map of medicine: ehi live 2013

Map of Medicine

Cross care setting best practice care

pathways and referral management

http://www.ehilive.co.uk/page.cfm/action=seminar/libID=1/libEntryID=143/listID=17

http://www.ehilive.co.uk/page.cfm/action=seminar/libID=1/libEntryID=143/listID=17

© 2013 Map of Medicine Ltd Commercial and in confidence 2

Overview

About Map of Medicine

Demonstration

Benefits

Localisation

Successful programme implementation


• Leading international provider of interdisciplinary, integrated care pathways and clinical decision support

• Team consists of Clinicians, Health managers, Researchers, Pharmacists

• Integrated with the major UK GP systems, including EMIS, TPP and INPS

• Subsidiary of Hearst Corporation – Healthcare Group

Introduction to Map of Medicine

http://www.rcophth.ac.uk/

http://www.rcpath.org/index.asp?PageID=1


A partner in transforming care

National 260 accredited pathways

Local 1,800+ customised pathways

Decision support Instant access within clinicians’ workflow at the point of care

Map of Medicine supports the optimisation of

patient care by providing easy access to

comprehensive, evidence-based local

guidance and clinical decision support at the

point of care

260 evidence-based, best-practice pathways

125 referral guides


Map Sidebar: One-click access

EMIS Web


What is the Map of Medicine Solution?


Map Referrals

GP system integration: embedded within clinical workflow via Sidebar

Locally relevant information: search for and identify the most appropriate

local care pathway, referrals guidance, provider and patient information

Standardised referral forms: updated centrally across a CCG

One click access, referral forms are opened and auto-populated with the

patients’ demographic and clinical information

Live commissioning data: CCGs can easily track the volume and cost of GP

referrals to local services, analyse usage, report on referrals by condition

Save administration time - 20 days a month across a 40 practice CCG

Empower GPs to consider cost of referrals at the point of care

Benefits Realisation


Reducing unwarranted variation in care

Locally-customised evidence based pathways ensure that all clinicians have easy access

to the same information about best practice care and local service availability.

In Devon, only one third of people with dementia receive a formal diagnosis. To improve

this figure, a single, clearly defined local dementia pathway was designed to meet the

needs of healthcare professionals, patients and their carers

The pathway aimed to support GPs and their staff in improving dementia care, and

improving the speed of dementia diagnosis.

Following implementation, the following benefits have been realised:

Professional relationships have been greatly improved between GP & specialist mental

health providers, resulting in an overhaul of community mental health services

Dementia prevalence rates have increased since implementation of the initial pathway

(diagnosis rate 2011 32.6%, 2012 35.7%)

Waiting times for memory assessment have dropped


Reducing inappropriate referrals

Map pathways include best practice referral information. These can be adapted to reflect

local policy and service options, supporting consistent referral decisions, reducing

inappropriate referrals and improving the quality of care for patients.

In Merseyside, the CCG has used the Map to manage inappropriate referrals between

primary and secondary care, achieving savings of over £0.5million in 2011-12. Specific

examples of pathways include:

Management of minor dermatological conditions, where referrals into secondary care

were reduced by 36% from 2010-2012, releasing almost £200,000 for re-investment.

Implementing a local dyspepsia pathway promoting use of H.Pylori testing in primary

care, reducing need for unnecessary gastroscopy, and leading to a saving of £70,000 in

avoided referrals in 2012.

In Southampton, creation of over 100 local pathways has enabled significant financial

savings as a result of a reduction in GP referrals.

Across trauma and orthopaedics, gynaecology, haemotology, paediatric orthopaedics

and endocrinology, there was a net decrease of 15% in the volume of GP referrals in

2011-2012 compared to the same period in 2010-2011.

The quality of referrals improved by more than 50%, with the number of referrals

rejected from secondary care falling to 112 for orthopaedics and to 56 in gynaecology


Delivering care in the right setting

Map pathways support redesign of services to deliver care in the right setting, moving

services out of acute hospitals into the local community, thereby improving patient

experience and reducing costs.

Shifting services into the community: In Newham redesign of the Anticoagulation

pathway has resulted in a Point of Care Testing service for stable patients in primary,

rather than secondary, care. With 25 clinics available, 33% of patients are now being

managed at this level, improving access for patients and saving Newham LHC

approximately £300,000.

In Western Cheshire, a local Cellulitis pathway was created to communicate the

introduction of a new service to enable otherwise healthy adults to be treated with

intravenous antibiotics in the community. This resulted in a reduction in the number of

hospital admissions and a saving of £2,000 per patient.

Right care, right time: in the Wirral, patients were waiting up to three months to be

treated for Aged related Macular Degeneration. A local pathway helping to align

primary care clinicians, optometrists and ophthalmologists resulted in a reduction in

waiting and treatment times to within two weeks of referral, and delivered an

associated 25% cost reduction and an overall saving estimated at £200,000 per

annum.


Achieving Benefits

Experience in the UK

and New Zealand

with health

economies averaging

250,000 patients

have revealed

considerable health

community benefits

for regions

effectively

standardising care

across at least 6

clinical pathways.

Local implementation of the Map of Medicine takes, on average, about 6 months to demonstrate savings.


2012 Benefits Analysis

In 2012, 8 mature

PCT in the UK,

using Map of

Medicine achieved

combined savings

of £19million* for

an average

population size of

250,000 patients.

Between them, the

cost saving

benefits across 32

pathways were

analysed.

*2011-2012 SUS. PCTs included Devon, Plymouth, Torbay, Southampton, Gloucestershire, Eastern & Costal Kent, Milton Keynes, and Medway

64%

21%

11% 4%

Breakdown of cost savings across PCTs using the Map in 2012

Optimising admissions forelective care/procedures (£12m)

Minimising outpatient referrals(£4m)

Decreasing IP length of stay(£2.1m)

Local pathway developmentsavings (£0.8m)

For a 250,000 CCG, potential savings include £1.2m; £400k; 200k, £80k respectively

Localisation


Localisation

care maps can be customised to reflect local

needs, practices and services

local communities have their own view

the view hosts all locally produced care maps and

defaults to the regional or international version


Local view


Customising

Three ways to customise:

—1. Add administrative information in the local info tab

contact details

clinic information

opening times

—2. Edit a map and referral guide

reflect locally agreed clinical protocols

incorporate local service arrangements

—3. Create a new map


Customising - local info tab

Worcester - Osteoporosis


Customising – editing a care map

Wirral - Osteoporosis


Customising - locally created

Worcester - Persistent pain management


Key messages

Southampton – Prostate cancer


Local formulary

Southampton – Female urinary incontinence


Images

Exeter– Basal cell carcinoma


Patient information

North Mersey – Clinical genetics – Female without cancer – Maternal family history


Useful forms

Worcester – Dementia


Links to youtube clips

Southampton – Vertigo


Considerations for a successful

implementation of the Map referral

and pathway solution

Gajan Srikanthan

Map of Medicine

Head of Clinical Strategy

[email protected]

map of medicine: ehi live 2013

Health & Medicine

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