Transcript Delivering True QIPP

HOW AN INTELLIGENT
DEVICE CAN CUT THE
MUSTARD
Dr Julian Brown
What Was Meant by This?
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Succeed
Come up to
Expectations
Provide High Quality
Obviously I must Have Been Good ?
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2006
+201%
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The Story
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2006: I became our PCT
Prescribing Lead.
My Surgery was
highlighted as having
significantly high
admissions for diabetes.
My Surgery was terrible.
They sent me to Chicago.
I decided to create an IT
solution
www.diabetesmanager.org.uk
The Result
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Went from one of the
worst to the best in 1
year.
No insulin initiations.
Reduced Admissions.
Reduced overall spend
Best HBA1C control
2009
Graph of glycaemic control
achieved from 2009 QOF
data.
What Had We Done?
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Performance Tracking
Risk Stratification
Integrated Care
Self-Management
Plans
Patient Access
Performance Tracking
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Accurate Benchmarking of
how the surgery and PCT
is performing on clinical
markers.
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NICE
QOF
How we were performing
in terms of outcome data.
How we were performing
in terms of cost.
6. Track Overall Cost-effectiveness at
surgery level
2. Risk Stratification:
Identification of High Risk Patients
Six types of High Risk Patients
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1. Those that have poor end-point
data.
2. Those that have deteriorating
end point data.
3. Those that fail to have screening
4. Those who are not on or not
collecting appropriate medications
5. Those that are on inappropriate
medications.
2.High Risk Patients:
a. Poor End Point Data
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The System will
automatically
create weekly
league tables
by each
parameter.
2.High Risk Patients:
b. Deteriorating Scores
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Looking
at flux
of
endpoint
data
helps
identify
patients
earlier.
3. Integrated Care: Sharing the eHealthcard
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Secure online for ease
of access by:
 GPs
 Other
HCPs
 Patients
3. Summary Reports
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Allows quick
overview of
patient
Allows prediabetes clinics
Allows remote
clinics
Allows compliance
issues to be
identified.
7. Liaising With Specialists
7. Liaising with Specialists
3. Patient Self Management Plan
7 essential steps for diabetes perfection.
 Blood
Pressure
Control
 Blood Sugar Control
 Cholesterol Control
 Weight Control
 Healthy Lifestyle
 Medication
Compliance
 Regular Screening
Self-Management Plans
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Encourage Patients.
Educate Patients.
Essential in achieving
long-term diabetes
control.
Reduce complications.
Reduce costs.
Makes the Patients
Happy
How did diabetesmanager work?
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Web based application.
Automated Data Extraction from
GP systems
Remote performance tracking of
all diabetes patients.
Automated self-management
plans for every patient.
Allows online access for patients
Allows online education and
remote specialist clinics.
Why Not Apply the Same Logic to
Medicines Management
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7% all emergency
admissions medicine
induced
60% of these
preventable
Each one costing
average £5000
The Process
The Result is Complete Safety
Monitoring
The System Allows True Integrated Care
Surgery Portal
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Identifies at risk
patients
Updated Weekly
Confidentiality
Maintained
Surgery Has Control
Preventing Emergencies
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Identifies the Patients who
don’t come to see us.
The ones that manage to
get themselves on drugs
that are dangerous for
them.
The ones that aren’t
taking their protective
medications.
QOF!
Better Integration
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Patients
Practice Diabetes Nurses
GPs
Specialist Nurses
Podiatrists
GPs specialist interest
Consultants
Commissioning Leads
Medicines Management
online, webinars , emails, reports
Communication!
The Future
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Better outcome for patients
Better education of patients
(autotranslation etc)
Increasing Self-management
Reduced need for
medications.
Easy patient alerts
Easy patient tracking
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Better outcomes for HCPs.
Reduced Emergencies.
Reduced Admissions
Better project and formulary
compliance.
Better use of services.
Identification of GP Surgeries
needing extra resources.
Better education
Online referrals
This can become a thing of the past!
 Microvascular
 Neuropathy
 Retinopathy
 Renal
Disease
 Diabetic ulcers
 Macrovascular
 Heart
Attacks
 Strokes
 Peripheral Ischaemia
 Diabetic Ulcers
And more importantly – it transforms
Patients
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Janet
She used her selfmanagement plans &
diabetesmanager.org.uk for 12 months
To this one!
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Same patient after 12 months
using her self-management guide
www.diabetesmanager.org.uk
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Time for live demo
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Does this Cut The Mustard?
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2009 QIPP arrived
Quality
Innovation
Prevention
Productivity
The Future of the NHS
£20 billion Savings
How Would It Work?
Quality
Cost-Savings with
reinvestment
Improved
Productivity
Innovation to
Implement
Prevention
allowing Improved
Efficiency