Hussey, Pamela

McDonald, Anne

DCU Online Research Access Service

Population Health Information Tool
PHIT  
Dr Pamela Hussey DCU
Ms Anne McDonald PHN 
ACENDIO 
March 2013 
Population Health Information Tool
 PHIT (2006-2008 ) Action Research Study 
 PHNs  in LHO Dublin North Central 
 Funded by HSE and the NCNM 
 Launched by the HSE (2011).
 In 2012 a pilot project funded by the ICHN 
 Test digital data entry of PHIT 
 Create business case for e.version of PHIT
Public Health Nursing in Ireland 
Key Role 
• Identify individual and population need 
through a continuous system of 
registration and analysis
• Case Finding Surveillance & Analysis
Background to PHIT  
• Existing project developed with 
practitioners based on requirements over 
4 years 
• Developing a pragmatic tool for population 
health data collection within public health 
nursing 
PHIT Data Life Cycle
1 Patient Registration
Evidence based 
assessment
• Family Health
• Chronic Sick /Disability
• Older Adults Care
• Acute Care
2 Coding
•Geography & Caseload
•Self Care ability
•Health Need 
•Primary care 
Referral and team
working
3 Caseload Analysis
•Health Needs 
Assessment
•Caseload Management
•Governance/Supervision
4 Comparison
•With Census etc. 
provides link to wider
epidemiological
framework  
•KPIs
•PC resourcing
•Audit / upgrade
Structure & Framework 
• Care Plan / 
Assessment
• Medication / Tx
• Status  Active / Inactive
• Care Plan Interventions / 
Evaluation
• HC Continuation Sheet
• Register Templates
• Quarterly  & Annual 
Summaries
• Reports, Views & 
Summaries 
Quarterly & Annual Summaries
Provide Information on:
 Acute and chronic care need
 Family Health Outcomes
 Performance Indicators
 Case Review Rate
 Case Dependency Rate
 Geographic Caseload Composition & Need
 Population Health 
Some Examples of Reports 
Register 1 Family Health 
2,000 approx. New Births Annually
15% received outside 48 hour PI and Low Birth Weight  Average 5.7% 
Low Birth Weight (less than 2.5Kgs) 4th Quarter 2011 DNC
0.00%
2.00%
4.00%
6.00%
8.00%
10.00%
12.00%
Series1 4.20% 10% 5.70% 7% 4% 10% 0% 7% 3% 2%
Summer
hill 
North 
Strand 
North 
Clarence 
St 
Eastwall 
Millmoun
t Ballymun Marino Larkhill Killester 
Vernon 
Avenue 
Register 2 Annual Outcomes Chronic Sick /Disability 
 430 new patients annually with total 1,504 on Register  
most likely to be between 45 and 64 years of age
 Highest incidence in Network 1 and 2 reflecting 
demographic profile 
 Most frequent diagnosis: mental health, neurological 
disease, chronic wound care
 Significantly higher smoking rates
 Average continuing care need = 5 years
Register 3: Older Adults
893 new Older Adults per annum with Total 6,307 on Register
8% with high dependency needs (suitable for SAT assessment)
Dependency Reg 3, 4 Qs 2011 DNC
0%
50%
100%
Health Promotion
Acute
Chronic Stable
Chronic Complex
Health Promotion 62% 59% 60% 58%
Acute 14% 14% 13% 13%
Chronic Stable 17% 20% 19% 21%
Chronic Complex 7% 8% 8% 8%
1st Q 2nd Q 3rd Q 4th Q
Register 4: Acute Care
 3,601 Acute Care Episodes
 69% are Older Adults 
 Most having need for wound care
 Most referred from acute services
 50% continuing to chronic care need 
 76% of those continuing are 65 years+ 
with co-morbidity
Nursing Treatments (Interventions) 
19,282 nursing treatments recorded in 2011
‘Setting Up’ home care most frequently 
recorded followed by:
 Wound Care 
 Medication
 Continence  
 Nutrition Management
Project Aims 
Pilot Phase Aim: Proof of Concept
1. To pilot a digital version of the PHIT using a digital pen as a vehicle 
for data collection.
2. To deliver point of care nursing documentation without duplication 
or transcription having a positive impact on time management and 
co-ordination of care 
3. To ensure that future electronic versions of PHIT are designed in 
accordance with integrated services framework 
– Data dictionary with associated clinical reference terminology codes
– Adoption of Harmonised standards used to define information and data models 
– High level business case with value proposition articulated 
Pilot Project Activities 2012 – Phase 1 
Pilot : Proof of Concept digital data entry 
1. Development and use of templates using digital pen 
2. Pre- testing in clinical simulation laboratory 
3. Liaising with HSE on network access and data storage
4. Training small number of staff for pilot data collection
5. Addressing governance and data protection issues.  
Pilot Project Phase 2 
Phase 2 : Health Informatics Development 
1. Select preferred standards for development of phase one and two
– EN12967 HISA    
– EN13940 Contsys 
– ISO 13606 / HL7 version 2.4
2. Develop business case with HSE ICT for regional/national roll out 
3. Consultation and communication with key stakeholders 
4. Identify core requirements to realise integrated solution of 
electronic PHIT in the future
5. Identify champions for executive sponsorship
6. Report back on initial pilot study  
Nursing Informatics Landscape
Big Picture Ecosystem Roadmap 
 Transatlantic eHealth 
Roadmap
 ACENDIO HISINM
 eHealth Summit May 
2013
Co‐operation 
Collaboration Convergence 
Challenges Encountered? 
Proactive versus Reactive 
Readiness 
Socio 
Political 
Technical 
Leadership in Nursing & Midwifery
Some personal reflections 
• HISINM New Strategic Plan 
• Readiness for engagement a key priority
Culture Eats Strategy for Breakfast
eHealth, EHR & Interoperability 
 First steps in this process of development 
is design for interoperability
Interoperability Requirements 
Socio
Technical 
• Political 
• Organisational 
• Legal 
• Economic
• Architecture 
• Processes 
• Structures 
• Semantics  
Interdependent Relationships  Kay S, 2012  
PHIT & Interoperability 
Green = Significant work completed Orange = Started  Black =Awaiting Decisions 
Data Dictionary 
Will not be done until 
Ireland has acquired a 
license from IHTSDO 
Contact Details 
anne.mcdonald@hse.ie
pamela.hussey@dcu.ie


Population Health Information Tool - PHIT

Name not available

Population Health Information ToolPHIT  Dr Pamela Hussey DCUMs Anne McDonald PHN ACENDIO March 2013 Population Health Information Tool PHIT (2006-2008 ) Action Research Study  PHNs  in LHO Dublin North Central  Funded by HSE and the NCNM  Launched by the HSE (2011). In 2012 a pilot project funded by the ICHN  Test digital data entry of PHIT  Create business case for e.version of PHITPublic Health Nursing in Ireland Key Role • Identify individual and population need through a continuous system of registration and analysis• Case Finding Surveillance & AnalysisBackground to PHIT  • Existing project developed with practitioners based on requirements over 4 years • Developing a pragmatic tool for population health data collection within public health nursing PHIT Data Life Cycle1 Patient RegistrationEvidence based assessment• Family Health• Chronic Sick /Disability• Older Adults Care• Acute Care2 Coding•Geography & Caseload•Self Care ability•Health Need •Primary care Referral and teamworking3 Caseload Analysis•Health Needs Assessment•Caseload Management•Governance/Supervision4 Comparison•With Census etc. provides link to widerepidemiologicalframework  •KPIs•PC resourcing•Audit / upgradeStructure & Framework • Care Plan / Assessment• Medication / Tx• Status  Active / Inactive• Care Plan Interventions / Evaluation• HC Continuation Sheet• Register Templates• Quarterly  & Annual Summaries• Reports, Views & Summaries Quarterly & Annual SummariesProvide Information on: Acute and chronic care need Family Health Outcomes Performance Indicators Case Review Rate Case Dependency Rate Geographic Caseload Composition & Need Population Health Some Examples of Reports Register 1 Family Health 2,000 approx. New Births Annually15% received outside 48 hour PI and Low Birth Weight  Average 5.7% Low Birth Weight (less than 2.5Kgs) 4th Quarter 2011 DNC0.00%2.00%4.00%6.00%8.00%10.00%12.00%Series1 4.20% 10% 5.70% 7% 4% 10% 0% 7% 3% 2%Summerhill North Strand North Clarence St Eastwall Millmount Ballymun Marino Larkhill Killester Vernon Avenue Register 2 Annual Outcomes Chronic Sick /Disability  430 new patients annually with total 1,504 on Register  most likely to be between 45 and 64 years of age Highest incidence in Network 1 and 2 reflecting demographic profile  Most frequent diagnosis: mental health, neurological disease, chronic wound care Significantly higher smoking rates Average continuing care need = 5 yearsRegister 3: Older Adults893 new Older Adults per annum with Total 6,307 on Register8% with high dependency needs (suitable for SAT assessment)Dependency Reg 3, 4 Qs 2011 DNC0%50%100%Health PromotionAcuteChronic StableChronic ComplexHealth Promotion 62% 59% 60% 58%Acute 14% 14% 13% 13%Chronic Stable 17% 20% 19% 21%Chronic Complex 7% 8% 8% 8%1st Q 2nd Q 3rd Q 4th QRegister 4: Acute Care 3,601 Acute Care Episodes 69% are Older Adults  Most having need for wound care Most referred from acute services 50% continuing to chronic care need  76% of those continuing are 65 years+ with co-morbidityNursing Treatments (Interventions) 19,282 nursing treatments recorded in 2011‘Setting Up’ home care most frequently recorded followed by: Wound Care  Medication Continence   Nutrition ManagementProject Aims Pilot Phase Aim: Proof of Concept1. To pilot a digital version of the PHIT using a digital pen as a vehicle for data collection.2. To deliver point of care nursing documentation without duplication or transcription having a positive impact on time management and co-ordination of care 3. To ensure that future electronic versions of PHIT are designed in accordance with integrated services framework – Data dictionary with associated clinical reference terminology codes– Adoption of Harmonised standards used to define information and data models – High level business case with value proposition articulated Pilot Project Activities 2012 – Phase 1 Pilot : Proof of Concept digital data entry 1. Development and use of templates using digital pen 2. Pre- testing in clinical simulation laboratory 3. Liaising with HSE on network access and data storage4. Training small number of staff for pilot data collection5. Addressing governance and data protection issues.  Pilot Project Phase 2 Phase 2 : Health Informatics Development 1. Select preferred standards for development of phase one and two– EN12967 HISA    – EN13940 Contsys – ISO 13606 / HL7 version 2.42. Develop business case with HSE ICT for regional/national roll out 3. Consultation and communication with key stakeholders 4. Identify core requirements to realise integrated solution of electronic PHIT in the future5. Identify champions for executive sponsorship6. Report back on initial pilot study  Nursing Informatics LandscapeBig Picture Ecosystem Roadmap  Transatlantic eHealth Roadmap ACENDIO HISINM eHealth Summit May 2013Co‐operation Collaboration Convergence Challenges Encountered? Proactive versus Reactive Readiness Socio Political Technical Leadership in Nursing & MidwiferySome personal reflections • HISINM New Strategic Plan • Readiness for engagement a key priorityCulture Eats Strategy for BreakfasteHealth, EHR & Interoperability  First steps in this process of development is design for interoperabilityInteroperability Requirements SocioTechnical • Political • Organisational • Legal • Economic• Architecture • Processes • Structures • Semantics  Interdependent Relationships  Kay S, 2012  PHIT & Interoperability Green = Significant work completed Orange = Started  Black =Awaiting Decisions Data Dictionary Will not be done until Ireland has acquired a license from IHTSDO Contact Details anne.mcdonald@hse.iepamela.hussey@dcu.ie

Irish Universities

http://doras.dcu.ie/20039/1/Acendio_2013__Final_PHusseyAMcDonaldimages_%5BCompatibility_Mode%5D.pdf

Population Health Information Tool - PHIT

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