using portal technology to improve services 8 october 2014 andrew haw head of health informatics...
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Using portal technology to improve services
8 October 2014
Andrew HawHead of Health Informatics Service
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5 Key Strategy priorities
Electronic Patient RecordElectronic Staff RecordBusiness IntelligenceMobile workingIntegration
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Portals – 3 typesOrganisation basedCommunity basedCare based portals for collaboration with patients e.g. renalpatientvew.org
Active Users: 3,700
Services:
• Adult Mental Health
• Older Peoples Service
• Forensics (3 hospitals)
• CAMHS Level 3&4
• Drug & Alcohol
• IDD
• Psychological Therapies
• Specialist Services
Users: 2,300
Services:
• Adult Community
• Allied Health Professional
• CAMHS Level 1&2
• Childrens Services
• SureStart
80% of GP Practices use SystmOne in Nottinghamshire – but unequally spread across 6 CCGs
One trust, two
systems
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Trust based: low level integrationBuilt an EDMS based on SharePoint for those documents that are not part of the RiO record
Role based access controls are identical in EDMS and RiO
Click through from one app to the other
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e-ICP – Responsible for mapping the patients care pathway and capturing key events/stages,
importing relevant clinical data from various systems including RiO, CESA and eCare
Plans.
CESA – Responsible for replacing paper versions of the MHA Legal
folder and Single Health Care Record into an Electronic storage
location.
RiO – Responsible for Patient Administration including
demographics and appointment status, Progress (Running Record)
notes and numerous Forms including Trims, HCR20 and
Therapy data
EPR – One or more computer applications capturing patient information. In Rampton's case
this is RiO, CESA, e-ICP and eCare Plans.
eCare Plan - Responsible for capturing in one RiO form
MDT care plans for a patient.
Forensics EPR solution
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Trust based – next stepPhysical health status recorded in SystmOne & Mental health status recorded in RiO, mostly not a problem except:
○ No trust wide Master Patient Index except in BI○ No integration between so some rekeying○ No access to some data out of hours except on paper○ Some services through merger are split across both
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Our plan Implementation of Viper360 clinical portal that allows a user
to see simultaneous views of patient data in Rio & SystmOne, so that RiO users can access SystmOne, SystmOne users can access RiO and all users can access Summary Care Record, MIG and PC-MIS for IAPT – starting with CAMHS
Confirm the type of electronic collaboration between service users and clinicians that best meet the needs of Children, Young People and Family strategy
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Why ViperUse of open source componentsPrice point designed to support starting small and growing later when requirements become clearer
No data is movedCredentials
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Community based portalsConnected Nottinghamshire: 2 acutes, 1 Ambulance, 2 Councils, 2 OOH, 6 CCGs, 2 community providers
All transformation programmes describe clinical information sharing as essential : 3 system wide requirements: Comprehensive Geriatric Assessment, End of life Care and Safeguarding Children and Adults, and a 4th on the way : urgent/emergency care
GPs using EMISFramework-i
County Council Integration Engine
Carefirst
City Council GPs using SystmOne
Ambulance
Community and Mental Health
Providers
Acute Providers
Out of Hours Organisations
Possible Use of Fortrus as Interim Clinical PortalPossible Use of Fortrus as Interim Clinical Portal
Emergency Admission to a Geriatric Ward
Fortrus
Patient Index ?
E-Forms and Other Capabilities
Comprehensive Geriatric Assessment
End of Life Care
Adult Safeguarding ?
CGAE-Form Started
CGATrigger
RequestCGA Updated
CGATrigger
RequestCGA
Updated
CGA Updated
CGATrigger
Request
Example: Comprehensive Geriatric AssessmentExample: Comprehensive Geriatric Assessment
Broadcast MessageCGA Phase 1 Complete
Next action according to business logic is X to be done by organisation Y
by time T
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Patient based portalsShould:
○ save time for both patient and clinician in care delivery / travelling / communicating
○ be a choice – standards?○ support interfaces to devices○ be portable - not be tied to an organisation or a group
of organisations○ support secure data sharing with providers
Proposed E-Health Platform
Users
Social MediaPersonal Health Record
Specific ToolSelf Referral
to HCP Search
Users choose the access path that works for them
Discussion Groups
E.g. Microsoft
HealthVault
E.g.. FLO BUDDY,
SilverCloud Avatars
(to be agreed)
Trust web site and others…
User facing services and sites
E-Health Portal
InformationPrescription
DictionaryGuided Search
Tool
Narratives Mood Monitor
Directory of Services
PortalLayer access
to Trust
National Services
Data Interchange withOther healthcare providers
Trust’s App Store / Patient Portal
PROMs My Care Plan Resources
Secure Network
Patient Held Record e.g. Microsoft
HealthVault
Rate My Day
NHC Electronic Patient Record
(RiO )
Research Information
System
NHC Patient dataOther provider dataUser Generated data E-Health Platform – 2015/6
