Physiotherapy Account Receivable - PowerPoint by usl47852

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									                      The Oracle HTB
                  Designed for Healthcare




Baltic IT&T 2005 – Riga, April 8

Thomas M Jones, MD
Vice President and Chief Medical Officer    ®
Healthcare challenges
        Challenge                Requirement
  Manage across the         Comprehensive patient
  continuum of care         centric record

  Assure data re-use for    Standards-based data
  multiple purposes         management
  Protect patient privacy   Access control, de-
  and adhere to             identification, reverse
  legislative mandates      notification
  Leverage existing         Transform and integrate
  investments               data from any source
                                                        Healthcare activity
                     Member
                    (Covered)                                                                                                     Costs
                                                                                                                                 Economic        Medical
                              selects                                                                                            Outcomes       Outcomes
Benefit Plan                                                       Citizen                         Caregiver
(Coverage)
      administers




                                                                                                                                                 manages
                           Account
                         (Receivable)        Problem
                                           (Condition)                                                   Is a part of
                                             exhibits




Plan Administrator
    (Arbitrator)                                                                  Encounte                                                Epicrisis
                                                                                      r                                            (Problem Occurrence)
                                                                                   (Event)
                                           Symptom
                                             (Sign)                                                schedules


                                                                                                                   Visit
                                             is a                                    Task                      (Appointment)               Order
                                 Staff
   Lab                                                      Resource           (Offered Service)                                         (Directive)
                                                                                      specifies



                                                            (Means)




                                                                                                                  tracks
                       is a
                                                            has




                                Facility
Pharmacy
                                (Area)                                                                                         records
                                                                         has

                                                           Provider                                                                          Result
                                                                                     Service                    Care plan
Radiology                                               (Organization)                                                                    (Measurement)
                              Equipment                                             (Catalog)                    (Chart)
  The importance of infrastructure

      It is important to note that the provision of
       infrastructure services is an enabling
       mechanism.
      The infrastructure itself will deliver some
       benefits, but the main outcomes will be
       achieved by the provision of additional
       applications and services.
      As with any infrastructure, information
       technology infrastructure enables other
       systems that do yield business benefits.


Implementing Information for Health - Denis Protti
A lifetime of care
                    GP   Hospital




           Dental                   Pathology



                                        Physiotherapy
   Birth
Current IT practice




              Building silos
A standards based platform




        Healthcare Transaction
                 Base
         A Standard Information Model
              Health Level 7 RIM
One place to store everything – and to
retrieve it for re-use




         Healthcare Transaction
                  Base
Creating a single person record
               GP 32561 F   HOSP 2345



                                              PHY 4562 LG




     DEN9001




                      Person
                     Services

 A10001




                    Healthcare Transaction
 12324
                             Base
                                        Single Identifier
                                        Patient: 123456
Integrating information                                             HL7 version 2.X



                                                                  Delaminated File
                                      HL7 Version 3   Interface
                                                       Engine




                                                                                  XML


          Person    Message
         Services   Services

                                                                              Flat File




         Healthcare Transaction                                       Bespoke Standard

                  Base
                    Single Record
                    Patient: 123456


                                                                    HL7 Version 3.0
Integration is more than just data
exchange
 HL7 Mission Statement:

 “Develop specifications that support
 interoperability in healthcare, i.e.
 “computer systems exchanging information
 in the healthcare space will predictably
 compute on the exchanged information
 based on an agreed upon set of
 specifications defining the structure and
 meaning of the exchanged information.”
More on interoperability

  Syntactic interoperability
     –   Structures are exchangeable but there is no
         guarantee that meaning will be consistent across
         system boundaries
  Semantic interoperability
     –   The exchange of meaning between systems
  Computable semantic interoperability
     –   The exchange of consistent and unambiguous
         meaning between two or more machines
HL 7 affiliates
       Members include Argentina, Australia,
        Brazil, Canada, China, Croatia, Czech
        Republic, Denmark, Finland, Germany,
        Greece, India, Ireland, Italy, Japan,
        Lithuania, Mexico, Netherlands, New
        Zealand, Poland, South Africa, South
        Korea, Spain, Switzerland, Taiwan,
        United Kingdom, and USA
Why HL 7 works – many brains




        RIM Harmonization Meeting
Allergy RMIM
Adding to and reading the EHR




         Person    Message
        Services   Services




        Healthcare Transaction
                 Base
                   Single Record
                   Patient: 123456
The ability to unify terminologies
                                              Dental   SNOMED
                            ICD 10             Code     Code
                             Code
                                                                Local
                                                                Code
                    LOINC




          Person      Message           Terminology
         Services     Services           Services
                                                                        ICD 9 Code




         Healthcare Transaction
                  Base
                      Normalised Data
                    SNOMED: 123456789
  Incorporating rules

                                                 Person: John Smith             MRN 12345

                                                 Diagnosis: Carcinoma Colon
                                                 Procedures: Colonoscopy
Rule Processing
                                                 Recent Results
                                                 Sodium:     137 mm/l         01 January 2004
                                                 Potassium: 4     mEq/l        01 January 2004




                           Snomed (Pre-RT) Code                                             Snomed (Pre-RT) Code
                                Colonoscopy                                                        Sodium
                             SNM 198/P1-57710                                                 SNM198/C 15500
                         Display Term - Colonoscopy
                                                                                            Display Term - Sodium

                     CPT 4        ICD 10          OPCS
                  Colonoscopy   Colonoscopy    Colonoscopy                     CPT 4                 LOINC          HCPCS
                  CPT 45355     ICD91/45.24       H22.9                    Sodium - serum        Sodium, ser/plas   Sodium
                                                                             CPT 45355           LNC1.0N 2951-2     84295
Protecting patient privacy




 Support for evolving
    technologies
                         Security     Auditing
                         Service      Service




                        Healthcare Transaction
                                 Base
                                    Single Source of
                                          Truth
Enhancing decision support


                 Star Schema            Drill to Detail   Analytic Workspace




                                     Business
                                    Intelligence




        Healthcare Transaction
                 Base
                 Single Source of
                       Truth
Rapid application development


          Application Programming Interface




        Healthcare Transaction
                 Base
                    Single Source of
                          Truth
      Supporting new healthcare
      applications and processes
                                                                 Remote Monitoring




        New Applications
                             Application Programming Interface




                           Healthcare Transaction
                                    Base
                                       Single Source of
                                             Truth



Existing Applications
Healthcare Transaction Base
Interoperability Framework
                         Third Party Applications

    • Application Flow                 • Proprietary Data Elements
    • User Interface                   • Content (e.g. Protocols)

                         Interoperability Platform

    •   Data Repository                •   Security Services
    •   Messaging Services             •   Auditing Services
    •   Terminology Services           •   Person Services
    •   Configuration Services         •   Business Process API

                            Core Technology

    • Database                         • Workflow Engine
    • Application Server               • Platform Security
    • Data Warehouse                   • Wireless Support
Current HTB projects - USA

  District of Columbia Department of Health
  Los Angeles County Public Health System
  National Cancer Institute
  US Military Health Service
   –   RITPO
   –   Madigan Army
  CMS
  Louisiana Department of Health and Hospitals
Municipal Public Health
                        Healthcare         Local Health          Federal
                                                                                   Researchers
                         Workers            Agencies            Authorities
 Data Capture
                                                  Internet
 Applications
                 Encounter           Results         Incident            Data             Alert
                 Summary             Access          Reports             Mining        Notifications




                          Healthcare Transaction Base                         Data Warehouse

                  •   Messaging Services
                  •   Person Services                Clinical
                  •   Terminology Management          Data
                  •   Security and Auditing         Repository
          iHUB




                              Facility ADT & Clinical Systems
        National Disease Surveillance
Clinical and Public
                                                    Healthcare Applications    Reporting & Analysis
  Health Systems




                                                    Application Programming      Data Warehouse


                                    Messaging
                                                            Interface
                                     Services       HL7 V3 Reference
                       OracleAS                 •   Person Services
                      Integration               •   Information Model
                                                    Terminology Management
                                                •   Security and Auditing
                                                •   Business Process Support



                                                        Healthcare Data
                                                             Model


                                                     Enterprise Data Model
EHR – Public Health Interoperability
System Scenario

         Clinical Care                                           Public Health Surveillance
Hospital of Birth

ADT –                                                                      Newborn
Birth Record                                                               Screening
                         HL7 2.4                         HL7 3.0           Registry
Newborn
Screening            HL7 3.0                                               Hearing
                                                              HL7 3.0
                                                                           Screening
                                         OracleAS                          Registry
                    HL7 3.0
Hearing                                  Integration          HL7 2.4
Screening
                    HL7 3.0                                                Immunization
                                                                           Registry
Immunization          HL7 2.4                 HL7 3.0
Administration
                                                                          Communicable
                                                                          Disease
                                                                  J2EE    Registry
External
                                   API




Laboratory                                  HTB         API
                                                                  J2EE
                                                                                          Healthcare
                                                                                          Transaction
                                                                                          Viewer
Metropolitan integration
Centralized decision support – Los Angeles
County        Executives Managers Researchers

                                                 Internet
    Executive        Operational                                              Encounter
                                      Cost Analysis         Historical                            Clinical
   Information       Day-to-Day                                               Lifecycle
     System           Reports           Reports             Trending          Monitoring         Outcomes




                                     Healthcare Transaction Base                           Data Warehouse

                             •   Messaging Services
         Interface
                             •   Person Services                  Clinical
          Engine
                             •   Terminology Management            Data
                             •   Security and Auditing           Repository




                                                                                              Business
                                                                                            Process Data
                                                                                             Warehouse




           ADT & Clinical Systems                              Financial Systems
Metropolitan integration
Results Review- Metropolitan
National Network
               Staff              Community                                 Care
                                                       Patients
             Physicians           Physicians                              Providers

                                            Internet

                                         Organization            Staff
                     Scheduling
                                         Management           Management




                                  Healthcare Transaction Base

                          •   Messaging Services
     Interface            •   Person Services                 Clinical
      Engine              •   Terminology Management           Data
                          •   Security and Auditing          Repository




                                     ADT & Clinical Systems
Staff Management
Current HTB projects - Europe

  Groupe Hospitalier du Havre
  Creteil et Montreuil
  Finsiel (Modena, Busto, Careggi)
  CSC Scandihealth
  Son Llatzer
  Stockholm County
  Cronos (Antwerp)
  Biobank
Integrated healthcare information
Groupe Hospital du Havre

       Legacy Applications              New Applications                    Analysis and Reporting




                                                            J2EE

                                       Healthcare Transaction Base             Data Warehouse

                               •   Messaging Services
                               •   Person Services              Clinical
                               •   Terminology Management        Data
                               •   Security and Auditing       Repository
 HIS             Integration
                   Engine



                                                                                External Data
                                                                                 Warehouse

ADT                            LIS

                    CIS
Summary                                The Healthcare Transaction
                                        Base is a standards based
                                        solution that:
                                           –   is based on proven
                                               scalable technology
                                           –   integrates healthcare data
                                               across single or multiple
                                               enterprises
                                           –   provides a rapid
  Application Programming Interface
                                               application development
                                               environment for
                                               healthcare solutions
                                           –   protects the IT
    Healthcare Transaction Base
                                               investments of
                                               purchasers, partners, and
                                               end users
                                           –   offers a unique service for
                                               citizens/patients world
                                               wide
Thank you – tom.jones@oracle.com

								
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