Transforming Care in the NHS through Digital Technology Paul Rice PhD Head of Technology Strategy NHS England 13 th April, 2015 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.
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
The NHS faces significant challenges Source: The NHS belongs to the people: A call to action 3
NHS Technology Strategy Five Year Forward View Personalised Health and Care 2020 HIMSS 2015
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.
The future digital NHS
Recent Progress GP Contract Spine NHS Number 1234567 Patient Online HIMSS 2015
Priorities in Primary Care 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. Patients able to view their full coded medical record, including the option for them to download their record into third party applications, where required. 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. 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 provide information prior to seeing the GP to aid pre-referral diagnosis and maximise effectiveness of patient-gp face time. 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. Telehealth devices made available to patients to test and undertake diagnostics then upload to GP for consideration. 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
Priorities in Primary Care 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. NHS 111 and OOH providers able to access and update the patient s primary care medical record, subject to patient s consent. 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. 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. Exploring the benefit of clinical decision support and links into NHS 111 as a pre-primary care triage service.
Standards for Digital Records IGT2 Network infrastructure Workstations & servers Identity verification NHS Number Open APIs Interoperability (ITK2) Online conferencing Use of existing national offerings
User needs 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 Discovery Alpha Beta Live
Modern Digital Design Standards
Citizen Identity and Consent Identification Verification Consent
Functionality and Fulfillment
Clinician Point of Care Order Entry Clinician, Patient and Drug identification and authentication via barcode Clinical Decision Support Tools Active Medications in IDCR Alerts re contraindications + Care Bundling Pharmacist working on safety at the back end Medicines optimisation recorded
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 Insight drawn from international exemplars and market capability Continuing to develop interoperability and security standards
Telehealth 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
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
Local Roadmaps (Bristol example) 24
Digital Maturity Indices 2014/15 2015/16 2016/17 Installed Capability Enterprise wide use of Systems Effective Use of Systems Benefits and Outcomes 25
In 2015 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 Oct Proposals for linking 111 with NHS Choices March Proposals for extending My NHS Publish roadmap for aligning national programmes with this framework June Guidance on Commissioning and Regulatory Roadmap Proposals for regulating and kitemarking digital services Proposals for Code 4 Health Proposals for personal data usage reporting Sept 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
2016 and beyond 2016 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 2018 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 2017 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 2020 All care records will be digital and interoperable Entire health and care system will adopt SNOMED clinical terminology
What are the benefits? Clinical diagnosis Patient & staff experience Safety Reduce burden & improve efficiency
A distance to travel 2 9
Thank you Contact paulrice1@nhs.net