprove Knowhowtoimprove p Knowthattheimprovementsareinfactimprovements

Challenge implementing e e-health health solutions

Identifyingthedataelements Collectingthedata Providethetools,technology,techniquesandsystemstoimproveourdiagnosticandprescriptive capabilitiesfortreatingprocesseswhichinturnservetotreatthepatients

Summary
In order I d to t have h successful f l solutions l ti need d to t focus f on:
Macro, M M Messo, Mi Micro People, People Process, Process Technology KM Dynamic y

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Thank you very much for your attention!

nilmini.work@gmail.com

Questions? Q

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