Wairarapa Community PHO EOI - New Zealand Doctor

3.3.4 Key Performance Indicators
SECTION 3.3 – INTEGRATED FAMILY HEALTH MODEL
Year 1 Year 2 Year 3
Health
System
Organisation
and Design
Decision
Support
Clinical
Information
Systems
Support for
self
management
Delivery of
services is
redesigned to
provide quality
well integrated
care.
Guided care
model
implemented
Shift a range of
appropriate
secondary care
services to
primary care
Full
implementation of
the model
completed
Information
management
developments
continue
Quality Framework developed
Clinical leadership and governance
structures developed and
implemented
Re-designing clinical pathways to
allow for integrated patient care
Systematic
programme
of combined
clinical audit
and quality
assurance
Create a framework for clinicians
to work to best practice standards
Internal referral system
established
Facilitate multi-disciplinary
models and team work
Develop single patient record
across all service provision
Establish integrated Information Management/PMS
systems
Merge Practice Management Systems and databases
Development
of enhanced
shared
wellness
plans
Development
of electronic
patient
health portal
Health linking
into MSD
local service
mapping and
collaborative
social service
planning
Implementation of enhanced
shared wellness plans between
clinicians
Implementation of electronic
patient health portal
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