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Dr Jason I BrochCCIO Leeds Health & CareSRO for Digital, WY&H STP

Together

we’re better

Leeds – A journey to place-based digital maturity

Together

we’re better

To be discussed

ContextImportance of Place

Business requirements / capabilitiesLeadership

What have we achieved?

Together

we’re better NHS 70 Years Young in 2018Paradoxes1. Growing numbers of people are living longer, healthier lives – but advances in medicine and technology, combined with an ageing population, mean we are using the NHS more2. The quality of care is improving – but greater transparency means that gaps and mistakes are placed in sharper focus3. Staff numbers are increasing – but staff are under greater pressure

And….Public satisfaction with the NHS remains high and people are on our side but are they ready for difficult decisions?

We need a clear plan to deliver the priorities that matter to patients and the public – is the Five Year Forward View enough?

Together

we’re better

The Current H&SC System• Silos of care / funding• Increasing Demand

• Demographic• Capability

• Misaligned incentives for providers• Paternal• Is it Sustainable?• Is Technology The Magic Bullet?

Together

we’re better

Principles of Technology Implementation

PeopleProcesses

Technology

Together

we’re better

Principles of Technology Implementation

PeopleProcesses

TechnologyPlace

Together

we’re better

Leeds• 3 CCG’s – becoming one• >100 GP practices in 3 ‘federations’• 13 neighbourhood teams – 3rd sector• 1 Acute trust – tertiary centre• 1 MH trust• 1 Community trust• 1 Coterminous Local Authority

Together

we’re better

STP footprint

• West Yorkshire & Harrogate• Leeds represents over 1/3rd

• Joint Committee of 11 CCGs• 6 Local plans & LDR coming together

Together

we’re better PHM - The New Paradigm?

• design health and care provision around the needs of patients as opposed to disease components with greater emphasis on prevention and self care;

• connect better with patients and citizens who are proactive in the design, management and delivery of their own care

• take proactive steps to meet the funding gap in health and social care by removing the duplication and investing in prevention

• fully utilising informatics solutions to direct care interventions to where they are most needed, and better support professionals in joint working.

New Commercial arrangements

Definition - “PHM means the proactive application of strategies and interventions to defined groups of individuals across the continuum of care in an effort to improve the health of the individuals within the group at the lowest necessary cost”

Strategic Context Population Health

Management

STRATEGIC COMMISSIONING FOR OUTCOMES

ACCOUNTABLE CARE SYSTEM

Together

we’re better

Together

we’re better

A model for change – Leeds Transformation

Together

we’re better

Digital Capabilities

DIGITAL TOOLS

INTEGRATE INFORMATION

BUSINESS ANALYTICS

PEOPLECLINICIANS

SYSTEM

• Integrate Information• Interoperability• Standards• Platform• IDCR, ?workflow

• Digital tools• Decision support• Patient devices• Near-patient testing• PHR

• Business Analytics• Population segmentation• Outcomes measurement• Change management• Risk management

Information for Professionals

Information for Citizens ‘Open Data’

Integration

Governance

Professional, Citizen and Partner Engagement

Our simple Informatics strategy for the city (‘place’)

Technology as a ‘utility’

Integration

Support Tools

Business Intelligence

…and in slightly more detail

One Information Governance Framework

Apps & devices to

support people live

their lives – health

and social care

View intelligence reports/

dashbords

Citizen Owned Data (PHR)Leeds Primary Care

Records

Non person sensitive

datasets prepared for open

publication

Open Data (Data Mill

North)

Common infrastructure for health and social care

City Office of Data

Analytics & Reporting

Information &

Advice

(Leeds Directory/

NHS.uk)

Professionals

Portals (Leeds

Care Record, CIS

etc)

Open data

analysis and

application

Digital literacy and leadership

Social care apps

CIS(eCM), eCB

ELMS

Consumer Applications and Tools

Co-designed with Service Users/Carers and Pratitioners

Care Act Apps

E.g. Personal Care

Account

Telex Assisted Living Leeds

Telecare/ Assisted

Living Devices

Software and Tools

Information Portals:

Leeds Directory,

Mental Health etc..

Digital tools: Video

(Skype), Social, Mobile

Open standards platform & messaging to allow data to flow across the whole system

Applications

Whole

system

Access

Infrastructure

NHS number to connect dataPublic and Private wifi

Citizen Portal

(My

information)

Data

Professionals‘Open Data’Citizens

The challenges: • Using the right language• Making it relevant to

individual organisations• Keeping it independent from

future organisational change

Integrated systems for Professionals

Integration

Support Tools

Business Intelligence

Integration

The progress: • Near real-time information from Acute, Community, Primary, ASC, Mental Health

• 4000+ active users

• Other users include hospices, 111, children's services

• Virtual ward view

• Stopped around 1m paper letters per year

The challenges: • Moving from a passive to a proactive system

• Alerts/notifications/work-flow

• Ownership

• Re-current funding

• In-house or commercial / LHCRE

IntegratedProfessionals

Integration

Support Tools

BUSINESS INTELLIGENCE

Integration

The progress: • Linked data model across Primary, Community, Mental Health, Acute, 111, ASC

• Worked with NHS Digital to ensure appropriate data linkage approvals

• Enabled whole system analysis including population segmentation, urgent and emergency care

The challenges: • Making analysis operationally useful; re-identification and de-identification

• e.g. commissioned schemes such enhanced care homes

• De-identified cohorts to re-identified for direct care action

• Strategies to work more closely with academia

• Nervousness around big data etc.• IG

Innovating to support citizens

Integration

Integration

Professional, Citizen and Partner

Engagement

Governance

Citizens

Technology as a ‘utility’

The progress: • No shortage of innovations and innovators

• Excellent TeleCare services• Falls• Flood

• Health Innovation Gateway established with Universities (Leeds Academic Health Partnerships)

• Examples: • International initiative with

Samsung – ActiveAge• Pain Management app as part of

chronic pain services

The challenges: • Real ownership and change management i.e. ‘push’ versus ‘pull’ of technology

• Inward investment perspective versus real-world capacity to test

• Selecting patients

• Matching innovations to our priorities

• Making benefits tangible enough to justify investment

Together

we’re better

(Digital)health and care

Practitioner

Carer/family Citizen

Self management and digital…

Person held

record

Leeds Care

Record

Health monitoring

Alerts/prompts Information Environment Appointments

accessfeed

CITIZEN DRIVEN HEALTH

Together

we’re better

Any Questions?