Download BCS ASSIST Autumn Conference, Manchester 10 October 2012

BCS ASSIST Autumn Conference, Manchester
10th October 2012
Lisa Brady, Head of Health Informatics
University Hospitals Birmingham NHS Foundation Trust
Presentation
• Background & overview of myhealth@QEHB
• System functionality
• Experience to date
• Next steps
• Lessons learnt
• Questions & comments
Overview of myhealth@QEHB
• A web-based system offering high-quality information &
support to Queen Elizabeth Hospital Birmingham (QEHB)
patients with long-term health conditions, to enable
informed choice & shared decision-making.
• Allows patients to:
– access information held in their QEHB clinical record;
– store their health records in one place & share with their clinicians;
– create their own support networks of patients with similar
conditions; &
– access reliable information & resources on their condition.
NHS context
• The recent White Paper acknowledges the need to:
– “…transform the way information is accessed, collected, analysed
and used by the NHS… so that people are at the heart...”
– move towards facilitating openness and transparency; to enable
patients to be in control of and active participants in their care.
• “The shared vision set out in [the DH Information] strategy
is for all of us to have secure electronic access to services
and to our own health and care records. This will include
access to letters, test results, personal care plans and
needs assessments.”
System development
• Developed by QEHB IT & informatics staff, in close
consultation with clinicians & patients.
– Web-based ‘portal’ + underlying data warehouse built & maintained
in-house, along with provision of support for patients & staff
– Servers & data housed onsite
– Data feeds taken real-time, electronically from Trust’s ‘clinical
portal’ (EPR)
• ‘ethical hacking’ / security tested & verify by external
company of expert consultants.
Pilot & further development
• Pilot commenced with liver medicine patients in 2010.
• Feedback suggests the system gives patients:
– more control over their care
– improves their experience
– makes their life much easier
• Road-testing undertaken with patients from wider range of
specialties, ages & computer skills.
• Responses positive; majority of patients found it relatively
easy to navigate & understand – all but 1 signed-up to use.
Road-testing feedback
• “Very good, & very helpful – what I’ve wanted for years.”
• “…perfect for me – I’ve recently moved away to university;
all my mail still goes to mums, & she’s always been very
involved [in the management of] my condition.... I think this
will help me make sure I don’t miss any appointments &
become more involved in understanding & managing my
condition.”
Key system functionality
Secure registration process & log-in:
Home page:
Results:
Medications:
Letters:
Contact QEHB (clinicians):
Profile / Support
Network:
Key system functionality (cont.)
Implementation
Went live on 31st July 2012 in the following specialties:
• Cancer
• Liver medicine
• Diabetes
• Renal
• Endocrinology
• Haematology
• Respiratory
• Rheumatology
• Inherited bone
conditions
• HIV
• Inherited metabolic
disorders
Gradual roll-out planned…
Early feedback & uptake
• Currently over 200 patients signed up; many used the
system multiple times last month.
• Haematology consultant: “I didn’t realise it would be so
simple” [to sign-up patients].
• Rheumatology patient: “my clinician has asked me to enter
BP readings at home & upload my GP prescriptions… so
we can find the best medication plan [for my condition].”
• Service evaluation to be conducted 6 months postimplementation by NHS Kidney Care.
Next steps / future directions
• Additional functionality identified for future releases
– e.g. PROMs & patient experience questionnaires.
• More specialties / sub-specialties keen to be involved.
• Applying for NIHR Research Grants to assess impact on
patient outcomes & experience.
• Potential to investigate, pilot & evaluate new ways of
delivering care to patients in the future
– e.g. communicating & sharing info with clinical team or ‘virtual
clinics’ via the system could replace/reduce no. of face-to-face
appointments & prevent several hours traveling to QEHB for some.
Lessons learnt
• Represents cultural change for many clinicians.
• Shift in mind-set required often more difficult to manage
than IT requirements.
• Clinical leadership & executive sponsorship is vital.
• Electronic storage & management of health information
essential.
• Overall, positively received by patients & clinicians.
Any questions or comments...?
Thank you!