Transcript Connecting Care Our story so far*

Connecting Care
Our story so far…
Andy Kinnear
March 2015
what is Connecting Care?
Connecting Care is the Bristol, North Somerset and
South Gloucestershire [BNSSG] programme,
dedicated to using technology to support • Better information sharing between local
health and social care organisations
• Joining up information to ensure care is
focused around the individual and their needs
• Improving better, safer and more joined-up
care
• Supporting increased efficiency in the delivery
of health and social care services
• Ensuring that the people who are providing
care have the information they need, when
they need it
• Our first deliverable has been a shared ‘view
only’ electronic patient record (using the
Orion Health ‘portal’)
our partnership
project approach
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2011 Vision
2012 Procurement
2013 Staged approach
– First stage (pilot) started in March 2013. Key deliverables:
• A working system for 500 users
• Evaluation of benefits
• Stage one themed on urgent & unplanned care
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2014 A business case for the second stage .Second stage started
Dec 2014 (next 5-7 years)
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2015 = GROWTH
Stage two will extend the breadth & depth (10,000 more users,
more information sharing)
what we’ve
delivered…so far…
Presentation
Connecting 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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Portal
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Medications
Problems
Procedures
Transcribed
Documents
Patient Search
Patient Lists
Patient Summary
Timeline
Flowcharts
Secure Messaging
Orion Health Applications
Third Party Applications
Integration
MiG
Rhapsody Integration Engine
Clinical Data Repository
Master Patient Index
GPs
Source Systems
NBT
Cerner
PAS
Weston
Cerner
PAS
UHB
Medway
PAS
RiO
Extracts X4
Adastra
End Of Life
Adastra
Out Of
Hours
Orders and
Results (CRIS
and Ultra) X2
Paris Social
Care Bristol
SWIFT –
North
Somerset
enabling safer & better care
Community • Saves time in triage and assessment
• Saves time – reduces the amount of calls to GPs
care
• Saves unnecessary home visits
• Supporting risk management and safeguarding
Social care
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General
practice
• Reduces burden on practice administrators
• Supports risk management and safeguarding
• Increased confidence in better care being provided outside of
the practice
• Immediate access to GP records (new registrations)
Supporting referral management
Saves time in triage and assessment
Informs assessments & care planning
Saves installation and equipment costs
Supports risk management and safeguarding
enabling safer & better care
Out of
hours care
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Pharmacy
• Safer prescribing – provides access to allergy and GP prescribing
information
• Saves time – Reduces the amount of time calling GP practices
• Safer communication – reduces errors
Hospitals /
A&E
• Safer care – patient background, context and medications
• Saves time – reduces time trying to find out information
• Reduces risks – where patients unable to inform clinicians about
relevant information / fax errors etc
Saves appointments and visits
Saves admissions
Safer prescribing
Improved quality of consultation
potential financial benefits
A sample of some possible financial benefits:
Admissions Prevention
10,000 users could see annual saving of £1,036,288 from admissions
prevented by using information in Connecting Care
Based on a Department of Health reference cost 2012/13 of £1,436 for a unplanned
admission and only the same rate of stated admissions prevented in the pilot
Reducing duplicate assessments
10,000 users could see a annual saving of £179,520 on stopping the
duplication of assessments as a result of using information in Connecting Care
Based on cost savings if the same rate of stated admissions prevented during the pilot
continues – based on £60 for an average cost of a face to face assessment by a
community nurse - Department of Health reference cost 2012/13
potential financial benefits
A sample of some possible financial benefits:
Time savings - calling other organisations
10,000 users could see a annual saving of £155,278 of ‘people time’ as Connecting
Care users spend much less time calling other organisations for information
Based on salary cost savings if only one call per week per user is saved where the medium
salary between NHS bands 7 to 8 is used.
Reducing home visits
10,000 users could see a annual saving of £68,000 on stopping unnecessary home
visits as a result of using information in Connecting Care
Based on cost savings if the same rate of stated home visits prevented during the pilot
continues – based on £60 for an average cost of a face to face assessment by a community
nurse - Department of Health reference cost 2012/13
enabling safer & better care
“Unable to obtain a
medication history or
allergy status from the
patient….accurately
confirmed through
Connecting Care …”
Pharmacist, NBT
“I now use Connecting Care on
almost every case I deal with it
(approx. 25 cases per shift). It
always makes a difference and
adds value. Every shift, acute
admissions are avoided.”
Doctor (out of hours)
“Have been able to identify trends
which have then resulted in swifter
[safeguarding] interventions…one case
where concerns would not have
increased without Connecting Care…”
Social Worker Safeguarding team
“Massive difference in time
spent accessing information.
On average [I can] access the
GP record within 30 seconds
compared with 15-20
minutes taken via telephone
or via fax”
Critical Care Pharmacist
Manager UHB
““Information about the
patient’s diagnoses has
helped our team decide
which type of therapy to
offer the patient”
UHB
“Connecting Care is
brilliant…I use it to
triangulate information
from service users, to find
out about other services
involved so that I can
contact them to inform my
assessments”
Bristol social worker
“it has enabled us to
commence discharge
planning earlier in the
patients stay to help
prevent delays later on.”
Discharge Nurse
“3 cases identified on
Connecting Care
today that were
already allocated to a
health practitioner
(BCH OT or IMCS OT)
so did not require
referrals to BCC OT”.
Occupational
Therapist Bristol City
Council
enabling safer & better care
“On Monday I managed to obtain details for
22 patients on Connecting Care, I saved a huge amount
of time as I didn’t need to phone the GPs and wait for
the faxes to arrive” Acute Pharmacist
“In cases where we are dealing with a
person who is being supported by Rapid
Response and the district nurses,
Connecting Care comes in to its own. All the
notes from visits are documented and it can
save at least 30-40 minutes on duty cases of
this nature” Social Worker
“Without Connecting Care
today I couldn’t have done my
job.” Pharmacist
“I used Connecting Care to find vital information for
the diabetes nurses . The information logged by
district nurses is a goldmine of information. We saved
20 minutes on the telephone and managed to find the
reason for patients insulin being discontinued”
Discharge Nurse
“Connecting Care has been really helpful tonight. Could not do
without it. Particularly in the case of an old lady with XX who I
could not reach on the phone. Without Connecting Care this
would have resulted in a visit and probably her door being
broken down. But with CC I was able to work out that all that
should of been done, had been done.” OOH Doctor
Having access to
accurate, timely,
shared information
is no longer a
‘blocker’ to
providing highquality, effective,
efficient care…
“The extra patient detail is
useful when deciding to stop
drugs such as anti-platelets
and it helps to identify risk
factors” Doctor
our next steps
next steps
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In 2015 our key projects are
Children's safeguarding project –
sharing information from our 3 local
authorities’ children’s systems
Document sharing – clinical and
social care documents being shared
in portal...and ‘sent on’ to other
recipients (GPs) ~ initial focus is
eDischarge
Lots of system replacements  (2
hospital PAS, 3 community systems,
1 social care system, 2 pathology
systems)
New infrastructure, new data
centre hosting, re-write lots of our
‘core config’ to support improved
performance
Rolling out to new users and
organisations (e.g. mental health)
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In the pipeline…
Pharmacy (sharing more – hospital
prescribing / community pharmacy)
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Supporting cancer care
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Mobile working, patient access
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Specialist systems (renal, maternity,
dental etc etc.)
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Sharing more information from
within hospitals – e.g. assessments,
care plans
• Enable sharing of end of life plans
• Better support for some workflow /
pathways
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And lots and lots more!!
5 reasons we have been successful…..
1. Line of business
systems that ‘share’
• You cannot share paper data easily
• Good electronic ‘line of business’ systems that
share data are critical
2. Integration Partner
• Integration is tricky. Find a software partner who
‘gets it’
3. Money…locally owned
money!
• Invest locally….seek national money too, but
make your local organisations put skin in the
game
4. People….local talented • Hire really talented project people….we did
people
5. SPIRIT
• Overrides everything else
• Stamp on ‘organisationally centric’ thinking at
every single opportunity.
• Command the morale high ground that the
patients/citizens best interest occupies
Thank you!