Transcript Dr Richard Flitton presentation slides

British Computer Society Health
Northern - June 30th 2016
Can the NHS survive with
externally controlled and
digitally excluded
patients?
British Computer Society Health
Northern - June 30th 2016
• From a presentation by John Hewitt,
communication engineer and patient at
Hadfield Medical Centre, in 2004, at a
meeting attended by Microsoft at Hadfield
Medical Centre Derbyshire with portal and
data extraction work by another Hadfield
patient Glenn Rich.
Communication Models
Current Model
(Patient perspective)
Efficient Model for Inclusion
Government
Foldercare / GePmail
Administration
(DOH)
Government
Administration
(DOH)
Medical
Professional
Patient
Patient
Medical
Professional
Patients and information are the most under
utilised resources in health service provision
Patient Access
to Record
Patient Contribution
to Record
Patient collaboration
and more Autonomy
Patient Partnership
Diverse Information
Clinicians
Patient
Electronic records
DOH
NICE
Admin
Published
Research
Stepcare
Stepcare is an embryonic lexicon of the generic processes of health and illness
management. Each step will have components of information management. These
may be executed face-to-face, by post, telephone, e-mail, Fax, telecommunication or
by other means. Stepcare refers to the processes undertaken by patients, carers and
professionals. It has been designed to aid the development of clinical care pathways.
It makes special reference to the clinical consultation process and the electronic
health record. It has not been peer reviewed and would benefit from further reference
to academic models of consultations
Some icons by a patient for
Privacycare
• Human Rights Act
• EC 95/46
• Data Protection Act
Video’d consultatons
RF1 14.46 – 15.20 Patient contributing blood
pressure reading
RF2 00.00 – 06.20 Boy using a peak flow meter
and BTS
reference values
RF5 Man questioning x-ray report and helping to
diagnose osteoporosis
Patient Care Record
(Extracted from Torex)
PRINT RECORD_DATE,CODE,VALUE1,VALUE2,TEXT
FROM JOURNALS (ALL FOR PATIENT)
WHERE NHS_NUMBER IN (“**********")
*RSP_IDENT,HMC,Hadfield Medical Centre
*RSP_AUTHR,USER1,Temporary HQL User
*RSP_RDATE,********,**/**/****
&1,"RECORD_DATE","CODE","VALUE1","VALUE2","TEXT"
$1,"20000628","-12","","","*PROMPT* Check family history"
$1,"20000628","-136","","","*PROMPT* Ask about alcohol"
$1,"20000628","-137","","","*PROMPT* Smoking history"
$1,"20000628","-229","","","*PROMPT* Check height"
$1,"20000628","-22A","","","*PROMPT* Check weight"
$1,"20000628","-22K","","","*PROMPT* Calculate BMI"
$1,"20000628","-246","","","*PROMPT* Blood Pressure Check"
$1,"20000118","06..","","","Managerial occupations - ********. -"
$1,"19950208","23..","","","Examn. of respiratory system - nad."
$1,"19950208","2D..","","","Ear, nose + throat examination - nad."
$1,"19990222","2DC1","","","O/E - pharynx hyperaemic"
$1,"19990224","41B3","","","Faeces test due"
$1,"19960124","652.","","","Typhoid vaccination typhim vi lo411 4.98 given"
$1,"19960124","6564","","","Booster tetanus vaccination e54452u 97.01"
$1,"19960124","6584","","","Booster polio vaccination s124j10 8.96"
$1,"19960124","65C.","","","Yellow fever vaccination given"
$1,"19960124","65FA","","","1st hepatitis A vaccination vha419b6 7.96 right"
$1,"19951205","67E1","","","Recommend travel vaccinations, enquiry re"
$1,"20021017","934Z","","","Computer record NOS-request"
$1,"20000202","982A","","","Night visit claimable - higher"
Unified Viewer
for
Integrated care records
Foldercare Is ………
•
•
•
•
A browser-based viewer for displaying personal health data from specified sources
Structured user friendly interface that can utilise all the patient data delivered from
floppy disc, CD or other secured location
Will link to the internet for further information for a given disease, condition, treatment
or drug.
Structured according to the World Health Organisation international classification of
disease.
• Data engines create many views of the patients’
data.
• One engine displays the codes to mirror the
structure of the Read coding hierarchy.
• One engine creates “folder” or chapter views of the
patient Read codes and text. Each “folder” is
populated by codes from it’s own Read code chapter.
Folders are designed to manage life long records and
to aid “sealed envelope” use for purposes of
confidentiality.
• One engine creates a view of each chronological
episode
• One engine creates a view of medications.
• A linkage has been created between Read codes
and web based information sources to explain
data.
Selection and display
• At the category selection page animated icons change from the category icon to the
“invitation to view” icon and back again which indicates current conditions or issues.
• Clicking on the desired icon will show the record detail for that disease category.
The Future
Foldercare
Artificial data engines will seek out information from the patient’s information repository
to populate empty fields within new or repeated clinical pathways. Data engines will
match and link codes from the data repositories to codes attached to original research,
local service provision information, local service outcome information and national or
international standards, allowing patients to rapidly increase their own knowledge base.
Perceived Benefits / Potential savings
Community
• Cumulative savings due to more efficient processes.
• More health conscious population developing a proactive plan for
healthy lifestyle.
• People with chronic disease adopting self help treatment plans.
Brexit REGULATION (EU) 2016/679 OF THE EUROPEAN
PARLIAMENT AND OF THE COUNCIL May 6th 2018
63)
A data subject should have the right of access to personal data which
have been collected concerning him or her, and to exercise that right
easily and at reasonable intervals, in order to be aware of, and verify, the
lawfulness of the processing. This includes the right for data subjects to
have access to data concerning their health, for example the data in their
medical records containing information such as diagnoses, examination
results, assessments by treating physicians and any treatment or
interventions provided. Every data subject should therefore have the right
to know and obtain communication in particular with regard to the
purposes for which the personal data are processed, where possible the
period for which the personal data are processed, the recipients of the
personal data, the logic involved in any automatic personal data
processing and, at least when based on profiling, the consequences of
such processing.
REGULATION (EU) 2016/679 OF THE EUROPEAN
PARLIAMENT AND OF THE COUNCIL
of 27 April 2016
• Where possible, the controller should be able to provide remote
access to a secure system which would provide the data subject
with direct access to his or her personal data. That right should not
adversely affect the rights or freedoms of others, including trade
secrets or intellectual property and in particular the copyright
protecting the software. However, the result of those considerations
should not be a refusal to provide all information to the data
subject. Where the controller processes a large quantity of
information concerning the data subject, the controller should be
able to request that, before the information is delivered, the data
subject specify the information or processing activities to which the
request relates.