Paper Free at the Point of Care- Digital Maturity Assessment … · 2018. 6. 7. · Digital...
Transcript of Paper Free at the Point of Care- Digital Maturity Assessment … · 2018. 6. 7. · Digital...
Paper Free at the Point of Care- Digital Maturity Assessment leading to your Digital Roadmap A clinician’s view ISD Network - November 15
Dr Colin Brown - CCIO Morecambe Bay Hospitals
• Highlighted by Declan
Burning Platforms
• Increasing demand for healthcare • Diabetes, obesity, dementia, very frail elderly • Deprivation / employment challenges in NW • Heading for annual £3b spend on H&S Care in Lancashire • Potential £800m system gap by 2020
Healthier Lancashire Strategy Digital Lancashire Strategy
• Focus on health and wellbeing
• Seamless care, shared records and partnerships • Right care, first time, every time • “Better information” (at point of care), “better decisions”,
leading to “better outcomes”
• Self-care & care closer to home • Telehealth and remote diagnostics
What do we want to achieve ?
Current State GP e-Records Systems
• Deployed in early 1990’s • Business and financial drivers • Some admin loading of information from Lloyd George Paper
Records • Early mis-trust of data • Clinical checking and validation of data - clinical provenance • Now this should be the “Master e - health record”
• Emisweb is the Lancashire and Cumbria dominant system (1
exclusion in Cumbria) • Documents, summaries, e-prescribing etc
Current state Morecambe Bay
Lorenzo EPR – June 2010 Clin Docs inc IDS / clinic letters ++ Test Requests +/- Test Results ++ Digital Terming +/- ED ++ Maternity ++ Interoperable 50 modular test results ++ Connected to GP records ++ E-whiteboards ++ Paperlite OPD ++ CDNR Project +/-
Current state Blackpool
IMS PAS Vision Clinical in ED Emisweb in community Mix of information flows , including use of MIG and Docman
Current state Preston
• Legacy EPR system • Streamlining departmentals • Exploring EPR options • Information flows via FAX,
Email and post.
Current state East Lancashire
• Portal approach on top • of departmentals • Community via Emisweb • Electronic letters to GPs • Electronic lab results to GPs • Electronic x-ray reports to GPs • Letters by Faxes and email
Current state Southport and Ormskirk
• Legacy PAS and departmental systems • E-test results –letters sent to GPs • Part e-letters (mental) rest communications with GPs via email, post and fax Committed to Meditech EPR and looking at community options
Current state Lancashire Care
• Mental Health – e-notes and e-prescribing (Ascribe) • Exploring EPR options • E-test results –letters sent to GPs • Part e-letters (mental) rest communications with GPs via email, post and fax
Connecting Care Pathways LPRES using Tiani Spirit (IHE compliant)
Progress with LPRES connecting system
Built • Preston Teaching Central Hub and Morecambe Bay Affinity Domains Next Step • Affinity Domains for East Lanc’s and Lancashire Care in next 2 weeks Not Yet Scheduled • Affinity Domain for Blackpool
Facilitators for Change
• Systems approach / Partnerships • Previous underpinning enablement NWSIS • Emergence of CCIO’s and National CCIO Network • ISD Network • Accreditation – networking, standards, sharing and improving • Development of IG Framework to support shared records and an e-Sharing System (C and Lancs IG Network) • Developing strategies aligned with Manchester, Mersey and the Healthy Cities agenda
CCG Digital Roadmaps
Separate Cumbria and Lancashire CCG Digital Roadmaps – Concern 1
Constraints – Geography • Not a neat fit for all emerging health economies • Better Care Together fits Morecambe Bay footprint • South Cumbria and Lancashire • Patients flow into Lancashire Hospitals and services
• North Cumbria “Success Programme” represents a health economy with links with the North East • Cumbria Digital Roadmap may well reflect north and south county
Constraints - Investment Sequencing • CCG declares Roadmap footprint - Oct 15 • Detailed CCG Digital Roadmap Plans and Digital Maturity
Returns – March 16 • NHS England engages with DOH / Treasury – Summer 16 • Investment expected to be delivered through Tech Fund
3+
• ?? No funding likely to flow until April 2017
Investment Sequencing – Concern 2
Tech Fund - Concern 3
• Tech Fund 2 delivery into Lancashire didn’t entirely fit with strategically needs • Late support for LPRES connecting system (£1m not £2.5m) • Support for comprehensive electronic nursing record in Morecambe Bay • Not for Source EPR systems at Blackpool or E-Prescribing system at East Lancs
• Treasury reduced Tech Fund 2 from £250m to £43m • This is not an overwhelming NHS endorsement of support for meeting the strategic goal of a paperless agenda
Vanguard - Concern 4
• Vanguard funding for Better Care Together in Morecambe Bay • Does the DOH / Treasury / Government believe ?? • Vanguard clinical leaders ready and on the “runway” • Small investment only so far – goal is “man in suit on telly ! ”
• Wait too long and a whole cohort of current doctor leaders will plan retirement • Costs and size of deficit will inexorably grow, until we implement re-designed health and social care
Are we in Lancashire doing enough ? – Concern 5
• Lancashire Digital strategy but no detailed delivery plan for wide footprint transformed care • Acute Trusts deep in the here and now, balancing finances, clinical quality, safety and finances • Not yet in place wide area detailed discussions about fundamental health and social care service design • Interested – intent – commitment • Commitment from organisations • Multi-organisational delivery plan
Are we in Lancashire doing enough ? Concern 5
• Has there been enough Acute Trust collaboration so far ?
• A current sense of increasing collaboration / converging views and principles
• Are we moving fast enough ?
• We need organisations to be brave, with collaborative,
strategic leadership to put patients first and not persist in organisation-centric thinking.
How hard can it be ?
SIMPLES !