Transcript Developing a Shared Vision for local health services

How CCGs can support whole
system interoperability?
Katie Summers
Chief Information Officer
CCG role in technology
Performance
Foster technology S-curve
Whole system co –ordination
Breakdown Information silos
Foster clinician engagement
Patient and public engagement
Shared information agreements
Introduction
Growth
Maturity
Decline
Effort
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The story of technology in West Berkshire
CCGS
Population: circa 600,000
4 CCGs (54 practices)
3 UA
1 Acute Trust
1 Community Trust
1 Ambulance Trust
The Berkshire West 10
“Integrated Care programme”
Integration Approach
• Engaging clinicians, managers and voluntary sector in
workshops, to develop a vision of “what good looks
like” for an elderly frail person – a patient centred
pathway across the health and social care economy
• Building on feedback received from service users,
patients and carers to inform the new design
• Identifying key features and metrics enabling us to
recognise and measure progress
Integration Approach
• Economic modelling, to assess system and
organisational impact and inform further
investment and savings
• BCF submissions , CCG QIPP Business cases and
provider IBP include key elements of the pathway
which have been developed locally and informed by
the Workshops
• This means that a significant number of initiatives
that contribute to the pathway are already
underway or planned
Global research shows successful integrated care systems require
three core building blocks 1
Success in integrated care
Address specific patient needs …
Patient cohorts
Very high risk
High risk
Moderate
risk
Low risk
Very low
risk
… by working in a multidisciplinary system …
1 Clinical protocols
and care
packages
3 Case
management
2 Care
coordination
and planning
4 Performance
review
… supported by key enablers
Aligned incentives and
reimbursement models
Accountability
and joint
decision-making
1. Source: AQuA/Tower Hamlets 2013
Information
transparency and
decision support
Clinical leadership and
team working
Patient engagement
What does good look like at each
stage…for Sam?
Objectives of our new pathway
• Our whole system shifts from reacting to
anticipating
• Personalised, shared coordinated care planning
– with Sam at the centre
• Common assessment and care planning process:
no duplication by multiple agents
• Ensuring most effective and efficient use of
resources and avoiding duplication
Sam tells his story once, has one assessment,
one care plan, one key coordinator who pulls
him through one integrated system
Information Enabler
Through the Integration Programme a Berkshire West’s
Digital Journey for the widespread exploitation of
information and IT to achieve whole system goals,
through:
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Enabling transformation of care pathways and services;
Improving whole-system care service efficiency, effectiveness and safety – right
information, right place, right time;
Supporting commissioning decision-making;
Empowering patients and the public to take greater responsibility for their health
and healthcare;
Ensuring confidential information is held securely and shared on a need to know
basis
Commencing our digital journey began
with listening
“There needs to be better
communication between ‘inhours’ and out of hours
services.”
“The information I have is
limited and frequently is
missing important
elements…”
“If I had better
information then it would
help me evaluate risks
when deciding whether to
admit a patient…”
“Adequate and timely information must
be shared between services whenever
there is a transfer of care between
individuals or services.”
“Services in all settings including
health and social care need to
improve their communication and
handover ”
“There are delays in getting
hold of information that I
need…and I spend a lot of
time chasing it up…”
“I don’t have access to some
important information
electronically…”
Berkshire West Connected Care – why?
Clinicians told us that NOT having access to accurate, timely,
shared information wastes time and is a ‘blocker’ to providing highquality, effective, efficient care…
Connected Care is our response to the call from practitioners and
clinicians across Berkshire West for better, more joined-up information to
support local care and local pathways.
Connected Care will deliver
• Single, secure, web-based clinical portal to view key information from
multiple systems
• Patient-centred view – your information follows you, instead of being
trapped in ‘silos’ in different hospitals and different systems
• Improving the quality, safety and efficiency of care and practice
• Underpinning transformations in where and how services can be
provided
Based on learning
from Bristol and
Northern Ireland
Presentation
Connected Care Clinical Portal
Security & Privacy
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Patient Record
Authentication
Authorization
Single Sign-On
Patient Privacy & Consent
Relationships
Audit Logs
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Demographics
Laboratory
Radiology
Encounters
Allergies
Diagnosis
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Notifications
Portal
Medications
Problems
Procedures
Transcribed
Documents
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Patient Search
Patient Lists
Patient Summary
Timeline
Flowcharts
Secure Messaging
Orion Health Applications
Third Party Applications
Secure
Inbox
E-Mail
Mobile
Integration
MiG
Rhapsody Integration Engine
Clinical Data Repository
GPs
Source Systems
RBFT
Cerner
PAS
BHFT RiO
Extracts
Adastra
End Of Life
Adastra
Out Of
Hours
Orders and
Results (ICE)
Framework i
Social Care
–
Wokingham
Framework i
Social Care
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Reading
RAISE –
West
Berkshire
Our Digital System
What we have achieved over 6 months
• Collaborative ownership of the programme and
challenge, developing alliance approach
• Proof of concept – testing clinical scenarios with
industry providers
• Clinical movement for programme
• Roll of MIG to primary care and out of hours
• Moving to pilot and PQQ
• Launched an information sharing agreement (53
or 54 practices sign up in 3 weeks)
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Question
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