Northern, Eastern & Western Devon Medical Interoperability Gateway MIG Shared Care Record Shirley McLean Programme Manager Delt Shared Services Ltd Shirley.mclean@deltservices.co.uk
Shirley McLean Jobs: IT Programme Manager, NHS Information Specialist, Rock Knocker (Geologist), Experienced Holidaymaker, Shared Care Record Evangelist, Member of the Healthcare Gateway Advisory Group Near death experiences: Two Stalked by paparazzi: Once Nights spent in very small car with entire family: 2 Star letter writer: From age 11 Language Fluency: 2 (English and American) Children: 2 Better halves: 1 Feathered friends: 3 Gravestone: An ordinary mortal who tried to do a few divine things
All About Delt Largest CCG in the UK 8000 Supported Users 2 Data centres 110 GP Practices 14.4M of IT Savings projected over 10 years More than 300 city services from Adoption to Waste Danish for Shared 200 Locations 12 Year inequality gap in Plymouth 1.1B Health commissioning budget 2,330 Sq Miles Formed Oct 2014 900,000 Population 130 Delt Staff Health and Local Government One Shared Service
Why we chose MIG TPP, Emis & Microtest practices decide which local organisations they will allow to view the GP record Read only view of the current record is shared (without duplication) Vital details not typically available in the Summary Care Record (problems, investigations) Available to clinicians all hours day or night / integrated and browser views Patients do not have to repeatedly recall details of their GP care record Individual patients can choose not to share
This presentation Where we are now How we got here Time for questions at the end 11/05/2017 5
Clinicians on board with MIG 90% practices agree to share with Devon Doctors Out of Hours Service. 750 records viewed by DDoc in March 95% Northern practices & 50% Eastern practices agree to share with NDHT 100 records viewed by NDHT in March Ideally >80% records need to be available 68% practices agree to share with DPT 17% practices agree to share with RD&E so far
It takes time Number of MIG Records Viewed by DDoc 800 700 600 500 400 300 200 100 April May June July Aug Sept Oct Nov Dec Jan Feb March 0 2016 2017
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From there to here What a lovely view! Vision, leadership, clinical / digital champions Got to be worth it - Business case The right way? Agreement and consent to share Who s got the map? Plan & manage Fellow travellers - Communication Vital supplies - Support and training Stoney path - Almost annoying persistence A milestone - Celebrate!
Share for Care 2012 MIG Test of Change in Northern Devon (6 practices) 2013 CCGs set up 2014 Memorandum of Understanding - signed by 13 Trusts, Local Authorities and CCGs across Devon identifies interoperability as a core feature 2014 IM&T Strategic Vision Statement for Service Transformation puts shared care data at the heart of the vision for an integrated service with the patient at the centre 2014 Funding for MIG project from Prime Ministers Challenge Fund and Delt project manager appointed 2015 80% GP practices agree to share records 2016 Roadmap for peninsula digital programme 2017 Record sharing an enabler for STP
Legal Basis Duty to share relevant information between health professionals in support of individual patient care Patients are informed Individual patients can choose not to share Local information sharing agreement, with consent as the legal basis for sharing If the agreement is broken and data is accessed inappropriately then enforcement action can be taken against the unauthorised user Clinician confirms having a legitimate relationship with the patient and records consent each time a MIG record is accessed
To share or not to share Records with dissent recorded (Emis & Microtest) or not shared out (TPP S1) are not available to the MIG Sensitive data (Emis & Microtest) or data marked as private (TPP S1) is not available to the MIG If an individual refuses consent at the point of care then the MIG record cannot be viewed (unless it is an emergency) Clinicians (care professionals) with a legitimate relationship only Audit third party record access visible to GPs from within the practice clinical system Emergency access reviewed by privacy officers / Caldicott Guardians
Local agreement Information sharing agreement & Privacy Impact Assessment LMC / Governance Steering Group SRO / CIO / Caldicott Guardian Online agreement by GP practice data controllers Enabled by HealthCare Gateway Activated by GP practice
Leaflets, Posters, Web Site for the Public Briefings, Intranet, FAQs for Health Professionals 15
Evaluation
Final thoughts Paralyze resistance with persistence Ramp up engagement Gather evidence More care settings Influence the direction of the MIG Time for Questions? deltservices.co.uk Better, Faster, Cheaper