Office of the CIO | Delivering eHealth Ireland

eHealth Improving the delivery of

services and patient care

Richard Corbridge

Chief Information Officer ndash Health Service Executive - Ireland

Chief Executive Officer ndash eHealth Ireland

richardcorbridgehseie

eHealthIrelandie | eHealthIreland R1chardatron

Office of the CIO | Delivering eHealth Ireland

Connected Health

Office of the CIO | Delivering eHealth Ireland

The story so farhellip

Office of the CIO | Delivering eHealth Ireland

The IT strategy question

Cross

Setting

Information

Integration

Electronic

Health

Records

National

Support

Systems

Care

Delivery

Enablement

Integrated Patient Centric

Efficient Care Delivery

Health

Service

Insights

Knowledge amp Information Delivery Transformation

Clinical amp Information Governance

Knowledge amp Information Plan

Office of the CIO | Delivering eHealth Ireland

Personalisation vs Contextualisation

Office of the CIO | Delivering eHealth Ireland

Connected Health

Office of the CIO | Delivering eHealth Ireland

The story so farhellip

Office of the CIO | Delivering eHealth Ireland

The IT strategy question

Cross

Setting

Information

Integration

Electronic

Health

Records

National

Support

Systems

Care

Delivery

Enablement

Integrated Patient Centric

Efficient Care Delivery

Health

Service

Insights

Knowledge amp Information Delivery Transformation

Clinical amp Information Governance

Knowledge amp Information Plan

Office of the CIO | Delivering eHealth Ireland

Personalisation vs Contextualisation

Office of the CIO | Delivering eHealth Ireland

The story so farhellip

Office of the CIO | Delivering eHealth Ireland

The IT strategy question

Cross

Setting

Information

Integration

Electronic

Health

Records

National

Support

Systems

Care

Delivery

Enablement

Integrated Patient Centric

Efficient Care Delivery

Health

Service

Insights

Knowledge amp Information Delivery Transformation

Clinical amp Information Governance

Knowledge amp Information Plan

Office of the CIO | Delivering eHealth Ireland

Personalisation vs Contextualisation

Office of the CIO | Delivering eHealth Ireland

The IT strategy question

Cross

Setting

Information

Integration

Electronic

Health

Records

National

Support

Systems

Care

Delivery

Enablement

Integrated Patient Centric

Efficient Care Delivery

Health

Service

Insights

Knowledge amp Information Delivery Transformation

Clinical amp Information Governance

Knowledge amp Information Plan

Office of the CIO | Delivering eHealth Ireland

Personalisation vs Contextualisation

Office of the CIO | Delivering eHealth Ireland

Personalisation vs Contextualisation

Office of the CIO | Delivering eHealth Ireland

Connected Health

Office of the CIO | Delivering eHealth Ireland

Where are the Gaps

Finance amp

Efficiency

Health amp

Wellbeing

Care amp

Quality

bull Efficiency

bull Savings

bull Affordability

bull Alcohol

bull Diabetes

bull Obesity

bull Patient Exp

bull Personalisation

bull Outcomes

Office of the CIO | Delivering eHealth Ireland

H = Health not Healthcare

Office of the CIO | Delivering eHealth Ireland

Current Projects

Office of the CIO | Delivering eHealth Ireland

ePharmacy Engagement

Office of the CIO | Delivering eHealth Ireland12

Office of the CIO | Delivering eHealth Ireland

Connected Health

Office of the CIO | Delivering eHealth Ireland

Currenthellip

Office of the CIO | Delivering eHealth Ireland15

Security

Data Quality

Information Governance

Data Dictionary

Office of the CIO | Delivering eHealth Ireland

The lsquofourth utilityrsquo

International eHealth investment Estimates

bull euro158Bn England ndash NPfIT over 10yrs

bull euro16Bn Canada Southwest Ontario ndash 2013-2017

bull euro25Bn ndash USA ndash HITECH Act Meaningful Use

bull euro16Bn ndash Australia ndash predicted over 10yrs

bull euro54Bn ndash NHS ndash predicted in next 5 yrs

The history of technology as it enters industries is that

people say lsquothis is going to transform everything in 2

yearsrsquo And then you put it in and nothing happens and

people say lsquowhy didnrsquot it work the way we expected it

to And then lo and behold after a period of 10

years it begins working

mdash Robert Wachter

UCSF

Technology has transformed hotel

transport retail banking communications

helliphelliphelliphealthcare

More than 80 of US providers

use an EHR

Ireland lags most developed countries but can

learn from the investments and initiatives

elsewhereThe goals of Reform cannot be delivered

without a National EHR

Globally there are

more than 400

EHR vendors on

the market

DENMARK

99 discharge letters

ordersresults

prescriptions are

electronic

FINLAND

100 health centres

with EHRs

NETHERLANDS

All prescriptions

electronic

US ndash VHA

$309Bn in

cumulative net

benefits

US ndash VHA

100 primary

care hospitals

EHR

Office of the CIO | Delivering eHealth Ireland

Overall Blueprint defined as the long term vision for eHealth in Ireland and endorsed by industry ndash Solutions for Hospital Groups identified as a core area

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What is the EHRMoving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

National

Shared

Record

Community

Operational

Systems

Acute

Operational

Systems

Individual Health Identifier

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

eHealth Blueprint

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

tConsumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

The Individual Health Identifier

Programme is a key enabler that

allows information to be shared about

a patient

PharmacyGP Systems

Private

Hospitals

Other healthcare providers will

access and contribute to the National

Shared Record through the

Integration Capability

Office of the CIO | Delivering eHealth Ireland

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

t

Consumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

Community

Operational

Systems

Acute

Operational

Systems

National

Shared

Record

Integration

Moving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

eHealth Blueprint

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

5 Years 10 Years

Cri

tic

al Ta

cti

ca

l

So

luti

on

s

Inn

ova

tive

Sp

ec

iali

st

So

luti

on

s

National Solutions

PAS

Replacement

Initial National Shared

Record

Haemophilia

Lighthouse Project

Epilepsy

Lighthouse Project

BiPolar Lighthouse

Project

Portal

(Organisation)

Other Future

Projects

OrderComms

Other Future

Projects

NCH Implementation Other

Single

Solution Set

Evolving to a single

solution set will require

agility and a governance

approach that supports a

dynamic environment

Other Future

Projects

National Shared Record Development

MEDLis

MN-CMS

NICIS

Acute Operational Components ndash Phased Implementation in HGrsquos

Community Operational Components ndash Phased Implementation in CHOrsquos

NIMIS

National Solutions

Other

Other

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What can eHealth Do

Office of the CIO | Delivering eHealth Ireland 22

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Office of the CIO | Delivering eHealth Ireland 23

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland

Where are the Gaps

Finance amp

Efficiency

Health amp

Wellbeing

Care amp

Quality

bull Efficiency

bull Savings

bull Affordability

bull Alcohol

bull Diabetes

bull Obesity

bull Patient Exp

bull Personalisation

bull Outcomes

Office of the CIO | Delivering eHealth Ireland

H = Health not Healthcare

Office of the CIO | Delivering eHealth Ireland

Current Projects

Office of the CIO | Delivering eHealth Ireland

ePharmacy Engagement

Office of the CIO | Delivering eHealth Ireland12

Office of the CIO | Delivering eHealth Ireland

Connected Health

Office of the CIO | Delivering eHealth Ireland

Currenthellip

Office of the CIO | Delivering eHealth Ireland15

Security

Data Quality

Information Governance

Data Dictionary

Office of the CIO | Delivering eHealth Ireland

The lsquofourth utilityrsquo

International eHealth investment Estimates

bull euro158Bn England ndash NPfIT over 10yrs

bull euro16Bn Canada Southwest Ontario ndash 2013-2017

bull euro25Bn ndash USA ndash HITECH Act Meaningful Use

bull euro16Bn ndash Australia ndash predicted over 10yrs

bull euro54Bn ndash NHS ndash predicted in next 5 yrs

The history of technology as it enters industries is that

people say lsquothis is going to transform everything in 2

yearsrsquo And then you put it in and nothing happens and

people say lsquowhy didnrsquot it work the way we expected it

to And then lo and behold after a period of 10

years it begins working

mdash Robert Wachter

UCSF

Technology has transformed hotel

transport retail banking communications

helliphelliphelliphealthcare

More than 80 of US providers

use an EHR

Ireland lags most developed countries but can

learn from the investments and initiatives

elsewhereThe goals of Reform cannot be delivered

without a National EHR

Globally there are

more than 400

EHR vendors on

the market

DENMARK

99 discharge letters

ordersresults

prescriptions are

electronic

FINLAND

100 health centres

with EHRs

NETHERLANDS

All prescriptions

electronic

US ndash VHA

$309Bn in

cumulative net

benefits

US ndash VHA

100 primary

care hospitals

EHR

Office of the CIO | Delivering eHealth Ireland

Overall Blueprint defined as the long term vision for eHealth in Ireland and endorsed by industry ndash Solutions for Hospital Groups identified as a core area

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What is the EHRMoving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

National

Shared

Record

Community

Operational

Systems

Acute

Operational

Systems

Individual Health Identifier

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

eHealth Blueprint

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

tConsumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

The Individual Health Identifier

Programme is a key enabler that

allows information to be shared about

a patient

PharmacyGP Systems

Private

Hospitals

Other healthcare providers will

access and contribute to the National

Shared Record through the

Integration Capability

Office of the CIO | Delivering eHealth Ireland

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

t

Consumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

Community

Operational

Systems

Acute

Operational

Systems

National

Shared

Record

Integration

Moving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

eHealth Blueprint

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

5 Years 10 Years

Cri

tic

al Ta

cti

ca

l

So

luti

on

s

Inn

ova

tive

Sp

ec

iali

st

So

luti

on

s

National Solutions

PAS

Replacement

Initial National Shared

Record

Haemophilia

Lighthouse Project

Epilepsy

Lighthouse Project

BiPolar Lighthouse

Project

Portal

(Organisation)

Other Future

Projects

OrderComms

Other Future

Projects

NCH Implementation Other

Single

Solution Set

Evolving to a single

solution set will require

agility and a governance

approach that supports a

dynamic environment

Other Future

Projects

National Shared Record Development

MEDLis

MN-CMS

NICIS

Acute Operational Components ndash Phased Implementation in HGrsquos

Community Operational Components ndash Phased Implementation in CHOrsquos

NIMIS

National Solutions

Other

Other

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What can eHealth Do

Office of the CIO | Delivering eHealth Ireland 22

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Office of the CIO | Delivering eHealth Ireland 23

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland

H = Health not Healthcare

Office of the CIO | Delivering eHealth Ireland

Current Projects

Office of the CIO | Delivering eHealth Ireland

ePharmacy Engagement

Office of the CIO | Delivering eHealth Ireland12

Office of the CIO | Delivering eHealth Ireland

Connected Health

Office of the CIO | Delivering eHealth Ireland

Currenthellip

Office of the CIO | Delivering eHealth Ireland15

Security

Data Quality

Information Governance

Data Dictionary

Office of the CIO | Delivering eHealth Ireland

The lsquofourth utilityrsquo

International eHealth investment Estimates

bull euro158Bn England ndash NPfIT over 10yrs

bull euro16Bn Canada Southwest Ontario ndash 2013-2017

bull euro25Bn ndash USA ndash HITECH Act Meaningful Use

bull euro16Bn ndash Australia ndash predicted over 10yrs

bull euro54Bn ndash NHS ndash predicted in next 5 yrs

The history of technology as it enters industries is that

people say lsquothis is going to transform everything in 2

yearsrsquo And then you put it in and nothing happens and

people say lsquowhy didnrsquot it work the way we expected it

to And then lo and behold after a period of 10

years it begins working

mdash Robert Wachter

UCSF

Technology has transformed hotel

transport retail banking communications

helliphelliphelliphealthcare

More than 80 of US providers

use an EHR

Ireland lags most developed countries but can

learn from the investments and initiatives

elsewhereThe goals of Reform cannot be delivered

without a National EHR

Globally there are

more than 400

EHR vendors on

the market

DENMARK

99 discharge letters

ordersresults

prescriptions are

electronic

FINLAND

100 health centres

with EHRs

NETHERLANDS

All prescriptions

electronic

US ndash VHA

$309Bn in

cumulative net

benefits

US ndash VHA

100 primary

care hospitals

EHR

Office of the CIO | Delivering eHealth Ireland

Overall Blueprint defined as the long term vision for eHealth in Ireland and endorsed by industry ndash Solutions for Hospital Groups identified as a core area

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What is the EHRMoving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

National

Shared

Record

Community

Operational

Systems

Acute

Operational

Systems

Individual Health Identifier

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

eHealth Blueprint

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

tConsumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

The Individual Health Identifier

Programme is a key enabler that

allows information to be shared about

a patient

PharmacyGP Systems

Private

Hospitals

Other healthcare providers will

access and contribute to the National

Shared Record through the

Integration Capability

Office of the CIO | Delivering eHealth Ireland

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

t

Consumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

Community

Operational

Systems

Acute

Operational

Systems

National

Shared

Record

Integration

Moving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

eHealth Blueprint

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

5 Years 10 Years

Cri

tic

al Ta

cti

ca

l

So

luti

on

s

Inn

ova

tive

Sp

ec

iali

st

So

luti

on

s

National Solutions

PAS

Replacement

Initial National Shared

Record

Haemophilia

Lighthouse Project

Epilepsy

Lighthouse Project

BiPolar Lighthouse

Project

Portal

(Organisation)

Other Future

Projects

OrderComms

Other Future

Projects

NCH Implementation Other

Single

Solution Set

Evolving to a single

solution set will require

agility and a governance

approach that supports a

dynamic environment

Other Future

Projects

National Shared Record Development

MEDLis

MN-CMS

NICIS

Acute Operational Components ndash Phased Implementation in HGrsquos

Community Operational Components ndash Phased Implementation in CHOrsquos

NIMIS

National Solutions

Other

Other

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What can eHealth Do

Office of the CIO | Delivering eHealth Ireland 22

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Office of the CIO | Delivering eHealth Ireland 23

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland

Current Projects

Office of the CIO | Delivering eHealth Ireland

ePharmacy Engagement

Office of the CIO | Delivering eHealth Ireland12

Office of the CIO | Delivering eHealth Ireland

Connected Health

Office of the CIO | Delivering eHealth Ireland

Currenthellip

Office of the CIO | Delivering eHealth Ireland15

Security

Data Quality

Information Governance

Data Dictionary

Office of the CIO | Delivering eHealth Ireland

The lsquofourth utilityrsquo

International eHealth investment Estimates

bull euro158Bn England ndash NPfIT over 10yrs

bull euro16Bn Canada Southwest Ontario ndash 2013-2017

bull euro25Bn ndash USA ndash HITECH Act Meaningful Use

bull euro16Bn ndash Australia ndash predicted over 10yrs

bull euro54Bn ndash NHS ndash predicted in next 5 yrs

The history of technology as it enters industries is that

people say lsquothis is going to transform everything in 2

yearsrsquo And then you put it in and nothing happens and

people say lsquowhy didnrsquot it work the way we expected it

to And then lo and behold after a period of 10

years it begins working

mdash Robert Wachter

UCSF

Technology has transformed hotel

transport retail banking communications

helliphelliphelliphealthcare

More than 80 of US providers

use an EHR

Ireland lags most developed countries but can

learn from the investments and initiatives

elsewhereThe goals of Reform cannot be delivered

without a National EHR

Globally there are

more than 400

EHR vendors on

the market

DENMARK

99 discharge letters

ordersresults

prescriptions are

electronic

FINLAND

100 health centres

with EHRs

NETHERLANDS

All prescriptions

electronic

US ndash VHA

$309Bn in

cumulative net

benefits

US ndash VHA

100 primary

care hospitals

EHR

Office of the CIO | Delivering eHealth Ireland

Overall Blueprint defined as the long term vision for eHealth in Ireland and endorsed by industry ndash Solutions for Hospital Groups identified as a core area

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What is the EHRMoving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

National

Shared

Record

Community

Operational

Systems

Acute

Operational

Systems

Individual Health Identifier

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

eHealth Blueprint

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

tConsumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

The Individual Health Identifier

Programme is a key enabler that

allows information to be shared about

a patient

PharmacyGP Systems

Private

Hospitals

Other healthcare providers will

access and contribute to the National

Shared Record through the

Integration Capability

Office of the CIO | Delivering eHealth Ireland

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

t

Consumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

Community

Operational

Systems

Acute

Operational

Systems

National

Shared

Record

Integration

Moving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

eHealth Blueprint

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

5 Years 10 Years

Cri

tic

al Ta

cti

ca

l

So

luti

on

s

Inn

ova

tive

Sp

ec

iali

st

So

luti

on

s

National Solutions

PAS

Replacement

Initial National Shared

Record

Haemophilia

Lighthouse Project

Epilepsy

Lighthouse Project

BiPolar Lighthouse

Project

Portal

(Organisation)

Other Future

Projects

OrderComms

Other Future

Projects

NCH Implementation Other

Single

Solution Set

Evolving to a single

solution set will require

agility and a governance

approach that supports a

dynamic environment

Other Future

Projects

National Shared Record Development

MEDLis

MN-CMS

NICIS

Acute Operational Components ndash Phased Implementation in HGrsquos

Community Operational Components ndash Phased Implementation in CHOrsquos

NIMIS

National Solutions

Other

Other

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What can eHealth Do

Office of the CIO | Delivering eHealth Ireland 22

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Office of the CIO | Delivering eHealth Ireland 23

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland

ePharmacy Engagement

Office of the CIO | Delivering eHealth Ireland12

Office of the CIO | Delivering eHealth Ireland

Connected Health

Office of the CIO | Delivering eHealth Ireland

Currenthellip

Office of the CIO | Delivering eHealth Ireland15

Security

Data Quality

Information Governance

Data Dictionary

Office of the CIO | Delivering eHealth Ireland

The lsquofourth utilityrsquo

International eHealth investment Estimates

bull euro158Bn England ndash NPfIT over 10yrs

bull euro16Bn Canada Southwest Ontario ndash 2013-2017

bull euro25Bn ndash USA ndash HITECH Act Meaningful Use

bull euro16Bn ndash Australia ndash predicted over 10yrs

bull euro54Bn ndash NHS ndash predicted in next 5 yrs

The history of technology as it enters industries is that

people say lsquothis is going to transform everything in 2

yearsrsquo And then you put it in and nothing happens and

people say lsquowhy didnrsquot it work the way we expected it

to And then lo and behold after a period of 10

years it begins working

mdash Robert Wachter

UCSF

Technology has transformed hotel

transport retail banking communications

helliphelliphelliphealthcare

More than 80 of US providers

use an EHR

Ireland lags most developed countries but can

learn from the investments and initiatives

elsewhereThe goals of Reform cannot be delivered

without a National EHR

Globally there are

more than 400

EHR vendors on

the market

DENMARK

99 discharge letters

ordersresults

prescriptions are

electronic

FINLAND

100 health centres

with EHRs

NETHERLANDS

All prescriptions

electronic

US ndash VHA

$309Bn in

cumulative net

benefits

US ndash VHA

100 primary

care hospitals

EHR

Office of the CIO | Delivering eHealth Ireland

Overall Blueprint defined as the long term vision for eHealth in Ireland and endorsed by industry ndash Solutions for Hospital Groups identified as a core area

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What is the EHRMoving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

National

Shared

Record

Community

Operational

Systems

Acute

Operational

Systems

Individual Health Identifier

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

eHealth Blueprint

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

tConsumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

The Individual Health Identifier

Programme is a key enabler that

allows information to be shared about

a patient

PharmacyGP Systems

Private

Hospitals

Other healthcare providers will

access and contribute to the National

Shared Record through the

Integration Capability

Office of the CIO | Delivering eHealth Ireland

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

t

Consumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

Community

Operational

Systems

Acute

Operational

Systems

National

Shared

Record

Integration

Moving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

eHealth Blueprint

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

5 Years 10 Years

Cri

tic

al Ta

cti

ca

l

So

luti

on

s

Inn

ova

tive

Sp

ec

iali

st

So

luti

on

s

National Solutions

PAS

Replacement

Initial National Shared

Record

Haemophilia

Lighthouse Project

Epilepsy

Lighthouse Project

BiPolar Lighthouse

Project

Portal

(Organisation)

Other Future

Projects

OrderComms

Other Future

Projects

NCH Implementation Other

Single

Solution Set

Evolving to a single

solution set will require

agility and a governance

approach that supports a

dynamic environment

Other Future

Projects

National Shared Record Development

MEDLis

MN-CMS

NICIS

Acute Operational Components ndash Phased Implementation in HGrsquos

Community Operational Components ndash Phased Implementation in CHOrsquos

NIMIS

National Solutions

Other

Other

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What can eHealth Do

Office of the CIO | Delivering eHealth Ireland 22

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Office of the CIO | Delivering eHealth Ireland 23

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland12

Office of the CIO | Delivering eHealth Ireland

Connected Health

Office of the CIO | Delivering eHealth Ireland

Currenthellip

Office of the CIO | Delivering eHealth Ireland15

Security

Data Quality

Information Governance

Data Dictionary

Office of the CIO | Delivering eHealth Ireland

The lsquofourth utilityrsquo

International eHealth investment Estimates

bull euro158Bn England ndash NPfIT over 10yrs

bull euro16Bn Canada Southwest Ontario ndash 2013-2017

bull euro25Bn ndash USA ndash HITECH Act Meaningful Use

bull euro16Bn ndash Australia ndash predicted over 10yrs

bull euro54Bn ndash NHS ndash predicted in next 5 yrs

The history of technology as it enters industries is that

people say lsquothis is going to transform everything in 2

yearsrsquo And then you put it in and nothing happens and

people say lsquowhy didnrsquot it work the way we expected it

to And then lo and behold after a period of 10

years it begins working

mdash Robert Wachter

UCSF

Technology has transformed hotel

transport retail banking communications

helliphelliphelliphealthcare

More than 80 of US providers

use an EHR

Ireland lags most developed countries but can

learn from the investments and initiatives

elsewhereThe goals of Reform cannot be delivered

without a National EHR

Globally there are

more than 400

EHR vendors on

the market

DENMARK

99 discharge letters

ordersresults

prescriptions are

electronic

FINLAND

100 health centres

with EHRs

NETHERLANDS

All prescriptions

electronic

US ndash VHA

$309Bn in

cumulative net

benefits

US ndash VHA

100 primary

care hospitals

EHR

Office of the CIO | Delivering eHealth Ireland

Overall Blueprint defined as the long term vision for eHealth in Ireland and endorsed by industry ndash Solutions for Hospital Groups identified as a core area

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What is the EHRMoving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

National

Shared

Record

Community

Operational

Systems

Acute

Operational

Systems

Individual Health Identifier

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

eHealth Blueprint

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

tConsumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

The Individual Health Identifier

Programme is a key enabler that

allows information to be shared about

a patient

PharmacyGP Systems

Private

Hospitals

Other healthcare providers will

access and contribute to the National

Shared Record through the

Integration Capability

Office of the CIO | Delivering eHealth Ireland

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

t

Consumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

Community

Operational

Systems

Acute

Operational

Systems

National

Shared

Record

Integration

Moving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

eHealth Blueprint

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

5 Years 10 Years

Cri

tic

al Ta

cti

ca

l

So

luti

on

s

Inn

ova

tive

Sp

ec

iali

st

So

luti

on

s

National Solutions

PAS

Replacement

Initial National Shared

Record

Haemophilia

Lighthouse Project

Epilepsy

Lighthouse Project

BiPolar Lighthouse

Project

Portal

(Organisation)

Other Future

Projects

OrderComms

Other Future

Projects

NCH Implementation Other

Single

Solution Set

Evolving to a single

solution set will require

agility and a governance

approach that supports a

dynamic environment

Other Future

Projects

National Shared Record Development

MEDLis

MN-CMS

NICIS

Acute Operational Components ndash Phased Implementation in HGrsquos

Community Operational Components ndash Phased Implementation in CHOrsquos

NIMIS

National Solutions

Other

Other

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What can eHealth Do

Office of the CIO | Delivering eHealth Ireland 22

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Office of the CIO | Delivering eHealth Ireland 23

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland

Connected Health

Office of the CIO | Delivering eHealth Ireland

Currenthellip

Office of the CIO | Delivering eHealth Ireland15

Security

Data Quality

Information Governance

Data Dictionary

Office of the CIO | Delivering eHealth Ireland

The lsquofourth utilityrsquo

International eHealth investment Estimates

bull euro158Bn England ndash NPfIT over 10yrs

bull euro16Bn Canada Southwest Ontario ndash 2013-2017

bull euro25Bn ndash USA ndash HITECH Act Meaningful Use

bull euro16Bn ndash Australia ndash predicted over 10yrs

bull euro54Bn ndash NHS ndash predicted in next 5 yrs

The history of technology as it enters industries is that

people say lsquothis is going to transform everything in 2

yearsrsquo And then you put it in and nothing happens and

people say lsquowhy didnrsquot it work the way we expected it

to And then lo and behold after a period of 10

years it begins working

mdash Robert Wachter

UCSF

Technology has transformed hotel

transport retail banking communications

helliphelliphelliphealthcare

More than 80 of US providers

use an EHR

Ireland lags most developed countries but can

learn from the investments and initiatives

elsewhereThe goals of Reform cannot be delivered

without a National EHR

Globally there are

more than 400

EHR vendors on

the market

DENMARK

99 discharge letters

ordersresults

prescriptions are

electronic

FINLAND

100 health centres

with EHRs

NETHERLANDS

All prescriptions

electronic

US ndash VHA

$309Bn in

cumulative net

benefits

US ndash VHA

100 primary

care hospitals

EHR

Office of the CIO | Delivering eHealth Ireland

Overall Blueprint defined as the long term vision for eHealth in Ireland and endorsed by industry ndash Solutions for Hospital Groups identified as a core area

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What is the EHRMoving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

National

Shared

Record

Community

Operational

Systems

Acute

Operational

Systems

Individual Health Identifier

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

eHealth Blueprint

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

tConsumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

The Individual Health Identifier

Programme is a key enabler that

allows information to be shared about

a patient

PharmacyGP Systems

Private

Hospitals

Other healthcare providers will

access and contribute to the National

Shared Record through the

Integration Capability

Office of the CIO | Delivering eHealth Ireland

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

t

Consumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

Community

Operational

Systems

Acute

Operational

Systems

National

Shared

Record

Integration

Moving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

eHealth Blueprint

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

5 Years 10 Years

Cri

tic

al Ta

cti

ca

l

So

luti

on

s

Inn

ova

tive

Sp

ec

iali

st

So

luti

on

s

National Solutions

PAS

Replacement

Initial National Shared

Record

Haemophilia

Lighthouse Project

Epilepsy

Lighthouse Project

BiPolar Lighthouse

Project

Portal

(Organisation)

Other Future

Projects

OrderComms

Other Future

Projects

NCH Implementation Other

Single

Solution Set

Evolving to a single

solution set will require

agility and a governance

approach that supports a

dynamic environment

Other Future

Projects

National Shared Record Development

MEDLis

MN-CMS

NICIS

Acute Operational Components ndash Phased Implementation in HGrsquos

Community Operational Components ndash Phased Implementation in CHOrsquos

NIMIS

National Solutions

Other

Other

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What can eHealth Do

Office of the CIO | Delivering eHealth Ireland 22

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Office of the CIO | Delivering eHealth Ireland 23

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland

Currenthellip

Office of the CIO | Delivering eHealth Ireland15

Security

Data Quality

Information Governance

Data Dictionary

Office of the CIO | Delivering eHealth Ireland

The lsquofourth utilityrsquo

International eHealth investment Estimates

bull euro158Bn England ndash NPfIT over 10yrs

bull euro16Bn Canada Southwest Ontario ndash 2013-2017

bull euro25Bn ndash USA ndash HITECH Act Meaningful Use

bull euro16Bn ndash Australia ndash predicted over 10yrs

bull euro54Bn ndash NHS ndash predicted in next 5 yrs

The history of technology as it enters industries is that

people say lsquothis is going to transform everything in 2

yearsrsquo And then you put it in and nothing happens and

people say lsquowhy didnrsquot it work the way we expected it

to And then lo and behold after a period of 10

years it begins working

mdash Robert Wachter

UCSF

Technology has transformed hotel

transport retail banking communications

helliphelliphelliphealthcare

More than 80 of US providers

use an EHR

Ireland lags most developed countries but can

learn from the investments and initiatives

elsewhereThe goals of Reform cannot be delivered

without a National EHR

Globally there are

more than 400

EHR vendors on

the market

DENMARK

99 discharge letters

ordersresults

prescriptions are

electronic

FINLAND

100 health centres

with EHRs

NETHERLANDS

All prescriptions

electronic

US ndash VHA

$309Bn in

cumulative net

benefits

US ndash VHA

100 primary

care hospitals

EHR

Office of the CIO | Delivering eHealth Ireland

Overall Blueprint defined as the long term vision for eHealth in Ireland and endorsed by industry ndash Solutions for Hospital Groups identified as a core area

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What is the EHRMoving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

National

Shared

Record

Community

Operational

Systems

Acute

Operational

Systems

Individual Health Identifier

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

eHealth Blueprint

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

tConsumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

The Individual Health Identifier

Programme is a key enabler that

allows information to be shared about

a patient

PharmacyGP Systems

Private

Hospitals

Other healthcare providers will

access and contribute to the National

Shared Record through the

Integration Capability

Office of the CIO | Delivering eHealth Ireland

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

t

Consumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

Community

Operational

Systems

Acute

Operational

Systems

National

Shared

Record

Integration

Moving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

eHealth Blueprint

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

5 Years 10 Years

Cri

tic

al Ta

cti

ca

l

So

luti

on

s

Inn

ova

tive

Sp

ec

iali

st

So

luti

on

s

National Solutions

PAS

Replacement

Initial National Shared

Record

Haemophilia

Lighthouse Project

Epilepsy

Lighthouse Project

BiPolar Lighthouse

Project

Portal

(Organisation)

Other Future

Projects

OrderComms

Other Future

Projects

NCH Implementation Other

Single

Solution Set

Evolving to a single

solution set will require

agility and a governance

approach that supports a

dynamic environment

Other Future

Projects

National Shared Record Development

MEDLis

MN-CMS

NICIS

Acute Operational Components ndash Phased Implementation in HGrsquos

Community Operational Components ndash Phased Implementation in CHOrsquos

NIMIS

National Solutions

Other

Other

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What can eHealth Do

Office of the CIO | Delivering eHealth Ireland 22

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Office of the CIO | Delivering eHealth Ireland 23

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland15

Security

Data Quality

Information Governance

Data Dictionary

Office of the CIO | Delivering eHealth Ireland

The lsquofourth utilityrsquo

International eHealth investment Estimates

bull euro158Bn England ndash NPfIT over 10yrs

bull euro16Bn Canada Southwest Ontario ndash 2013-2017

bull euro25Bn ndash USA ndash HITECH Act Meaningful Use

bull euro16Bn ndash Australia ndash predicted over 10yrs

bull euro54Bn ndash NHS ndash predicted in next 5 yrs

The history of technology as it enters industries is that

people say lsquothis is going to transform everything in 2

yearsrsquo And then you put it in and nothing happens and

people say lsquowhy didnrsquot it work the way we expected it

to And then lo and behold after a period of 10

years it begins working

mdash Robert Wachter

UCSF

Technology has transformed hotel

transport retail banking communications

helliphelliphelliphealthcare

More than 80 of US providers

use an EHR

Ireland lags most developed countries but can

learn from the investments and initiatives

elsewhereThe goals of Reform cannot be delivered

without a National EHR

Globally there are

more than 400

EHR vendors on

the market

DENMARK

99 discharge letters

ordersresults

prescriptions are

electronic

FINLAND

100 health centres

with EHRs

NETHERLANDS

All prescriptions

electronic

US ndash VHA

$309Bn in

cumulative net

benefits

US ndash VHA

100 primary

care hospitals

EHR

Office of the CIO | Delivering eHealth Ireland

Overall Blueprint defined as the long term vision for eHealth in Ireland and endorsed by industry ndash Solutions for Hospital Groups identified as a core area

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What is the EHRMoving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

National

Shared

Record

Community

Operational

Systems

Acute

Operational

Systems

Individual Health Identifier

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

eHealth Blueprint

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

tConsumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

The Individual Health Identifier

Programme is a key enabler that

allows information to be shared about

a patient

PharmacyGP Systems

Private

Hospitals

Other healthcare providers will

access and contribute to the National

Shared Record through the

Integration Capability

Office of the CIO | Delivering eHealth Ireland

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

t

Consumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

Community

Operational

Systems

Acute

Operational

Systems

National

Shared

Record

Integration

Moving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

eHealth Blueprint

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

5 Years 10 Years

Cri

tic

al Ta

cti

ca

l

So

luti

on

s

Inn

ova

tive

Sp

ec

iali

st

So

luti

on

s

National Solutions

PAS

Replacement

Initial National Shared

Record

Haemophilia

Lighthouse Project

Epilepsy

Lighthouse Project

BiPolar Lighthouse

Project

Portal

(Organisation)

Other Future

Projects

OrderComms

Other Future

Projects

NCH Implementation Other

Single

Solution Set

Evolving to a single

solution set will require

agility and a governance

approach that supports a

dynamic environment

Other Future

Projects

National Shared Record Development

MEDLis

MN-CMS

NICIS

Acute Operational Components ndash Phased Implementation in HGrsquos

Community Operational Components ndash Phased Implementation in CHOrsquos

NIMIS

National Solutions

Other

Other

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What can eHealth Do

Office of the CIO | Delivering eHealth Ireland 22

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Office of the CIO | Delivering eHealth Ireland 23

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland

The lsquofourth utilityrsquo

International eHealth investment Estimates

bull euro158Bn England ndash NPfIT over 10yrs

bull euro16Bn Canada Southwest Ontario ndash 2013-2017

bull euro25Bn ndash USA ndash HITECH Act Meaningful Use

bull euro16Bn ndash Australia ndash predicted over 10yrs

bull euro54Bn ndash NHS ndash predicted in next 5 yrs

The history of technology as it enters industries is that

people say lsquothis is going to transform everything in 2

yearsrsquo And then you put it in and nothing happens and

people say lsquowhy didnrsquot it work the way we expected it

to And then lo and behold after a period of 10

years it begins working

mdash Robert Wachter

UCSF

Technology has transformed hotel

transport retail banking communications

helliphelliphelliphealthcare

More than 80 of US providers

use an EHR

Ireland lags most developed countries but can

learn from the investments and initiatives

elsewhereThe goals of Reform cannot be delivered

without a National EHR

Globally there are

more than 400

EHR vendors on

the market

DENMARK

99 discharge letters

ordersresults

prescriptions are

electronic

FINLAND

100 health centres

with EHRs

NETHERLANDS

All prescriptions

electronic

US ndash VHA

$309Bn in

cumulative net

benefits

US ndash VHA

100 primary

care hospitals

EHR

Office of the CIO | Delivering eHealth Ireland

Overall Blueprint defined as the long term vision for eHealth in Ireland and endorsed by industry ndash Solutions for Hospital Groups identified as a core area

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What is the EHRMoving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

National

Shared

Record

Community

Operational

Systems

Acute

Operational

Systems

Individual Health Identifier

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

eHealth Blueprint

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

tConsumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

The Individual Health Identifier

Programme is a key enabler that

allows information to be shared about

a patient

PharmacyGP Systems

Private

Hospitals

Other healthcare providers will

access and contribute to the National

Shared Record through the

Integration Capability

Office of the CIO | Delivering eHealth Ireland

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

t

Consumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

Community

Operational

Systems

Acute

Operational

Systems

National

Shared

Record

Integration

Moving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

eHealth Blueprint

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

5 Years 10 Years

Cri

tic

al Ta

cti

ca

l

So

luti

on

s

Inn

ova

tive

Sp

ec

iali

st

So

luti

on

s

National Solutions

PAS

Replacement

Initial National Shared

Record

Haemophilia

Lighthouse Project

Epilepsy

Lighthouse Project

BiPolar Lighthouse

Project

Portal

(Organisation)

Other Future

Projects

OrderComms

Other Future

Projects

NCH Implementation Other

Single

Solution Set

Evolving to a single

solution set will require

agility and a governance

approach that supports a

dynamic environment

Other Future

Projects

National Shared Record Development

MEDLis

MN-CMS

NICIS

Acute Operational Components ndash Phased Implementation in HGrsquos

Community Operational Components ndash Phased Implementation in CHOrsquos

NIMIS

National Solutions

Other

Other

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What can eHealth Do

Office of the CIO | Delivering eHealth Ireland 22

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Office of the CIO | Delivering eHealth Ireland 23

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland

Overall Blueprint defined as the long term vision for eHealth in Ireland and endorsed by industry ndash Solutions for Hospital Groups identified as a core area

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What is the EHRMoving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

National

Shared

Record

Community

Operational

Systems

Acute

Operational

Systems

Individual Health Identifier

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

eHealth Blueprint

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

tConsumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

The Individual Health Identifier

Programme is a key enabler that

allows information to be shared about

a patient

PharmacyGP Systems

Private

Hospitals

Other healthcare providers will

access and contribute to the National

Shared Record through the

Integration Capability

Office of the CIO | Delivering eHealth Ireland

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

t

Consumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

Community

Operational

Systems

Acute

Operational

Systems

National

Shared

Record

Integration

Moving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

eHealth Blueprint

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

5 Years 10 Years

Cri

tic

al Ta

cti

ca

l

So

luti

on

s

Inn

ova

tive

Sp

ec

iali

st

So

luti

on

s

National Solutions

PAS

Replacement

Initial National Shared

Record

Haemophilia

Lighthouse Project

Epilepsy

Lighthouse Project

BiPolar Lighthouse

Project

Portal

(Organisation)

Other Future

Projects

OrderComms

Other Future

Projects

NCH Implementation Other

Single

Solution Set

Evolving to a single

solution set will require

agility and a governance

approach that supports a

dynamic environment

Other Future

Projects

National Shared Record Development

MEDLis

MN-CMS

NICIS

Acute Operational Components ndash Phased Implementation in HGrsquos

Community Operational Components ndash Phased Implementation in CHOrsquos

NIMIS

National Solutions

Other

Other

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What can eHealth Do

Office of the CIO | Delivering eHealth Ireland 22

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Office of the CIO | Delivering eHealth Ireland 23

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland

What is the EHRMoving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

National

Shared

Record

Community

Operational

Systems

Acute

Operational

Systems

Individual Health Identifier

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

eHealth Blueprint

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

tConsumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

The Individual Health Identifier

Programme is a key enabler that

allows information to be shared about

a patient

PharmacyGP Systems

Private

Hospitals

Other healthcare providers will

access and contribute to the National

Shared Record through the

Integration Capability

Office of the CIO | Delivering eHealth Ireland

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

t

Consumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

Community

Operational

Systems

Acute

Operational

Systems

National

Shared

Record

Integration

Moving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

eHealth Blueprint

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

5 Years 10 Years

Cri

tic

al Ta

cti

ca

l

So

luti

on

s

Inn

ova

tive

Sp

ec

iali

st

So

luti

on

s

National Solutions

PAS

Replacement

Initial National Shared

Record

Haemophilia

Lighthouse Project

Epilepsy

Lighthouse Project

BiPolar Lighthouse

Project

Portal

(Organisation)

Other Future

Projects

OrderComms

Other Future

Projects

NCH Implementation Other

Single

Solution Set

Evolving to a single

solution set will require

agility and a governance

approach that supports a

dynamic environment

Other Future

Projects

National Shared Record Development

MEDLis

MN-CMS

NICIS

Acute Operational Components ndash Phased Implementation in HGrsquos

Community Operational Components ndash Phased Implementation in CHOrsquos

NIMIS

National Solutions

Other

Other

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What can eHealth Do

Office of the CIO | Delivering eHealth Ireland 22

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Office of the CIO | Delivering eHealth Ireland 23

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland

National EHR Registries and Domains

Stakeholders

Clinical Management Point of Care Environment

National EHR Integration and Access Layer

Communication Layer

Core Capabilities

IAAALayer

Prov

ider

Hea

lth P

orta

l

National EHR RegistriesClient Registry Provider Registry Location Registry

National EHR DomainsMedical Imaging Laboratory Results Pharmaceutical

HistoryClinical Document

RepositoryEncounter History

Message Queuing

Message Data amp Transformation

Message Encoding

Service Management

Identity Management

Authentication Access Secure Audit

Single Sign On Exception Handling Context Management Terminology ServicesRecord Locator Services

Orchestration ETL PrivacyCertification and Integration Toolkit

Secure Messaging

Logging

Immunization History

Infectious Disease History

National AnalyticsPerformance Management

Population Based Analytics

Business Intelligence

Registration

National eHealth Blueprint

Healthcare Providers Patients Corporate Administrators and Managers

Legitimate Relationship Services (LRS)

Corporate Setting

Fina

nce

Man

agem

ent

Proc

urem

ent

Hum

an R

esou

rces

and

Pa

yrol

l Man

agem

ent

Ass

et M

anag

emen

t

Hea

lth amp

Saf

ety

Cont

ract

Man

agem

ent

Faci

litie

s M

anag

emen

t

Rost

erin

g Ti

me

Reco

rdin

g

Prog

ram

Man

agem

ent

Cust

omer

Rel

atio

nshi

p M

anag

emen

t

Consumer Health amp Wellbeing

Patie

nt to

Pro

vide

r Se

cure

Mes

sagi

ng

Self-

Hea

lth

Man

agem

ent

Sche

dulin

g an

d A

dmin

istr

atio

n

Nat

iona

l Pat

ient

Po

rtal

Virt

ual C

are

Educ

atio

n amp

A

war

enes

s

Community Healthcare Organisations

Patie

nt A

dmin

istr

atio

n

Case

Man

agem

ent

Elec

tron

ic D

ocum

ent

Man

agem

ent

Clin

ical

Not

es a

nd R

ecor

ds

Patie

nt T

est

Resu

lts

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Refe

rral

Man

agem

ent

Mob

ile C

linic

al M

anag

emen

t

Popu

lati

on H

ealth

M

anag

emen

t

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

ePre

scri

bing

Hospital Groups

Hos

pita

l Pat

ient

A

dmin

istr

atio

n

Hos

pita

l Med

ical

Imag

ing

Hos

pita

l Lab

orat

ory

Hos

pita

l Pha

rmac

euti

cals

Case

Man

agem

ent

Dis

ease

Man

agem

ent

Care

Pat

hway

s an

d D

ecis

ion

Supp

ort

Com

pute

rize

d Ph

ysic

ian

Ord

er

Entr

y

Refe

rral

Man

agem

ent

Popu

lati

on H

ealth

M

anag

emen

t

Elec

tron

ic D

ocum

ent

Man

agem

ent

ePre

scri

bing

Elec

tron

ic C

linic

al N

otes

and

Re

cord

s

Community

Operational

Systems

Acute

Operational

Systems

National

Shared

Record

Integration

Moving from paper records

locked in organisations to a

digital patient record shared

across care settings

4 Components

Examples

bull Order Communications

Results Reporting

bull Medicines Management

bull Clinical Notesstems

The ldquogluerdquo that binds all this together

and maintains integrity and security

across the system

Examples

bull Single MPI

bull Scheduling

bull Clinical Notes Records

bull Screening amp Surveillance

eHealth Blueprint

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

5 Years 10 Years

Cri

tic

al Ta

cti

ca

l

So

luti

on

s

Inn

ova

tive

Sp

ec

iali

st

So

luti

on

s

National Solutions

PAS

Replacement

Initial National Shared

Record

Haemophilia

Lighthouse Project

Epilepsy

Lighthouse Project

BiPolar Lighthouse

Project

Portal

(Organisation)

Other Future

Projects

OrderComms

Other Future

Projects

NCH Implementation Other

Single

Solution Set

Evolving to a single

solution set will require

agility and a governance

approach that supports a

dynamic environment

Other Future

Projects

National Shared Record Development

MEDLis

MN-CMS

NICIS

Acute Operational Components ndash Phased Implementation in HGrsquos

Community Operational Components ndash Phased Implementation in CHOrsquos

NIMIS

National Solutions

Other

Other

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What can eHealth Do

Office of the CIO | Delivering eHealth Ireland 22

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Office of the CIO | Delivering eHealth Ireland 23

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland

5 Years 10 Years

Cri

tic

al Ta

cti

ca

l

So

luti

on

s

Inn

ova

tive

Sp

ec

iali

st

So

luti

on

s

National Solutions

PAS

Replacement

Initial National Shared

Record

Haemophilia

Lighthouse Project

Epilepsy

Lighthouse Project

BiPolar Lighthouse

Project

Portal

(Organisation)

Other Future

Projects

OrderComms

Other Future

Projects

NCH Implementation Other

Single

Solution Set

Evolving to a single

solution set will require

agility and a governance

approach that supports a

dynamic environment

Other Future

Projects

National Shared Record Development

MEDLis

MN-CMS

NICIS

Acute Operational Components ndash Phased Implementation in HGrsquos

Community Operational Components ndash Phased Implementation in CHOrsquos

NIMIS

National Solutions

Other

Other

eHealth Blueprint - EHR

Office of the CIO | Delivering eHealth Ireland

What can eHealth Do

Office of the CIO | Delivering eHealth Ireland 22

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Office of the CIO | Delivering eHealth Ireland 23

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland

What can eHealth Do

Office of the CIO | Delivering eHealth Ireland 22

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Office of the CIO | Delivering eHealth Ireland 23

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland 22

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Office of the CIO | Delivering eHealth Ireland 23

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland 23

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland 24

Epilepsy All patients on the EHR Patient mobile application

Population health analysis GP access and image reviews IHI

Genomic sequencing for under 5s

Haemophilia National Integration to hospital PAS Open

source platform Open Data pilot Patient mobile application

IHI Secure clinical communicator Next generation solution

Bipolar Disorder Secure clinical communicator Information

integration regardless of setting Open Source solution

Innovation led approach Clinical support tool

Office of the CIO | Delivering eHealth Ireland

Office of the CIO | Delivering eHealth Ireland