dr jonathan richardson chair clinical health informatics forum, consultant in old age psychiatry and...
TRANSCRIPT
Dr Jonathan RichardsonChair Clinical Health Informatics Forum, Consultant
in old age psychiatry and Clinical Director of Informatics,
Northumberland, Tyne and Wear NHS Foundation Trust
Introduction
• Programme• Background• Electronic patient record (RiO) in NTW• Clinical Dashboards in NTW• Lessons Learned
Programme• 9.00am Registration and Refreshments• 9.30am Welcome & Introductions
– Dr Jonathan Richardson, chair clinical health informatics forum, consultant in old age psychiatry and clinical director of informatics, Northumberland, Tyne and Wear NHS Foundation Trust
• 9.45am The Campaign– Jon Hoeksma, editor eHealth Insider
• 10.00am What clinical leadership can bring to informatics in the NHS– Bill McAvoy, Deputy Transition Director, Patients and Intelligence,NHS Commissioning Board
Authority• 10.30am The business benefits of clinical leadership in informatics
– Dr Daniel Birchall, consultant neuroradiologist and chair of the Information Systems Strategy Board, the Newcastle Upon TyneHospitals NHS Foundation Trust
• 11.00am Breakout session with refreshments– Facilitated discussion groups
• 12.00pm Breakout group session feedback• 12.45pm Concluding remarks
– Dr Jonathan Richardson, consultant in old age psychiatry,acting chair clinical health informatics forum, Northumberland, Tyne and Wear NHS Foundation Trust
– Jon Hoeksma, editor eHealth Insider • 1.00pm Lunch
Information strategy to give people more control over their care
• More efficient, with more time
• Sharing information safely to improve care
• Recording real time, accurate data and sharing it with people
• Ensuring patients are fully involved in decision making
• The information system
The purposes of the clinical record• To record risk assessments to protect the patient and others• To record the advice given to general practitioners, other clinicians and other agencies• To record the information received from• others, including carers To store a record to which the patient may have access• To inform medico-legal investigations• To inform clinical audit, governance and accreditation• To inform bodies handling complaints and• inquiries• To inform research• To inform analyses of clinical activity• To allow contributions to national data-sets, morbidity registers
• To act as a working document for day-today recording of patient care• To store a chronological account of the patient’s life, illnesses, its context and who did what
and to what effect• To enable the clinician to communicate with him- or herself• To aid communication between team members• To allow continuity of approach in a continuing illness• To record any special factors that appear to affect the patient or the patient’s response to
treatment• To record any factors that might render the patient more vulnerable to an adverse reaction to
management or treatment
Improving standards in clinical record-keeping,Ian Pullen & John Loudon,Advances in Psychiatric Treatment (2006), vol. 12, 280–286
• 15% of outpatient appointments were affected by missing clinical information
• In 20% of these cases patients were exposed to risk (as judged by the doctors involved).
Brief history of RiO in Newcastle
1997 – Trust completed clinical information system procurement – began implementation of InteHealth
2002 – Migrated from InteHealth to RiO 2003 – Started clinical rollout in Community Mental Health and Early
Intervention In Psychosis teams2006 – NTW Trust formed through merger -
• One of the largest MH Trusts in the country• Direct contract with supplier
2010 – Trust achieved Foundation Trust status2011 – Currently
• 3500 users covering a population of 1.2 million• At peak approx. 900 concurrent users• Complete coverage by March 2012 including a diverse range of
services.
Enhancing RiO Access Data Collection
• Variety of data collection methods used
• Recurring themes raised in all areas
• Directorate• Medical• Trust
– All users email– Over 700 responses
Team / Ward Data
Medical Staff Data
Trust Survey
Recurring
Themes
Clinical Forms• Lean workshop over 80 clinicians and patient user groups• Went live with core documentation for 3500 users in October 2011• Care Programme Approach Association National Award • Currently in the process of a further review Data Entry/Mobile Access• Vodafone mobile access solution available• 300 deployed• To deploy 1000• Great feedback• Improved usability
Clinical Standards• Developed NTW Clinical Standards for Electronic Record KeepingScanning and Document Capture• Upgrade of the scanned document section has gone live Clinical Coding• Work stream planned during 2012Northumberland/Partnership Working• Access Newcastle Social Services summary of risk, directly from RiOSpeed of RiO• Upgrade to v6 included full hardware upgrade
Progress on issues
Good quality information is a driver of performance for clinical teams and helps ensure the best possible care for patients.
• providing timely, relevant information for clinical teams, presented in easy to understand formats, with high visual impact
• utilising multiple sources of existing data, even across organisational boundaries
• providing clinical information across multidisciplinary teams• displaying information in ‘real time’ without delay for data cleansing• allowing local configuration and comparison against national data sets• permitting regular changes to displays, as required by the local teams, to
keep the information relevant and up to date
Clinical Dashboards help to drive this process by:
Clinical Dashboards
Lessons learned from Clinical Dashboards
Quality Standards
Care Pathways
EPRRiO
Quality Standards
Care Pathways
EPRRiO
Data Warehouse
Quality Standards
Care Pathways
ESR
Safe guarding
Acute Trust
EPRRiO
Data Warehouse
Quality Standards
Care Pathways
ESR
Safe guarding
Acute Trust
EPRRiO
Clinical Dashboard
Spreadsheets
Data Warehouse
Standardised Quality outputs
Q and P DashboardData
Quality
Data Quality
Quality Standards
RiO Champions
Care Pathways
ESR
Safe guarding
Acute Trust
EPRRiO
Clinical Dashboard
Spreadsheets
Data Warehouse
Standardised Quality outputs
Q and P Dashboard
NTW Caldicott and Health Informatics Groups
Urgent and Planned Care Caldicott and Health Informatics Groups
Data Quality
Data Quality
External Communication
Clinical System Content Build Maintenance
Clinical requirements
Business requirements
= Design/Build/Test/Train = major change= minor change
Core Documentation
(inc national core headings)
Contract\
CQUIN e
.g
communica
tion w
ith G
P
Workstream
A
Workstream
B
Workstream
C
Wor
kstre
am D
Audit e
nhan
ceen
ts
<<------------------------------------------------- RiO --------------------------------------- >>
Clinical System Content Build Maintenance
Clinical requirements
Business requirements
= Design/Build/Test/Train = major change= minor change
Core Documentation
(inc national core headings)
Contract\
CQUIN e
.g
communica
tion w
ith G
P
Workstream
A
Wor
kstre
am D
Audit e
nhan
ceen
ts
Unplanned Work
Unplan
ned
Wor
lk
<<------------------------------------------------- RiO --------------------------------------- >>
Benefits of a Clinical Director of Informatics
• Engagement• Clinical validation of systems • Education and training• Links with professional bodies• Networks• Promoting innovative practice