kevin hamer uhs nhsft - nihr · my medical record the transactional record - appointment...
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My medical record
Kevin HamerIT Development Service Manager
UHS NHSFT
UHSFT My medical record 3
Some practical uses... Appointments and record management
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Some practical uses... Online journals
UHSFT My medical record
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Some practical uses... Secure messaging
UHSFT My medical record
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Some practical uses... Clinician approved patient information
UHSFT My medical record
My medical record
The transactional record
- Appointment cancellations / re-bookings- Updated demographics, allergies, medications etc.- Journals and surveys- Secure messaging
- Appointments- Electronic documents- Lab results & Radiology result messages- Secure messaging
PatientUHSFT
There are many patient benefits in use of My medical record, including;
• Ability to co-manage your healthcare online• Reduce the need for hospital visits
• 24/7 support and information• no parking• no need to adjust work or family arrangements
• Cancel or re-book your appointments• Access information about your condition• Receive information from the hospital
• Electronic documents• Lab results• Patient information
• Message your clinician
Where is the value for the patient?
What is the value for the hospital?
There are many clinician/hospital benefits in use of My medical record, including;
• Patient takes more proactive management of their healthcare• Access to information we don’t normally have• Ensuring the right patients are coming in to hospital• Capacity management• Supports DNA rate reduction• Maintaining patient demographic details• Cost savings on staff time and paper• Income generation through clinical trials• Income generation through new activity (messaging, online consultations)• Supports Trust business strategy
Why do this?1. Co-production leading to efficiency
Pre assessment for surgery
2. Demand management Prostate cancer saving outpatient appointments
3. Self care with no business case Quality and reputation bonus
What about
Clinical Research?
Patient centred care
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Heading here
On average 112 men with prostate cancer are diagnosed everyday in the UK
81% live for at least 5 years
4 out of 10 men with prostate cancer feel abandoned once treatment is finished. A significant proportion report unmet needs
Current system of follow up often fails to address men’s health needs
Resource intensive follow up AND demand rapidly escalating
Most prevalent cancer in men – 330,000 in UK today, 620,000 by 2030
Severe shortage of urology specialist nurses
The Prostate challenge
It is estimated only 294 uro-oncology CNSs in England (Macmillan Cancer Support 2014), whilst a further 195 are required to deliver standard of care (Frontier Economics 2010).
Nearly half of urology CNSs plan to retire in the next 10 years (Prostate Cancer UK, 2014)
Nearly 20% have a caseload of greater than 600 (Prostate Cancer UK, 2014)
The Prostate challenge
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Supported Self-
Management
•Remote monitoring•Support worker•4 hour workshop
•PSA Tracker•Patient Online Service •Rapid re-access to clinic
• 74 out of 285 men enrolled on care programme did not register for portal
• Out of the 211 patients who did register, only 6 did not log on.• 134 electronic health MOTs completed by 88 patients• 143 electronic messages sent by 54 patients• 156 paper health MOTs completed (number of patients unknown)
• Health warning: our cohort our younger and fitter than population of prostate cancer patient population generally, due to opt in nature of evaluation and criteria for enrollment in care programme
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Preliminary analysis of 285 men
Men are using the system, and feedback is very positive
Considerations for older age group. Sign up process had to be simplified
Paternalistic attitudes of clinical teams regarding patient held information had to be overcome
Variation between NHS Trusts in capability to integrate system with PAS and pathology
IT system has played a key role in making follow-up more efficient
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Key lessons
• TrueNTH Supported Self-Management and Follow Up Care Project commenced in January 2014
• Designed, implemented and evaluated new prostate cancer follow-up care pathway with over 2500 patients enrolled across five sites
• Controlled cohort study to evaluate impact on HRQoL, unmet need and cost utility – reaches conclusion in July 2017
Pathway redesign & research study
Why it can work for research
Patient engagement – easy to capture patient reported data
Data electronically stored in one place
Evaluations can be carried out using the online service (patient satisfaction surveys etc.)
Data can be analysed using Google Analytics (or other BI tools)
Evaluations and academic papers are being written using a range of the above
