Download Information to Support Patient  Involvement Terri Holcroft

Information to Support Patient Involvement
Terri Holcroft
The White Paper
“Equity and excellence: Liberating the NHS”
• “We will put patients at the heart of the NHS, through an information revolution and greater choice and control: – Shared decision‐making will become the norm: no decision about me without me. – Patients will have access to the information they want, to make choices about their care. They will have increased control over their own care records. – Patients will have choice of any provider, choice of consultant‐led team, choice of GP practice and choice of treatment. We will extend choice in maternity through new maternity networks. – The Government will enable patients to rate hospitals and clinical departments according to the quality of care they receive, and we will require hospitals to be open about mistakes and always tell patients if something has gone wrong. – The system will focus on personalised care that reflects individuals’ health and care needs, supports carers and encourages strong joint arrangements and local partnerships. – We will strengthen the collective voice of patients and the public through arrangements led by local authorities, and at national level, through a powerful Commission. – We will seek to ensure that everyone, whatever their need or background, benefits from these arrangements. The Emerging National Picture ‐
“An Information Revolution”
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There is significant emphasis in the White Paper on the importance of information. It is considered key to the delivery of better care, better outcomes & reduced costs.
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Critical elements of this include:
– Making a much wider range of information available to citizens & patients so that they can make informed choices about their health, care & lifestyle
– Increasing access to & use of PROMS & patient experience data – Giving patients greater control of their own care records
– Supporting new ways of delivering care including development of on‐line services
National Information Strategy
• We expect a draft strategy will be published for consultation in early Autumn
• NHS North West is actively engaged with DH Informatics Directorate in developing this
• Anticipate a statement of direction rather than a detailed strategy
Potential Components of the National Strategy?
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Open publication of data
Patient control of records
Information to support choice
Information intermediaries
Digitalisation of services
Information for management & clinicians
Information for quality
Information for health improvement & protection
Regional Informatics Strategy
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There was an explicit expectation in the Operating Framework that SHAs would develop an Informatics Strategy
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There has been work done to identify priority areas, which will describe how informatics will contribute to the delivery of our regions’ strategic aims and objectives
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This aims to identify the role that informatics should play in supporting the transformation of services:
• Improving productivity
• Increasing organisational efficiency
• Improving patient experience
• Achieving better clinical outcomes
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The aim is to provide an organising framework for informatics delivery across the North West
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All consistent with the White Paper and will be aligned with the National Information Strategy
A Regional Informatics Strategy ‐ Key Drivers
• Recognising the need to place the patient at the heart of everything we do
• Increasing expectations on the NHS to exploit information technology to deliver tangible improvements in health care delivery ‐ whilst also reducing cost
• Informatics investment to‐date has been significant ‐ but we are not yet realising maximum benefit from this investment
A Regional Informatics Strategy
• Focuses on the capabilities we need rather than specific systems and technologies
• Addresses the wider health economy and key partner organisations
• Needs to consider organisational and workforce capability & capacity requirements
• The Time Horizon for this – 5 Year Vision with a focus on transition and delivery over next 12 to 18 months
• Needs to identify where we have capabilities that are not being exploited
Informatics – Can Help Transform the Relationship we have with Citizens & Patients
• Providing multi‐channel access to information, advice & services
• Supporting a personalised patient centred service model • Empowering patients and the public to manage and improve their health & well being
• Increasing transparency and enabling patients to make informed choices and decisions An Informatics Enabled Health Care Model ‐
The Current Position in the North West
A communication system surrounds the patient and healthcare systems.
Access to Information, Advice & Services
Web Based Services:
‐NHS Choices, NHS Direct, HealthSpace, Dr Foster, Various Web 2.0 Applications
Digital Services:
Citizens & Patients
Digital TV; Huge potential but currently limited to a few notable examples in the UK (Sefton – ‘Looking Local’
& Birmingham)
General Practice
Shared Care Records:
Significant capability exists to provide patients with on‐line access to their GP record but there are very few examples of this capability being activated e.g. Cumbria, Stockport & Tameside & Glossop, Cheshire PCTs
Decision Support:
Care Pathway information is available to GPs & patients via ‘Map of Medicine’ & becoming more widely used
Our Patient
The Patient Scheduling Services: Capability exists for patients to book GP appointments, order repeat prescriptions and have on‐
line consultations but implementation is not yet widespread
Shared Care Records:
‐Small, but growing number of shared GP/Community records are being developed e.g. Liverpool, Cheshire, Cumbria PCTs
‐Limited use of Summary Care Record e.g. in Out of Hours & Palliative Care – but where it is used, it is proving beneficial
“Community Providers”
General Practice
The Patient Decision Support:
Scheduling Services:
‐Increasing use of Map of Medicine to manage patients along care pathways
‐Appointment booking from primary to community services is widespread e.g. podiatry, physio, dietetics – but it is not yet used everywhere!
Medication Management:
‐No joint management of medications across providers save for few examples between GP and hospital for small groups of patients
Diagnostic Services:
‐Very few examples of electronic prescribing in our hospitals e.g. Salford, Wirral, Christies
‐Results viewing – widespread in hospitals and to GPs but basic in most locations
‐Image sharing (PACS) widespread
“Acute Care”
“Community”
Shared Care Records:
‐Limited examples of shared patient records e.g. Salford Diabetes system, Cheshire PCTs (EMIS)
‐Increasing use of Summary Care Record in A&E e.g. Bury and Bolton
Decision Support:
‐Increasing use of Map of Medicine to manage patients along care pathways
General Practice
‐ Test requesting – confined almost solely to hospitals and in most cases basic only (i.e. no decision support)
The Patient Scheduling Services:
‐ Scheduling between providers and advanced scheduling within provider units is limited to few notable examples e.g. Trafford with “Ultragenda”
‐Appointment booking from primary to acute providers is widespread for all services – Choose and Book is included in the White Paper
‐SMS messaging reminders to patients are being used in a small number of Trusts
Medication Management:
‐No joint management of medications across providers save for few examples between GP and hospital for small groups of patients
‐Very few examples of electronic prescribing in our hospitals e.g. Salford, Wirral, Christies
Shared Care Records:
‐Limited examples of shared patient records e.g. Salford Diabetes system, Cheshire PCTs (EMIS)
‐Increasing use of Summary Care Record in A&E e.g. Bury and Bolton
‐Only patient demographic information shared
Diagnostic Services:
Mental Health
“Acute Care”
“Community”
General Practice
The Patient Scheduling Services:
Decision Support:
‐Scheduling between providers and advanced scheduling within provider units is limited to few notable examples e.g. Trafford with “Ultragenda”
‐Increasing use of Map of Medicine to manage patients along care pathways
‐Appointment booking from GP to Mental Health Services is increasing usually into MDTs
‐Image sharing (PACS) widespread
‐Results viewing – widespread in hospitals and to GPs but basic in most locations
‐ Test requesting – confined almost solely to hospitals and in most cases basic only (i.e. no decision support)
Medication Management:
‐No joint management of medications across providers save for few examples between GP and hospital for small groups of patients
Shared Care Records:
‐Limited examples of shared patient records e.g. Salford Diabetes system
‐Increasing use of Summary Care Record in A&E e.g. Bury and SS
Bolton
‐Summary Care Record not available to Social Care
‐A few examples of shared records to support CAF and SAP but typically only small scale pilots
Decision Support:
‐Increasing use of Map of Medicine to manage patients along care pathways
‐Increasing use of Map of Medicine for decision support but not extended to Social Care elements of the pathway
Social Care/LA
Diagnostic Services:
Mental Health
“Acute Care”
“Community”
General Practice
‐Image sharing (PACS) widespread
‐Results viewing – widespread in hospitals and to GPs but basic in most locations
‐ Test requesting – confined almost solely to hospitals and in most cases basic only (i.e. no decision support)
‐Rich imaging sharing infrastructure but limited test requesting and viewing
The Patient Scheduling Services:
‐Scheduling between providers and advanced scheduling within provider units is limited to few notable examples e.g. Trafford with “Ultragenda”
‐Appointment booking from GP to other providers is widespread
‐Currently no scheduling for LA provided services
Social Care/LA
Mental Health
“Acute Care”
“Community”
General Practice
SS
The Patient Patient with access to an Integrated, Personalised Health Record:
‐Currently very limited & generally restricted to single pathways or conditions e.g. Salford Diabetes project, Cheshire PCTs (EMIS)
An Informatics Enabled Health Care Model
A Possible Future?
Social Care/LA
Scheduling:
‐Booking and scheduling available across all sectors with automatic update and notification to patients
Mental Health
“Acute Care”
“Community”
General Practice
Medication Management: ‐Ability to manage patient medication across all care settings
Diagnostic Services:
‐Image sharing across all sectors
‐Requesting and viewing tests with decision support and scheduling
The Patient Shared Care Record:
Decision Support:
‐ All key transactions in the patients care are underpinned by real time decision support –
and are available to the Patient
‐Patient controlled, personalised
‐Includes all care providers and agencies
‐Secure access from anywhere at anytime
‐Record once, share information across the pathway
Multi Channel Access :
‐Information, advice & services available via the Web, Digital TV, Mobile Devices & Tele Healthcare
Questions we should be asking: • What are the most important changes needed to enable patients to
fully take part in decision making?
• How can patients be enabled to gain greater control over their health and care through information?
• How can information be used to support clinicians and providers in delivering better health and care outcomes?
• What is your local vision for an Informatics enabled Healthcare System?
• Which of the key capabilities that I have outlined are currently
available within your Local Health Community?
• Are we effectively exploiting the potential of existing systems and leveraging maximum benefit from our investment?
• Do we have the capability and capacity necessary to deliver effective IT enabled change?
One Key Capability: Patients Access To Their Records • The SHA is keen to encourage this ‐ the benefits for patients are significant
• The facility for patients to have access to on‐line services, including access their records is already available for many practices in the Northwest
• These facilities enable patients to access services at a time that is convenient to them and can empower them to have a greater involvement in managing their own health
• Research has shown that where patients have access to their own records, they have a greater participation in their care, felt an improvement in in the quality of care and used the access to manage their self‐care more effectively Patients Access To Records: Two areas that Dr Hannan will now discuss further:
• Access to GP Records, through EMIS and TPP
• Access to Specific Care Records, such as Renal Patient View:
Dr Amir Hannan Next Steps:
– Access to GP Records, through EMIS and TPP:
• In line with the White Paper – and the Vision for Patient Involvement
• Patient Access to Records already identified as a priority in NW
Strategy
• Could be enabled in 851 practices in NW NOW!
• NW Action Plan being developed
• Two Workshops being planned:
– For the 15 practices who are already enabled for Patient Record Viewing
– For Practices that are enabled for EMIS Access, but have not yet enabled Patient Record View
• Awareness Raising – PCTs, Clinicians and Public
Next Steps:
Any Questions?
To get involved, or find out more, contact:
Dr Amir Hannan – [email protected]
Terri Holcroft – [email protected]