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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?