transforming care in the nhs through digital...
TRANSCRIPT
www.england.nhs.uk
Transforming Care in the NHS
through Digital Technology
Paul Rice PhD
Head of Technology Strategy
NHS England
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
13th April, 2015
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Learning Objectives
• Share the progress of delivering digital enabled transformation in the
NHS (and social care)
• Identify the technologies available to enable connected care
• Demonstrate how these innovations are driving improvements in
quality and patient safety outcomes
• Recognize the benefits and opportunities that exist by using innovation
to transform care
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The NHS faces significant challenges
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Source: The NHS belongs to the people: A call to
action
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NHS Technology Strategy
© HIMSS 2015
Personalised Health and Care 2020
Five Year
Forward View
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Better use of data and technology has the power to improve health, transforming the quality and reducing the cost of health and care services.
It can give patients and citizens more control over their health and wellbeing, empower carers, reduce the administrative burden for care professionals, and support the development of new medicines and treatments.
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The future digital NHS
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Recent Progress
© HIMSS 2015
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NHS Number
GP Contract
Spine Patient
Online
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Patients able to view their full
coded medical record,
including the option for them to
download their record into
third party applications, where
required.
Installing Wi-Fi and other
enabling infrastructure in
practices, allowing patient
access to online services (e.g.
repeat prescriptions, online
appointment booking) from
their own mobile devices.
Patients able to book
appointments online. This may
also include the capability to
inform patients if an
appointment is actually needed.
Depending on presenting
conditions there may be more
appropriate services to meet
the patient’s needs.
Integrated and interoperable
working with other agencies,
for example GPs to be able to
access child and adult records
held in Local Authority Social
Care systems, specifically to
inform diagnosis and
safeguarding.
GPs visiting patients at home,
care homes, or other care
settings, having access to
systems they would have if they
were in their own practice
building.
This could include:
• Full access and ability to
update patient records in real
time
• Ability to prescribe medicines
electronically and either print
a ticket or text/email a
confirmation, to initiate a
dispensing instruction to the
pharmacy of the patient’s
choice
Telecare and healthy living
apps which enable patients to
monitor and manage their
health or live independently
without having to visit their GP
surgery as often.
Patients able to provide
information prior to seeing the
GP to aid pre-referral
diagnosis and maximise
effectiveness of patient-GP
face time.
Telehealth devices made available
to patients to test and undertake
diagnostics then upload to GP for
consideration.
Priorities in Primary Care
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GPs able to visit or offer appointment
times to patients from other general
practices with the ability to view their
records, write to the patient record and
issue electronic prescriptions, subject
to information sharing agreements
across shared care models.
Exploring the benefit of clinical decision
support and links into NHS 111 as a
‘pre-primary care’ triage service.
NHS 111 and OOH providers able to
access and update the patient’s
primary care medical record, subject to
patient’s consent.
NHS 111 and GP OOH providers able
to access and view the patient’s
summary care record and/or full coded
record.
Offering a ‘click and collect’ or ‘click
and deliver’ service for repeat
prescriptions (e.g. patient orders
repeat prescription online,
GP signs off in electronic prescription
service, pharmacy dispenses and
patient either collects or pharmacy
delivers), all trackable online by the
patient. Enabling new channels for
consultations with a GP, e.g. via
telephone, email, webcam or instant
messaging, where this is deemed to
be appropriate and clinically safe.
Priorities in Primary Care
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Standards for Digital Records
IGT2
Workstations &
servers
Identity
verification
Use of existing
national
offerings
Online
conferencing Interoperability
(ITK2)
Open
APIs
NHS
Number
Network
infrastructure
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Digital Customer Journey
Transformation of NHS Choices will:
• Extend our reach to meet unmet user needs
• Enhance experiences for current users
• Retain our usage baselines
• Continue to be highly trusted
• Intelligently respond to user behaviours to meet user needs
User
needs
Discovery Alpha Beta Live
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Modern Digital Design Standards
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Citizen Identity and Consent
Verification Consent Identification
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Functionality and Fulfillment
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Active
Medications in
IDCR
Clinician Point of
Care Order Entry Clinician, Patient
and Drug
identification and
authentication via
barcode
Alerts re contra-
indications +
“Care Bundling”
Clinical Decision
Support Tools
Pharmacist
working on safety
“at the back end”
Medicines
optimisation
recorded
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Personal Health Records
Nearly 100% primary care use of Electronic Patient
Record
National contract for GP Systems set requirements for
open APIs
Future Enablement
Working with patient cohorts using GP
records to understand needs
Learning from early adopters across
health and care
Continuing to develop interoperability and
security standards
Insight drawn from
international exemplars
and market capability
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“Telehealth is not a single, uniform type of technology;
rather it is a targeted approach appropriate to the
individual’s needs, combining process, organisational
and responsibility changes supported by monitoring
and collaboration technologies…”
Healthcare without walls: A framework for delivering telehealth at scale
John Cruickshank - 2020 health.org Nov 2010
Telehealth
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Technology-enabled capabilities
• Mobile access to digital care records across the community
• Digital capture of clinical data at point-of-care
• Digitally-enabled observations management
• Real-time digital nursing dashboards
• Remote face-to-face interaction
• Digital images for nursing care
• Equipment tracking and monitoring
• Safer clinical interventions
• Smart workforce deployment
• Digital transformation of pre-operative assessment
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Local Roadmaps (Bristol example)
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Digital Maturity Indices
Installed
Capability Effective Use
of Systems
2014/15 2015/16 2016/17
Enterprise wide
use of Systems
Benefits and Outcomes
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In 2015
Proposals for extending My NHS
Publish roadmap for aligning national programmes with this framework
Proposals for linking 111 with NHS Choices
Guidance on Commissioning and Regulatory Roadmap
Proposals for regulating and kitemarking digital services
Proposals for Code 4 Health
Proposals for personal data usage reporting
March
April
All citizens will have online access to GP records
Publish roadmap and standards for accessing core transaction systems
Agree standards for real-time and interoperable care records
Mandated use of NHS number as primary identifier in clinical correspondence and patient activity
Publish new Insight Strategy
Publish data quality standards for NHS care providers
Publish data security standards and IG toolkit
Publish Digital Maturity Index indicators for NHS Trusts on NHS Choices
June Sept
Oct
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2016 and beyond…
2017
2016 2018
2020
Core ‘secondary uses’ dataset agreed
CQC to consider performance against data quality standards as part of regulatory regime
New knowledge and skills framework introduced for all levels of the workforce
100,000 individual genomes will have been sequenced
Individuals will be able to record to their care record
Core curriculum and knowledge and skills framework updated
Clinicians in primary care, urgent and emergency care and other key transitions of care will be operating without paper records
Until 2018 GPSoC procurements used to stimulate innovation
All care records will be digital and interoperable
Entire health and care system will adopt SNOMED clinical terminology
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What are the benefits?
Clinical diagnosis
Patient & staff experience
Safety
Reduce burden & improve efficiency
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A distance to travel
2
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