Presentation - ICMCC

icmcc.org

Presentation - ICMCC

e-Care Contact Centers:

A Strategic Vision for Chronic

Care

Mary McKeon Stosuy - New Jersey Department of Health &

Senior Services

Mary.McKeon@doh.state.nj.us

Bryan Manning - European Federation for Medical

Informatics [EFMI]

bryan.manning@btinternet.com


International Initiatives in e-Care

• USA: Aging and Disability Resource Center

Grant Program [ADRC]

• EU: e-Health- making healthcare better

for European citizens: An action plan

for a European e-Health Area

[COM(2004) 356]

• UK: NHS -National Programme for Information

Technology

[NPfIT]


UK NHS National Programme for IT (NPfIT)

DEPARTMENT OF HEALTH MODERNISATION AGENCY

DEPARTMENT OF HEALTH MODERNISATION AGENCY

Strategic Health Authorities

Strategic Health Authorities

Local NHS Performance Management

PRIMARY CARE SERVICES

Primary Care

Trusts

Planning / Supply of

SECONDARY CARE SERVICES

Care

Trusts

Mental Health

Trusts

NHS

Trusts

Ambulance

Trusts

Doctors /GPs

Dentists

Opticians

Pharmacists

Walk-in Centers

NHS Direct

Health/

Social

Care

Services

Mental

Health

Services

NHS

Hospitals

Ambulance

Services

-------

Patient

Transport

Provision of all local Health and Care Services

Provision of all local Health and Care Services


NPfIT “SPINE” COMMON CORE DATA

Example Spine Information

Personal Details

• Name, address, etc

Summary Health Information

• Medication

• Allergies & Adverse Reactions

• Problems

• Procedures

Reports of Events

• Clinical correspondence

• Discharge summaries

• Referrals

Current Care Providers

Common

Integrated

Health

Information

“The Spine”

Information

Patient Care

Clinical Events

Internal Health

Information

Organisational

Systems

• GP Systems

• Hospital Systems

• NHS Direct

• etc


NHS LOCAL SERVICE PROVIDER CLUSTERS

• The programme has divided England into

five geographical areas, or ŅClustersÓ

• Each Local Service Provider (LSP) is

implementing a phased integration of all

NHS IT systems within their Cluster

Cluster

Local Service

Provider

Systems

Supplier

N.W & West Midlands CSC

iSoft

North East

Accenture iSoft

Eastern

iSoft

London BT IDX

Southern [S.W & S.E] Fujitsu Alliance IDX

Demographics - Southern Cluster

Population 13.000,000

Staff 256,000

Strategic Health Authorities 7

Primary Care Trusts 81

GP Practices 2,100

GPs 7,800

Hospital Trusts 48

Acute Hospital Staff 36,500

Social Service Departments 31

Ambulance Trusts

12


GENERIC e-GOVERNMENT/e-PEOPLE

PUBLIC SERVICE ACCESS ARCHITECTURE

PC

Interactive

Digital TV

Mobile

Computing

Phone

Electronic

Kiosks

Public Access Internet Links

Letters

Face

-to-

Face

Firewall

PORTAL

Dialogues

for

Transcription

Website

Content

System

Customer

Relationship

Management

Support

Systems


Administration on Aging: Generic Resource Center

SERVICE ELEMENTS

Crisis

Public

Awareness

Needs

Assessment

Referral

Care Plans Case Mgt.

Short-term

Web Self Help

Tollfree

One-Stop

Access

Support

Services

Counselling

Long-term

Placement

Unmet

Needs

Face-to-Face

Benefits

Screening

Funding

Need

Eligibility

Assessment

Eligibility

Determination

Waiver

Program

MANAGEMENT INFORMATION

Integrated

Database/s

Tracking/Case

Records

Performance

Reporting

Resource

Utilisation

Service

Costs

Resource/

Skills Dev.


MULTI-AGENCY COMMUNITY INFORMATION SERVICE

Multi-mode Access

Knowledge

Finance

Electronic

Clinical

Justice

Social Work

Contact

Center

Education

Housing

Health

Social

Care

Benefits

Environmental

& Amentities

Support

Education

& Training

Records

Databases

Multi-agency Action

Knowledge

Acquisition


e-CARE SUPPORT SERVICE FEATURES

Safety & Security monitoring

e.g. Bath overflowing, gas left on,

door unlocked

Mitigating Risk

Personal monitoring

Information &

Communication

e.g. health advice,

triage, access to

self-help groups

home/wider environment

Physiological signs, e.g.

COPD, symptom

change, oxygen

saturation, weight &

temperature

Activities of daily living,

e.g. detecting falls, room

occupancy, use of

appliances

Improving

Functionality

Electronic Assistive Technology

e.g. envinmental controls, doors

opening/closing, controls of beds

Source: Barlow et.al 2003


ONE STOP SHOP: FRONT OFFICE

Electronic Communication Channels

Physical Communication Channels

Inter-agency e-Links

Web

E-mail

Phone

Letter

Face-to-Face

PORTAL INTERFACE

Website

Letter routing

prior to EDRM

Letter routing

post EDRM

Dialogue

for

transcription

CUSTOMER RELATIONSHIP MANAGEMENT

[CRM]

e-forms

Client Index

Content

Management

Knowledge

Portal to Back Office

Direct Information

Exchanges

GIS

Records

MULTI-AGENCY BACK OFFICE PROCESSES


KNOWLEDGE CONTENT EXTRACTION

Physical Communication Channels

Electronic Communication Channels

Letter Face-to-Face

e-Links

Web

E-mail

Phone

EDRM

Portal

Dialogue

for

transcription

Knowledge

Acquisition

Voice/Text

Transcription

Letter routing

prior to EDRM

Letter routing

post EDRM

One Stop Shop Interface


AUTOMATED KNOWLEDGE ACQUISITION/ACCESS

Salient

Concepts

Summaries

Contextual

Face-to-Face

Phone

Audio

Transcription

Short

Clustered

Letter

E-mail

Web

Content

Gateway

Portal

Concept

Extraction

Taxonomies

Hierarchic

Retrieval

E-payment

E-links

Categorisation

Tagging

Matching

Interest

Profiling

Expertise

Information Repositories


COMMUNITY LIAISON INFORMATION SERVICE

Patients Family Proxy

Knowledge

Benefits Needs

Information Counselling

Screening Assessment

Support

Services

Finance

Electronic

Clinical

Social Work

Environmental

& Amentities

Process

Libraries

Security

One Stop

Shop

Resource

Center

Firewall

Patient Event

Log Indexes

Genomaps

Education

Housing

Justice

Health

Support

Social

Care

Benefits

Education

& Training

Databases

CRM/Front Office

Systems

Records

Multi-Agency Back Office Processes/Systems


Geno-mapping - Service Demand/Usage

Benefits

Agency

CPN

GP

Literacy

Training

Midwife

Mother

Ms Smith

18 yrs

Drug Abuse

DETOX

Housing

Association

Joan

4 yrs

Harry

2 yrs

Pregnancy

2 months

Social

Worker

Ante-Natal

Services

Foster

Care

Child

Protection


PROCESS LINKED KNOWLEDGE ACCESS

BUSINESS PROCESS

CRM

Enquiry

Stage A

Stage E Close

Set X

Stage C

Set Y

Stage D

Set Z Stage B

Knowledge

Structure

Hypertext Linked Knowledge Threads

Text Statistics Images Sound Video


SECURE MULT-MODE INFORMATION SYSTEM

Public Key Infrastructure [PKI]

Certificated Access controls

Firewall

Epidemiology/

Demographics

Read ONLY

Research Activity & & Case Mgt.

Record Access Input

Management Summary-level

Security controls

Multi-level Record

Nested Security

Electronic

Aggregate

Performance

Write ONLY

Activity & Case

Record Input

Event Log

Index

Education

Housing

Justice

Health

Support

Social

Care

Benefits

Data Sets

Anonymised

Case-specific

Genomaps

Case Progress

Summaries

Read ONLY

Case Enquiry

Access

Professional

“Need to Know”

controls

Records

Professional Summary-level

Security controls

Professional

Enquiry Access

Service Process/

Pathway Maps

Clinical Management Access

Security controls

Professional

Governance

Professional Knowledge/

Library Support Service


Enquiry

Request

Feedback

Client

Index

Request

for

Services

and/or

Goods

Enquiry

Processing

&

Response

Case

Requirement

Processing

Query

about

Regulations

Services

and/or

Goods

Comment

about

Regulations

Services

and/or

Goods

Service

Process

Business

Appllication

Status

Reporting

Service

Delivery

Feedback

Processing

&

Response

Case/Service

Progress

Records

Business

Knowledge

CUSTOMER RELATIONSHIP MANAGEMENT

ONE STOP SHOP

ONE STOP SHOP

MULTI-AGENCY

SERVICES

Service

Process

Service

Process

Service

Process

Service

Process

Service

Process

Service

Process


INTEGRATED REQUEST PROCESSING

ONE STOP SHOP

CONTACT CENTER

Interactive

e-Forms/

CUSTOMER

Request

Requirement

Dialogue

Scripted Inquiry

/Response

Procedures

Rules

Regulations

Procedures

Domain

Knowledge

Dialogue/

Transaction

Record

FinancIal

Systems

Service

Provision

Mgt.System

Question

& Answer

Interaction

Contextual

Records

Contextual

Analysis

Knowledge

Aquisition

Service

Booking


WEBSITE DYNAMICS

TECHNOLOGY CONTENT

Functionality

Structure

Acquisition

Validation

Knowledge

Access

Navigation

PATIENTS/CLIENTS

IT + Content Provider - Consumer = Potentionally Useless e-CRM


A VIRTUAL UTILITY: INFORMATION BANKING

State

Department

of Health

State

Department

of Human

Services

Client

Community

ONE-

STOP-

SHOP

Local

Commission

on Health

Local

Department

of Social

Services

County

Hospital

Urban

League

Family

Service

Center

Managed

Care

Provider

Benefit

Agency

Housing

Authority

Homeless

Shelter

County

Court


VIRTUAL UTILITY - SECURITY ISSUES

Function

Issue

Example Solutions

Authentication

Privacy

Certify that communicating

parties are who they claim

to be

Prevent inappropriate

disclosure of information

Data Integrity Ensure that data received

is the same as that sent.

Provide means to prevent

tampering

Authorization Ensure that only parties

having a need to know

have access to information

PIN, Password, shared

secrets, biometrics

Protected lines, encryption

Digital signatures,

time/date stamping

Role-based item level

access specified by policy

and enforced by data

management

Authentication, Privacy and Data Integrity solutions are available in the open market,

e.g. ..., ENTRUST

Authorization presents a new challenge


VIRTUAL UTILITY BENEFITS

Planning & Policy Formulation

Service

Delivery

Cost

Forecasting

Improved

Multi-Agency

Program

Budget

Planning

Improved

Service

Delivery

Impact

Measurement

Improved

Inter-agency

Program

Policies/Funding

Streams

Improved

Service Delivery

IMPROVED

PLANNING

& POLICY

FORMULATION

Dependency

Level Reduction

Time/Cost

Reduced

Collaborative

Case

Management

Costs Reduced

Intake

Costs

Reduced

Referral

Costs

Reduced

50%

60%

Administration

80%

80%

IMPROVED

SERVICE

DELIVERY

SERVICE

QUALITY &

SATISFACTION

ENHANCED

Client Status

Determination

Costs Reduced

Unit

Pricing

Enabled

Periodic/

Ad-hoc Report

Production

Times/Costs

Reduced

Authorization

of Benefits

Time/Costs

Reduced

80% 70% 70%

IMPROVED

ADMINISTRATION


BENEFITS REALIZATION

TRANSITION PATH

Benefits

Desired

‘AS IS’

Multi-Agency

Process

Integration

Features &

Functionality

Implied

Integrated

Information

Requirements

Integrated

System

Functionality

End-to-End

Process

Optimization

Enabling

Information

Environment

‘TO BE’

Benefits

Realized

Measurable

Improvement

More magazines by this user
Similar magazines