© Copyright Quicksilva 2009

The IT Challenges of Healthcare Personalisation

Gayna Hart, Quicksilva

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IT Challenges

Speaking of IT in Health…

• Quicksilva incorporated

• National Programme for IT initiated by the DoH

• Consultancy to NHS CFH NPfIT

• NHS HL7 Toolkit created, NHS Naked Prescriber delivered, NHS Choose & Book Unplugged developed

• Spinal Tap® launched

• Spine-in-a-Box® launched

• Compliance-in-a-Box® service launched

• National Institute for Health ResearchSharePoint site

• Managed Support service launched

• Gloucestershire Hospitals diabetic retinopathy screening programme SharePoint site

OCT

1999

DEC

2002

JUN

2005

NOV

2006

NOV

2007

OCT

2008

AUG

2008

SEP

2008

MAY

2004

JAN

2003

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Possible IT Challenges

• moving and storing data

» between sites

» on the move

• alerts and triggers

• sharing knowledge

• informatics, predictive

modelling

• procuring IT, contracting

for IT, buying IT

IT Challenges

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Possible IT Challenges

• moving and storing data

» between sites

» on the move

• alerts and triggers

• sharing knowledge

• informatics, predictive modelling

• procuring IT, contracting for IT,

buying IT

IT Challenges

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Challenges? – it’s all about…

• Capacity

• Security

• Information

• Knowledge

• Ownership

• DATA – the challenge to IT is to deliver it

IT Challenges

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What data are we talking about here?

• We call it “patient data”

» but is it the patient’s?

» or is it the NHS’s?

• Who uses it?

» frontline staff

» secondary uses

• Where is it stored?

» across the NHS domain

» private sector

IT Challenges

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The Spine Debate

• National Care Records debate

» single centralised source

» agreement sought since 2003

» consultation…or lack of it

» privacy issues

» cost over-runs

» still raging…

• 10 Aug 2009 – Tory plans

» “dismantle central architecture”

» contract buy-out

» alternatives…Google Health?

IT Challenges

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NHS Spine

• National Care Record System

» Summary Care Record

• Spine Services

» Personal Demographics

» Choose and Book

» Electronic Prescriptions

» Laboratory

» Common Assessment

So…do we kill off the Spine?

IT Challenges

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Data – Capacity

• Can the Spine cope?

» traffic capacity

» Service Level

Agreements

• Local networks

» Images – been around

for a while

• Beyond?

» Europe

» cross-sector

IT Challenges

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Data - Security

• Legitimate Relationship

» is this my patient?

• Role Based Access Control

» what you have and what you know

» Smartcard plus PIN

• Sealed Envelope

» whole or partial file

» emergency access

» implications of breaking seal

IT Challenges

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Data – Information

• Needed at the point of delivery

» GP

» A&E

» Out-of-Hours

» Mobile

• Information Technology is there

to deliver…

» …information

» at what price?

» evolution/reuse

IT Challenges

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Data - Knowledge

• Data sharing across domains

» Health

» Social Care

» Justice

• Predictive modelling

» e Prescribing

» drug development

» epidemiology

» patients at risk

» “cross-selling”

IT Challenges

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What data are we talking about here…again?

• We call it “patient data”

» but is it the patient’s?

» or is it the NHS’s?

• Who uses it?

» frontline staff

» secondary uses

• Where is it stored?

» across the NHS domain

» private sector

IT Challenges

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Data - Ownership

• Who owns the data?

» Patient?

» NHS?

» Pharmacists?

» Suppliers?

» Service providers?

» Collection agencies?

IT Challenges

data pseudonymised for secondary uses

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Joined-Up…thinking?

• Sharing information to build

knowledge

» within the NHS

» cross-sector

» from private sector

» with private sector

• Can we be open enough while

still protecting the individual?

• …and can we afford it?

IT Challenges