tim straughan: the nhs information revolution
DESCRIPTION
Tim Straughan discusses Health informatics - driving integration and efficiencies across primary, secondary and community care at The King's Fund's NHS Information Revolution conference.TRANSCRIPT
The NHS Information Revolution Conference
Health informatics – Driving integration and efficiencies across primary, secondary and community care
Tim Straughan
Chief Executive, NHS Information Centre for Health and
Social Care
Changing world….
Context
• Economic pressures (QIPP v cuts) • Health & Social Care Bill • Structural change • Future Forum • Open data/transparency • Patient- and citizen-centred approach – not
organisational-centred • Information Strategy
“Standards are the fundamental building block for the accurate
description and representation of health and social care activities. We rely upon them to underpin day-to-day activities both locally
and nationally”
“We do not sufficiently exploit the data we already collect. Our
ability to access useful information in the current
landscape is hampered by a number of factors; awareness, protocols, tools, complexity”
“Our system is increasingly reliant upon Quality information to
support operational and business processes; poor quality
undermines our ability to support those processes effectively, but we do not have a coordinated
approach to improvement”
“Our ability to understand and control The System is dependent to a large degree on
using, analysing and interpreting data gathered from the system. Unfortunately we have large gaps in coverage which
limits our ability to do this”
Key issues for the Information Strategy
• Open data/transparency • Data linkage • Concept of integrated care record • Standards across care settings and sectors • Roles
– national organisations – local organisations – Intermediaries/market place
Four dimensions of transparency
SOU
RC
E: D
avid
Cam
eron
, TED
, 18
Feb
2010
Text Text
ACCESS TO MY DATA ACCESS TO DATA ON OUTCOMES
ACCESS TO MY COMMUNITY
ACCESS TO OTHER PEOPLE
‘An Information Revolution will remake society to give real transparency, choice and accountability’ David Cameron
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4
2
3
The patient
• We must design the system around the patient not the other way around.
• We must design the system so the patient is an active not passive recipient of care.
• Patients should have visibility of: – their own care plans and journeys – cost of their care – outcome of their care.
Overcoming barriers
• Avoid one-size-fits-all approach • Levers and incentives • Collaboration and co-production • Creative use of information from a number
of sources • Intelligence, analysis and expertise • Returns on investment over years not
months • Information governance
So where are we with information in….
• Secondary care – eg, UHB (local, national, international)
• Primary care – eg, Tower Hamlets – 36 EMIS practices (primary, community, secondary)
• Community care – eg, North East London NHS Foundation Trust – MIDAS – System 1 (activity, finance, HR)
• Social care – eg, Torbay (secondary, community, social)
East London & City Alliance
Sean Key, Programme & Business Manager Health Intelligence Unit East London & the City Alliance
EMIS Web in South Cumbria
Allows bi-directional sharing of clinical record across the local health community • All 21 practices now using EMIS • All community nursing teams • Specialist community teams (including short-term intervention service, single point of access for unscheduled admissions and liaison nurses) • Community wards • Read-only access to GP summaries by GP Out of Hours, and in primary care assessment service • Access now in secondary care settings
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Urgent Care Pathway (before April 2008)
GP Referral
999 Ambulance
DGH
DGH
DGH
Care Homes
Four options
Walk In
Urgent Care Pathway 2010
GP/other clinician referral DGH
999 Ambulance
Short Term Intervention Service
(nursing/therapy/SW)
Community IV antibiotic service
Community respiratory team
Short term urgent Home Care
Community Urgent Care
Hub
Step-up Step-down
beds
Single point of access
Care Homes
DGH
DGH
Liaison Nurse
Liaison Nurse
Primary Care Assessment Service
Walk In
650
700
750
800
850
900
950
1000
1050
1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12
2008/09 2009/10 2010/11
Actual Trend
Non-elective inpatient spells
300
500
700
900
1100
1300
1500
1700
1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12
2008/09 2009/10 2010/11
Actual Trend
Non-elective excess bed days
Current sharing model
Enhanced sharing model to replace current model – in final testing
GP surgery
DN unit
Podiatry Unit
Podiatry Unit
DN unit
GP surgery
Shareable information
Manual share Automatic share
Make shareable View shared info
Opportunities for allocative efficiencies
• System-wide approach – organisational reconfiguration
• Pathway redesign • Care settings • Demand management • Prevention
All of the above need measures and evidence