HL7 Australia Plenary WGM Sydney, July 2016 FHIR Adoption in New Zealand Peter Jordan MSc LLB MCPD Vice-Chair HL7 New Zealand
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HL7 AustraliaPlenary WGM Sydney, July 2016
FHIR Adoption in New Zealand
Peter Jordan MSc LLB MCPD
Vice-Chair HL7 New Zealand
Page 2 • HL7 New Zealand
House Rules
National Health IT Plan 2010
National / Regional / Local
Systems Our Year of the
Portal 2014
Deloitte Report 2015
Page 3 • HL7 New Zealand
Standards Journey
• Reference Architecture for Interoperability...– Detailed Clinical Modelling – openEHR Archetypes– Clinical Data Repositories - IHE XDS– Exchange – HL7 CDA
• Up and Running…– HL7 v2 messaging (Labs, RSD, Service Fee Claiming, ADT, CDA packages)– HL7 v3 CDA (GP2GP, NZePS, interRAI, Maternity, Ambulatory Care)– Clinical Data Repositories (TestSafe)
• Speed Bumps– Varying, and often non-compliant, v2 implementations– CDA hard to consume and no transport standard– Record Locator Service - slow progress– 100k Users of Patient Portals by March 2016
Then came ...
Page 4 • HL7 New Zealand
FHIR Roots, New Routes
• 2011 – West Island - Resources for Healthcare
• 2012 – HL7 NZ Chair at FHIR Connectathon #1
• 2013 – Presentation at Health Informatics NZ Conference
• 2014 – HL7 NZ Key Focus
• 2015 - Heath Information Standards Organisation (HISO) endorsed FHIR as an approved HL7 Standard
• 2016 – APIs for National & Regional Systems
Page 5 • HL7 New Zealand
Trailblazers
Community Participation (FMG)
Vendor Uptake (Orion Rhapsody, Sysmex, HealthOne)
NZ Inc. (Appointments)
Patients First Terminology Server
HL7 NZ Registry Server
ClinFHIR Profiling Tool for Clinicians
Page 6 • HL7 New Zealand
clinFHIR tooling (clinFHIR.com)
• Developed to support clinicians understand FHIR– Educational
• Supports:– Building resources– Show resource references– Simple profiling– Simple ValueSet editor
• Will use to engage clinicians– Working Group Meetings
– NZ Seminar
– Available on line
– DevDays(November)
– UK NHS Digital
Page 7 • HL7 New Zealand
NZ Inc.
– Project to create single data repository from multiple source systems
• Data aggregator
– Predominantly read-only
– FHIR interfaces
– Orion, CSC, MedTech, Sysmexmain partners
• About 15 others
– Starting with appointments
– Iterative development
Page 8 • HL7 New Zealand
Reality Checks
Doesn’t solve or change fundamentals…• EHR Systems must reflect business strategy & operational
models.
• Successful projects derive working solutions from well-defined business needs.
• Within healthcare, IT is an enabler – not the driver.
• Hype v Reality – FHIR will not solve interoperability – but will make it easier and cheaper to achieve!
• FHIR cannot standardise clinical practice.
• FHIR won’t force unwilling partners to collaborate…
Page 9 • HL7 New Zealand
FHIR Extinguishers - Barriers to Adoption
Classic Project “Iron Triangle” 2/3 mapped to Primary Care IT
• Ministry of Health (Governance)
• Software Vendors (Applications)
• General Practices / PHOs (Providers)
Page 10 • HL7 New Zealand
2016: A Transformational Year
New Health Strategy…live well, stay well, get well
1. people-powered
2. closer to home
3. value & high performance
4. one team
5. smart system
NZ Electronic Health Record– “Single” EHR…probably
– Design Stage – widespread engagement
– Build, Buy or Adapt?
– HL7 NZ – key input to standards
– FHIR-based APIs & SNOMED CT clinical coding
– Seeking overseas success stories?
Page 11 • HL7 New Zealand
…but we kept the old flag!
Page 12 • HL7 New Zealand
A Smart EcoSystem With FHIR
Page 13 • HL7 New Zealand13
Wellington, New Zealand
SNOMED CT Expo Host
27-28 October 2016
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