interoperability, pop up uni, 10am, 3 september 2015
TRANSCRIPT
Interoperability Indi Singh, Head of Enterprise Architecture, NHS England, [email protected]
Barbara Rushton [email protected]
Nigel Watson [email protected]
Tim Cotton [email protected]
Joseph Stepney [email protected]
Peter Cambouropoulos [email protected]
Mark Pugh [email protected]
Taking Forward Personalised Health and
Care 2020: Interoperability Strategy Indi Singh
Head of Enterprise Architecture, NHS England
As a Clinician, Paper-Free Health and Care
will Mean I Can:
The Ambition Will be About Improving High
Priority Care Pathways
Delivering Integrated Digital Care
How do I get there? Interoperability Strategy
Where am I going? Where am I now?
Interoperability Strategy the development of an open environment for information sharing supporting emerging models of care based on open interfaces and open standards.
Transfers of Care
NHS Number
Key Priorities
Procurement Guide
Interoperability Handbook
Tools
Interoperability – The Offers
Introduction to Hampshire Vanguards • Better Local Care – South Hampshire (MCP)
• North East Hants and Farnham (PACS)
Introduction to Hampshire Vanguards East Hampshire
10 practices / 70k patients
Semi-rural “new town”
Gosport 11 practices / 80k patients
Urban deprived
New Forest
7 practices / 70k patients Rural – older demographic
Doctors St
uff
th
ey’
re g
oo
d a
t Stuff th
ey
’re n
ot go
od
at
Remembering 206 bones in the
human body
Remembering 206 User names and passwords
Patience with patients
Patience with technology
Where we are now Hampshire Health Record (HHR)
• Started in 2004, now covers around 1.9 million patient records
• Holds 20 million documents including discharge letters and pathology tests
• Approximately 85% of GP practices upload daily extracts in HHR
• It has seen increasing usage and derived improved clinical and business outcomes
• Usability, ease of access, IG issues and changing requirements mean the system
is underutilised
Prime Minister’s Challenge Fund:
• Using TPP and EMIS in primary care to interoperate
Care.data in West Hampshire
HHR Diagram
Medicines
Note: Ambulance services and OOH also able to see record
Preliminary Conclusions - HHR use in AE &
Inpatients setting Use of HHR is associated with:
• Increasing complexity of patient presentation
• Statistically significant reduction in decision to admit patients to hospital – 9% reduction
• Statistically significant reduction in the number of pathology and radiology tests – Reduced X-ray exposure
• Statistically significant reduction in average length of stay in hospital – 1.7 days average
nb evidence of association may not be evidence of cause
What are the future needs • Support the evolving needs of the extended primary care team
– Flexibility to support changing models of care
• Extended teams working on a single version of the truth
– Seamless two way integration
• Greater engagement with the patient and their extended support network
– Self service, proactive care
• A usable solution supporting the future Digital transformation
– A platform/backbone for developing applications and integration
Expanding and Improving Interoperability • Build on the HHR repository as a foundation
• New Care and Health Interoperability Programme (CHIP)
– Focussed on the requirements from stakeholders across the wider care system
– Supporting key future information sharing and Digital needs
Lessons learnt so far • Centralise governance as soon as possible
• The right level of stakeholder engagement
• Start with the future requirements rather than the current issues and focus
on transformation
• Review all existing solutions or plans in place
• Consider the implications/impact for providers
• Engage with suppliers early and build confidence in the market
Getting IT right in Rushcliffe
Dr Stephen Shortt
Stephen Murdock
Andy Evans
TPP District Nursing Community Unit
NEMS OOH
GP practices x 3
Primary Care Connectivity for Prime Minister’s Challenge Fund
GP Practices x 9
Medical Interoperability Gateway (MIG)
Read &
Write
Primary Care Connectivity
TPP District Nursing Community Unit
Rushcliffe CCG TPP Organisation Group
Group wide recalls using SMS where possible
Group wide reporting and feedback
Central appointment booking and management
Federation of back office functions e.g. secretarial, scanning
Standardised and centralised templates, forms, letters etc..
Primary Care Data Sharing
EDSM
MIG
PATI
ENT
CO
NSE
NT Hospitals
Out of hours services
Ambulance Services
96% of eligible Rushcliffe GP records
are now shared
Information Distribution and Management
Information, news, documents, pathways etc. held and maintained centrally
Nurse GP Managers & Staff
All information targeted to subscribed groups Accessible direct from SystmOne
Patient Online Access
Personalised access to online services, information & health data
Standard and simplified interface across platforms and organisations
Pharmacy
Access to Care Records Access to SystmOne records for care home nursing staff Record viewing Medication requesting Tasks to clinical staff Care plans Care Homes
Access to SystmOne medication screens only Medication requesting Tasks to clinical staff
Rushcliffe Care Professionals e.g. Community Geriatrician
Access to SystmOne records across CCG via shared admin Ability to report on cohorts of patients Write into records and task clinicians for actions
