Harmoni: The TeleHealth Perspective from a 111 and Out of Hours (OOH) provider Tuesday 26 th June 2012 Steve Turner Director of Acquisitions and Strategy
Harmoni Overview Harmoni are leading independent provider of OOH Healthcare in UK. Patient care to 8 million+ patients with 23 PCT s Harmoni started as GP co-operative in NW London in 1996 & still have in excess of 300 GP shareholders All of our solutions are supported by state-of-the-art healthcare applications, information management and technology solutions During the last five years extended our Healthcare services to approximately one million new patients every year Although we are a private company all of our services are free to the patient at the point of delivery Page 2
What do we do and how? Established provider of OOH to the NHS. CQC registered We handle over 1 million Healthcare calls per annum-plus F-2-F and also provide: UCC s, WIC s, RMC & 111 Prison HealthCare: SARC s Forensic and Custody suites We specialise in Demand management services; all delivered via our Smartcare service Page 3
Harmoni s Smartcare model Page 4
111-what is it? NHS 111: new service improving patients access local NHS healthcare services-all over England by April 2013. Some exceptions for 6 months Mantra for patients is Call 111 if: They need medical help fast but it's not a 999 emergency They think they need to go to ED or need another NHS urgent care service They don't know who to call or don't have a GP to call They need health information or reassurance about what to do next For immediate, life-threatening emergencies, call 999 In essence replacing NHSD Page 5
111-How does it work? A 24/7 by 365 service staffed by Health Care Advisers, supported by experienced nurses They ask patients questions assessing symptoms using NHS Pathways-then give healthcare advice to direct patients to most appropriate local service such as: ED; WIC; Community Nurse; OOH GP; UCC; Emergency dentist or a late-opening chemist 111 team will attempt to book appointments if required If 999 is required they will make call Page 6
Harmoni 111 delivery Current Services: Hillingdon and Croydon Preferred Provider: Wandsworth Suffolk South West Bristol, North Somerset, South Gloucestershire, Wiltshire, Gloucestershire, Swindon, Bath and North East Somerset South East Coast Kent, Surrey and Sussex. (In partnership with the South East Coast Ambulance Service) Other Bids Awaiting results of a further 10 bids Page 7
DH & CQUIN (Commissioning for Quality and Innovation) Whole System Demonstrator (WSD) programme shown the effectiveness of Tele-Health. DH adamant that Tele-Health is now major part of future vision of NHS & the 3ML industry commitment letter stated We will also work with the NHS to integrate Telehealth into all appropriate clinical pathways including 111 6 Mandated Innovation Health and Wealth themes embedded in the 2012-2013 NHS Innovation Health and Wealth Document of 2011. Of these, one is specific to TeleHealth; To rapidly accelerate use of assistive technologies aiming to improve the lives of at least 3 million people over next 5 years From April 2013 compliance with all High Impact Innovations will become prequalification requirement for CQUIN payments Page 8
Tele-Health Generic Tele-Health must be part of integrated care pathway & 111 natural bed-fellow Potential monitoring of Kaiser triangle patients: 15 million patients in UK with LTC s Level 1: 70% or 10.5 million: Supported self care: medication concordance-when to take pills-advice and reminder service Level 2: 25% or 3.7 million: Disease Management-monitoring of patients via remote technology. Level 3: 5% or 790,000: Complex Needs-1or more LTC s-possible requirement of intervention and case management. Page 9
Harmoni Offering Harmoni will use 24/7 Regional Clinical Contact Centres to monitor patients: Service Provision IGSOC compliant -fundamental criteria for all NHS and 3rd party organisations who provide services for the NHS Providing services within N3-national secure broadband network data passing across N3 is not encrypted & does not meet Caldicott guidelines Patient identifiable info is transmitted via email or Fax it must go via N3 in NHS net e-mail or NHS netfax. (Not just sent in e-mail via N3) Patient readings from Tele Health equipment can go via N3 as long the patient cannot be identified by them. i.e discrete number not NHS number. Patient triage or advice passed via telephone should be recorded in case of SI s/complaints. Use of VOIP GP s able if they wish to monitor patient readings via Smartcare Portal. NB GPs will retain CG responsibility for patient Page 10
Process Map -111 Integration, Reporting & Governance Page 11
Tele-Health Best of Breed Monitoring by tele-health systems should be best of breed solution and hardware agnostic: Horizontally integrated service Allows TeleHealth hardware to be cost effective allowing commissioners to source the lowest price & better VFM Harmoni s understanding of specialities, clinicians & locations enables commissioners to deliver most clinically appropriate local pathways TeleHealth alone not panacea to stem rising costs in the NHS; however if part of integrated clinical pathway it will revolutionise Healthcare in UK & further afield Page 12
Vision TeleHealth cannot purely be about cost savings A community that implements TeleHealth should have objective to focus upon all sections of society who will benefit from assisted living Those in Nursing homes either by choice, or circumstance, can continue to live and be monitored in this environment End of life patients should be given access to Tele-Health services so that they can be monitored both face to face and remotely 3ML can be hugely beneficial to many of the UK s population Page 13
Any questions? Page 14