Siaw-Teng Liaw1, Rachael Kearns2, Jane Taggart2, Oliver Frank3, Riki Lane4, Michael Tam5, Sarah Dennis6, Christine Walker7, Grant Russell4, Mark Harris2. 1. Academic GP Unit, SW Sydney Local Health District, Australia; UNSW Medicine, Sydney, Australia; Ingham Institute of Applied Medical Research, Sydney, Australia. Electronic address: siaw@unsw.edu.au. 2. UNSW Medicine, Sydney, Australia. 3. University of Adelaide, Adelaide, Australia. 4. Monash University, Melbourne, Australia. 5. Academic GP Unit, SW Sydney Local Health District, Australia; UNSW Medicine, Sydney, Australia; Ingham Institute of Applied Medical Research, Sydney, Australia. 6. University of Sydney, Australia. 7. Chronic Illness Alliance, Melbourne, Australia.
Abstract
CONTEXT: Integrated primary care requires systems and service integration along with financial incentives to promote downward substitution to a single entry point to care. Integrated Primary Care Centres (IPCCs) aim to improve integration by co-location of health services. The Informatics Capability Maturity (ICM) describes how well health organisations collect, manage and share information; manage eHealth technology, implementation, change, data quality and governance; and use "intelligence" to improve care. AIM: Describe associations of ICM with systems and service integration in IPCCs. METHODS: Mixed methods evaluation of IPCCs in metropolitan and rural Australia: an enhanced general practice, four GP Super Clinics, a "HealthOne" (private-public partnership) and a Community Health Centre. Data collection methods included self-assessed ICM, document review, interviews, observations in practice and assessment of electronic health record data. Data was analysed and compared across IPCCs. FINDINGS: The IPCCs demonstrated a range of funding models, ownership, leadership, organisation and ICM. Digital tools were used with varying effectiveness to collect, use and share data. Connectivity was problematic, requiring "work-arounds" to communicate and share information. The lack of technical, data and software interoperability standards, clinical coding and secure messaging were barriers to data collection, integration and sharing. Strong leadership and governance was important for successful implementation of robust and secure eHealth systems. Patient engagement with eHealth tools was suboptimal. CONCLUSIONS: ICM is positively associated with integration of data, systems and care. Improved ICM requires a health workforce with eHealth competencies; technical, semantic and software standards; adequate privacy and security; and good governance and leadership.
CONTEXT: Integrated primary care requires systems and service integration along with financial incentives to promote downward substitution to a single entry point to care. Integrated Primary Care Centres (IPCCs) aim to improve integration by co-location of health services. The Informatics Capability Maturity (ICM) describes how well health organisations collect, manage and share information; manage eHealth technology, implementation, change, data quality and governance; and use "intelligence" to improve care. AIM: Describe associations of ICM with systems and service integration in IPCCs. METHODS: Mixed methods evaluation of IPCCs in metropolitan and rural Australia: an enhanced general practice, four GP Super Clinics, a "HealthOne" (private-public partnership) and a Community Health Centre. Data collection methods included self-assessed ICM, document review, interviews, observations in practice and assessment of electronic health record data. Data was analysed and compared across IPCCs. FINDINGS: The IPCCs demonstrated a range of funding models, ownership, leadership, organisation and ICM. Digital tools were used with varying effectiveness to collect, use and share data. Connectivity was problematic, requiring "work-arounds" to communicate and share information. The lack of technical, data and software interoperability standards, clinical coding and secure messaging were barriers to data collection, integration and sharing. Strong leadership and governance was important for successful implementation of robust and secure eHealth systems. Patient engagement with eHealth tools was suboptimal. CONCLUSIONS: ICM is positively associated with integration of data, systems and care. Improved ICM requires a health workforce with eHealth competencies; technical, semantic and software standards; adequate privacy and security; and good governance and leadership.
Authors: Lydia Jidkov; Matthew Alexander; Pippa Bark; John G Williams; Jonathan Kay; Paul Taylor; Harry Hemingway; Amitava Banerjee Journal: BMJ Open Date: 2019-03-30 Impact factor: 2.692
Authors: Sharon M Parker; Nigel Stocks; Don Nutbeam; Louise Thomas; Elizabeth Denney-Wilson; Nicholas Zwar; Jon Karnon; Jane Lloyd; Manny Noakes; Siaw-Teng Liaw; Annie Lau; Richard Osborne; Mark F Harris Journal: BMJ Open Date: 2018-06-04 Impact factor: 2.692