WWW.MOH.GOV.GE Ministry of Labour, Health and Social Affairs of Georgia Georgia Health Management Information System Strategy “Healthy Georgia, Connected to You” 2011 Table of Contents Executive Summary . 5 Goals and Objectives. 6 Governance. 7 Operational.Aspects. 9 HMIS Standards. .10 Message.Standards. .10 Vocabulary.Standards.for.Medical.Care. .11 Diagnosis.-.ICD.10,.Medcin. .12 Treatments.-.CPT. .13 Drugs.–RXNorm,.Multum,.Medispan,.First.Data.Bank. .13 Lab.–.LOINC,.SNOMED . .13 Administrative.Standards . .13 Citizens/Patients. .14 Provider.Credentialing,.Licensing.and.Unique.Identifiers. .14 National.Drug.Database . .14 Health.Data.Dictionary . .14 HMIS.Key.Indicators.and.Metrics. .15 HMIS.Core.Data.Sets. .15 HMIS Functionality . .16 Overview. .16 What.is.not.an.HMIS.component . .19 Software.Acquisition.versus.Development. .19 Selective.review.of.relevant.systems.that.are.already.available.in.Georgia . .23 Hesperus . .23 Vaccinations.system . .23 Electronic.registration.for.births.and.deaths.system. .23 TB.system,.AIDS.system,. .23 Surveillance.system.(DETRA).–.Infectious.Disease. .24 EU.project.for.MD’s.in.villages.to.be.equipped.with.400.PC’s . .24 SIMS. .24 Electronic Medical Record (EMR) . .25 Personal.and.Health.Information. .26 Results.Management. .26 Order.Management. .26 Decision.Support. .26 Reporting . .26 Electronic.Communication.and.Connectivity. .26 Patient.Support . .27 Administrative.Processes . .28 3 Financial Information System Functionality. .29 Georgian Health Data Repository (GHDR) . .32 Populating.the.Georgian.Health.Data.Repository.(GHDR) . .33 Extract,.Transform.Load. .34 Data.Domains.(Categories). .34 Data.Analysis.and.Presentation. .35 Reporting . .35 Dashboards . .36 GHDR.Uses. .36 Georgian.Healthcare.Statistics. .36 Monitoring.Healthcare.Costs. .36 Public.Health.Surveillance .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. ...36 Decision.Support:..Improving.Patient.Care . .36 Pharmaceutical.Inventory.Tracking. .36 Research. .37 Data.Quality. .37 HMIS System Architecture. .38 Architecture.Model.and.Design.Patterns. .38 Architecture.Model:.3–Tier.with.MVC. .38 Design.Patterns:.SOA,.AOP,.IoC. .38 Exchange.Model:.Web.based.Middleware. .38 Architecture.Components. .39 Presentation.Layer. .40 Service.Layer . .40 Data.Layer .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .40 HMIS Project Phases. 41 References and Additional Reading . .43 Appendix B: Other Countries HMIS Functionality . .44 4 Executive Summary In 2011, the MoLHSA will implement a new and innovative program to interconnect the information needs of the Ministry, insurers, providers and patients. Healthy Georgia, Connected to you, will be a comprehensive Health Management Information System (HMIS) that will draw from lessons learned around the world, and will be built upon existing international standards. In addition, it will also be uniquely designed to meet the current and future requirements of the citizens of Georgia and the country’s Healthcare Delivery System. While providing the leadership role, the MoLHSA will also partner with other governmental agencies and rep- resentatives of the private sector to provide a new Governance structure that will be responsible for the HMIS. This new body will define the Georgian Health Management Information System Strategy and it will include the stewardship, strategy, vision and policies necessary for operational success. Just as an architect uses a blueprint, this vision will provide the framework within which various entities (both private and public) will operate in the future across the health sector. It will identify priorities, highlight major issues, and mandate adoption of standards, to raise the quality and improve the performance of health care delivery in Georgia. This common vision will ensure that all future efforts are directed toward development of health systems that are interoperable and provide an accurate view of the health status of Georgians. New software products such as an electronic medical record, personal health record and public health surveil- lance system will be obtained and integrated. Because these systems must be in compliance with the govern- mental requirements and standards, they will allow a uniform set of core health data elements to be collected throughout the healthcare delivery system. The subsequent availability of accurate clinical information, will not only improve care delivery to individual patients, but will also allow for the aggregation of the population’s healthcare information. It is this integration of information that allows the Georgian leadership to obtain true knowledge on the current health status of its citizens. Utilization of this knowledge will empower the patients, the providers and the Government. Patients will have access to their personal health information and will have improved awareness, education and self-management of chronic diseases. No longer will providers only have fragmented pieces of a patient’s medical care but instead will have access to a longitudinal view of each pa- tient’s medical history. The Government will be able to optimize healthcare delivery by focused interventions in the event of a disease outbreak, by measurement of clinical outcomes by different treatment approaches and by identification of opportunities to improve resource allocation. For every stakeholder within the healthcare delivery spectrum, the implementation of this vision will result in a Healthy Georgia, Connected to you. 5 Goals and Objectives The goal of the Government of Georgia is to create a country wide health care information system that will support the Citizens of Georgia, State of Georgia and the Health care industry. Success in this endeavor will be measured in: Increased efficiency Increased governmental oversight of state subsidized programs Increased transparency of healthcare financing and reduction of fraudulent claims Standardized and Institutionalize business processes and increase service quality Improved quality of healthcare data allowing benchmarking against international statistics Increased access to healthcare and insurance information to patients Creating effective tools for decision and policy making. The objective of this document is to describe the Georgian Health Information Strategy and provide a frame- work for action for the development of a Health Management Information System (HMIS). This concept paper will guide the developmental processes resulting in the creation of a country-wide health management system that will serve as the basis for evidence based decision processes. These concepts will help to commu- nicate the Ministry of Health’s vision, mission, and long-term strategic goals to the various stakeholders and other interested parties. The HMIS Project will be initiated in February 2011 and will define these strategies and identify potential partners that will re-engineer and modernize the current environment to a knowledge managed health system. Information Technology (IT) and Information Management Systems (IMS) have a central role as an enabler in the healthcare business and the ministry recognizes that it requires a sophisticated IT system to measure and improve the quality of care. Strategic Goals of HMIS Implementation Primary Care Development Quality, Clinical Excellence and Perfor- Health Gain Promote the role of family health mance Improvement Reduce the burden of disease by address- care as being at the heart of health Improve quality and responsiveness of services ing the priority health areas through the service provision in Georgia and to and strengthen the role of the Ministry of development of evidence based national deliver health promotion, preventative, Health as regulator in the promotion of clinical protocols and standards for the preven- curative, rehabilitation and palliative excellence and the performance management of tion and treatment of these conditions. services. service improvements. Future Investment Partnership Working Develop a structured approach to Service Development Develop local, regional and international part- investment in existing and new services, Develop an integrated model of health nership working with providers to achieve ser- workforce development, buildings, care provision that delivers high qual- vice rationalization, optimize scarce resources equipment and drugs to ensure delivery ity services as locally as possible. and skills, and minimize duplication. of the Georgian Health Strategy. Organization and Management Ensure the appropriate organizational Human Resources Community Involvement structure is in place to implement the Strengthen human resources man- Encourage individuals, families and communi- Strategic Direction. Strengthen and agement, workforce planning and ties to take more responsibility for their own decentralize responsibility for the man- value staff in their provision of health health and to contribute to determining the agement of health services, separating services. shape and pattern of delivery of health services responsibility for policy, strategy and in the future. performance management from opera- tional issues. Information and Communications Technol- Education, Research and Develop- Financial Management ogy (ICT) ment Develop sound financial management Build upon the current strategy for the develop- Develop the role of the health services skills