interoperability solution medical directorate conference...
TRANSCRIPT
Berkshire Connected Care Interoperability Solution
Medical Directorate Conference
Wednesday 7 June 2017
Nigel Foster Director of Finance & Performance
Berkshire East CCGs
Aligning a lot of organisations…
Aligning a lot of systems…
• 70 staff from across all organisations involved in the procurement supplier days
• Strong clinical engagement developed through patient stories which formed a key part of the procurement
• Funding through BCF and whole system programme boards have ensured all organisations “own” Connected Care and contribute to the success
Doing it together
2016 - Building the foundations
Patient facing Health and Social care facing
Patient Portal
Conn
ecte
d Ca
re
2016 2017 2018 2019 2020 2020 2019 2018 2017
Decision Support
Whole System
Intelligence Genomics
Integrated dynamic
care plans
Paper Free Patient Triage
Patient Portal
Apps
Wearables Support
Integrated Hubs
BI tools to support early identification
Technology to support behaviour
change
It’s live… Connected Care (Graphnet) Records Accessed From 27 February 2017 to 21 May 2017 (12weeks)
Number of Records Accessed - By Organisation Number of Users - By Organisation
Number of Different UsersNumber of Records Accessed
282258 267
298269
304
257241
287 279
319 328
0
50
100
150
200
250
300
350
745806
849 874 850
953890
846911 933 937
1133
0
200
400
600
800
1000
1200
9 6 5 11 23
554623 589
706802
38 6 5 14 14
275 274331
205292
2 1 20
100
200
300
400
500
600
700
800
900
Week 8 Week 9 Week10 Week11 Week12
BFCouncil BHFT Central Cluster RBFT WestCall WBCouncil
5 3 2 4 7
202
245 239
282 282
12 2 3 4 432 35 34 28 34
2 1 10
50
100
150
200
250
300
Week 8 Week 9 Week10 Week11 Week12
BFCouncil BHFT Central Cluster RBFT WestCall WBCouncil
“I feel very passionate about this excellent resource so excuse the rant!!” “ We are coming to understand that this excess mortality is not the result of suicides it is the result of neglecting physical health risk factors. I’m leading on this improvement of physical health monitoring for those with SMI. As part of this work we have been urging people to attend GP for PHC especially cholesterol and glucose monitoring – connected care means we can easily check if our request has been actioned, we can then use this information for the important cardio metabolic monitoring. We can also see if patients have had their annual health check and we can use this info to target interventions if required or we can put our efforts into encouraging the patient to go along to the surgery for this if not. “ “Previously we would have had to call up the GP to get this information and to be honest people were not doing this –connected care has made it much more accessible.” “I have recently investigated the unexpected deaths of 5 patients from physical causes. Findings have highlighted we request various physical health tests but we don’t always check if they have been actioned-connected care will enable us to do this easily.” “Last week I had a patient tell me that his GP had not prescribed his medications or the personal training sessions we had agreed I was able to go in to the system whilst the patient was with me and check-I was able to see that this had been done that morning so they could be collected on the patients way home. In the past I would have been trying to get hold of the GP, the patient wouldn’t be able to get reassurance as more often than not you can’t get through so you wait until patient has gone to chase. He was really pleased to hear an answer there and then.” “The system itself is really easy to use no additional passwords etc –very clear where things are from the front screen, nicely laid out and easy to read.” “In the future I can see this being so useful for sharing risk information, discharge information and just making communication so much easier. I think this is a really important step forward for us and it will improve our ability to provide physical and mental health care and improve patient experience.”
And making a difference
Rollout
• There is a staggered rollout split over three tranches
• By the end of Tranche 3, all participating organisations will be viewing data and all apart from OOH & SCAS will be providing data
Tranche 1
Tranche 2
Tranche 3
Jun Jul Aug Sept Oct Nov Dec Apr May
Q1 2017 Q2 2017 Q3 2017
Feb Mar
Q1 2017
Jan
• 95% GP Data • X2 Social Care
Feeds (WBC and BFC) • BHFT
Comm & MH Feed
• Social Care Data Enhancement
• X1 new Feed (RBWM)
• RBFT ADTs • 2 Yr Backload
• 100% GP Data
• RBFT Documents and embedded access
• RBH Lab Results
• FHFT ADTs • 2.5 Yr Backload
• BHFT Documents
• Remaining x3 Social Care Feeds
• Children's Social Care Feed (WBC and BFC)
Tranche 1, 2 and 3 indicative time-scales
• Patient Tracking Pilot
Stepwise Delivery of Increased Data and Functionality
Patient information available at point of care (June)
Care
Cent
ric
GP Practices 94 0f 99
Administration
Alcohol Exercise Diet
Allergies
Glucose / HbA1C
Blood Chemistry
Cervical Cytology
Blood Pressure
Child Health Data
Chronic Disease Data
Contraception & HRT
ECG Pulmonary
Family History
Heamatology
Height & Weight
Other Diagnostics
Medication Issues
Other Therapeutics
Pregnancies etc.
Smoking
Urinalysis
Immunisations
Active Problems
Encounters
Operations
Obstetric Procedures
Cytology
Other Pathology
Problems List
Social History
Physiology Function Tests
Investigation Admin
OTC Prophylactics
Referrals
Medication Admin
Admissions
Past Problems
Diabetes Diagnosis
Contraindications
Recent Tests
Active Problems
Encounters
Microbiology
Repeat Medications
Administration
Alcohol Exercise Diet
Allergies
Glucose / HbA1C
Blood Chemistry
Cervical Cytology
Blood Pressure
Child Health Data
Chronic Disease Data
Contraception & HRT
ECG Pulmonary
Family History
Heamatology
Height & Weight
Other Diagnostics
Medication Issues
Other Therapeutics
In SCR
Not in SCR
Demographics
Case Workers
Disability Type
Care Plans
Needs/ Outcomes
Risks Demographics
Admissions
Referrals
Appointments
A&E Attendances
Demographics
Discharges
Transfers
Inpatient activity
Outpatient activity
Waiting Lists
Admissions
Discharges
Transfers
Inpatient activity
Outpatient activity
Referrals
Allergies
Risks / Warnings
Diagnosis
Care Plans
Appointments
Referrals
Associated Carer
Disability Type
Lessons learned / challenges
It isn’t a digital project
• Embedded context launching has been imperative to high usage (Ease of use)
• Simple, clean, interfaces within core systems • Enhancements and developments are being worked
through by a whole system clinical group
User experience
Maximising the value of a shared digital ecosystem
Connected Care has been built using “LEGO”
Technology made of “MEGA BLOKS” will not link up and could cause issues with engagement or increased costs.
• IG framework that all organisations are bought into
• LMC chair the IG group • Every practice signed up within a few weeks • Start with provision of care and clearly defined
data sharing to build confidence
Getting the IG right
Exciting stuff coming soon!
Epilepsy use case
The information collected will be
analysed and reported on to
monitor the success of the
project
As part of the project NHS Staff will also be asked to pilot some
additional applications - an “all about me”
application, for example.
A wearable device that captures activity data and stores this data in the cloud
(Azure) A mobile application that helps
visualise activity and provides insights on progress (using cloud based
machine learning)
Staff pilot
400 NHS staff in Berkshire will
pilot an activity improvement programme
A patient portal (web and mobile?) that allows access to the Berkshire Record (GP data, results, hospital information,
etc.).
…and provides information, resources and signposting to services
1
2
3
4
5 6
7
They will use:
Alerting
Big data, machine leaning and all that…
The public face of Connected Care
https://www.shareyourcareberkshire.org
Any Questions?