Transcript 2 nd June 2015 - Redhouse Lane

NATIONAL
INFORMATION
BOARD
Interoperability workshop –
Taking forward Personalised
Health and Care 2020
Indi Singh
2nd June 2015
NATIONAL
INFORMATION
BOARD
Key themes that rely on effective information sharing
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Interoperability Programme - Operating principles NATIONAL
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• “Interoperability” wide and expansive term and overly technical
• Breaking down “interoperability” into meaningful parts
• Key priorities e.g. use of NHS Number, Transfers of Care
• Key blockers e.g. information governance guidance
• Future direction – new ways of information sharing
• Scope across health and care
• Co-creation of products to assist local organisations, developed in conjunction
with local organisations such as Integration pioneers
• Facilitating communities on information sharing
• showing local best practice and direction of travel
3
Working directly with local
organisations
Airdale, Wharfedale
& Craven (W2)
Flyde Coast (W2)
Greater Manchester
(W2)
Cheshire (W1)
N Staffordshire and
Stoke (W1)
South Tyneside (W1)
Leeds (W1)
Wakefield (W2)
Vale of York (W2)
Barnsley (W1)
Sheffield (W2)
Nottinghamshire (W2)
NW London (W1)
WELC (W1)
Greenwich (W1)
Islington (W1)
Camden (W2)
Nottingham City (W2)
Worcestershire (W1)
Southend-on-Sea (W1)
West Norfolk (W2)
South Somerset (W2)
Cornwall & Isles
of Scilly (W1)
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South Devon &
Torbay (W1)
Kent (W1)
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Complementing by bringing together cohorts on
information sharing
Technology Fund
Applicants
Pioneers Wave
1
e.g. Royal
Marsden
e.g. Barnsley
Pioneers Wave
2
e.g. Wakefield
“Pioneering
organisations”
e.g. Hampshire,
Bristol
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Driving priority standards for
information sharing
Collective guidance on
breaking down “myths”
Understanding common and
priority needs
Articulating direction of
travel
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Interoperability programme
Interoperability/Information
Sharing
Interoperability
roadmap
Articulate direction of travel - key
standards, key priorities, national
functionality.
Sub-package 1:
Priority Standards
Transfers of Care
Adoption of
NHS Number,
eDischarge,
End of Life,
ITK
Sub-package 2:
Interoperability
Maturity
(System)
Maturity
across care
settings,
across
organisations
Sub-package 3:
Interoperability
Maturity
(Transfers of
care)
Maturity for
specific
information
sharing needs
Sub-package 4:
Priority Use Cases
(Discovery)
Breaking
down
“information
sharing” into
key needs
Sub-package 5:
Toolkit for
commissioners on
interoperability
Commissioning case
for change; Sample
OBS; Handbook of
policies, standards,
guidance;
Sub-package 6:
Interoperability
Strategy
Role of integration
offerings - local and
national into aligned
strategy
Open-source accelerators
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Information Sharing – Near Term Milestones
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Key components
Output
Audience
Date
Transfers of Care
Clinical Case for Change
Commissioning Case for Change
Standards development
Supplier Readiness
Implementation (at scale)
Levers/incentives (CCG planning / Standard Contract 16/17)
CCIO
CCGs
All
Vendors
Vendors
Trusts
Q2 ’15/16
Q2 ’15/16
Q1 ’15/16
(HSCIC)
(HSCIC)
Q3/4 ‘15/16 (levers stream)
Interoperability Maturity (System)
Dataset definition and engagement
Scoring methodology
Assessment
Local and Health Economies
Q1 ’15/16
Q2 ’15/16
Q3 ‘15/16
Interoperability Maturity (Transfers of
Care)
Dataset definition and engagement
Scoring methodology
Assessment and Baseline
Acute, Primary Care
Q1 ’15/16
Q2 ’15/16
Q3 ’15/16
Discovery: Priority use cases
Engagement through leading lights
CCIOs, CCGs
Q1 ‘15/16
Toolkit for commissioners on
interoperability
Priority requirements for IDCR
Information governance guidance
Sample OBS
Interoperability roadmap
CCGs
Q2 ’15/16
Q1 ’15/16
Q2 ’15/16
Q2 ’15/16
Interoperability Strategy
Engagement with key industry suppliers, CCIOs and CIOs,
Role of SCR?
Trusts, National Programmes
Q2 15/16
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What the design principles….
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1. Still enable local “leading lights” delivering integrated digital care records to
continue to progress whilst supporting those less mature localities
2. Keeping information at source and having the ability to retrieve this as
needed and so removing unnecessary duplication of information.
3. Holding information nationally where they is a clear justification to do so
(e.g. such as national flags).
4. Providing an approach that enables access and contribution by citizens and
professionals in the most convenient and effective ways possible
5. Having an architecture for information sharing that supports/reflects and
adapts to the current and emerging care workflow
6. Ensuring the strategy optimises public investment, at national and local level
7. Allows for those most appropriate to take ownership at the right level
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Where do we want to get to?
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The GP record remains the main point of the curation
of the health and care record. Record can be accessed
into IDCRs through open interfaces.
Options
Curation of care
record
(supports
workflow)
Co-ordination of care
across care settings
Patient access
Clinician access
Public
perception
Market position
Completeness of
record
Integrated Digital Care Records pervasive and provide
access to the detailed care record and speciality
information for care co-ordination
GP systems
GPs the main
custodian of care
record
Only works where primary
care is the care
coordinator (e.g. doesn’t
work for end of life)
Widespread
(March 2015)
Only primary
care (with
difficulty to
share across
primary care)
“family doctor”
Duopoly
High proportion of
care record
information
needed
Ability to link across local Integrated digital care
records through Open APIs to avoid creating silos
Summary Care
record
Reliant on
content provided
by source
systems (GP)
Provides limited record
information to all settings
to enable them to coordinate care
Not available
National (e.g.
CPIS flag)
“Big brother”
Provides access
of information
to any consumer
Limited
Local integrated
care records
initiatives
Reliant on
content provided
by source
systems
Provides detailed care
record access for care cordination
Limited but
growing
Always problem
at boundaries
Locally owned
Potential to
create oligopoly
of integration
vendors
Provides full
coverage
SCR provides the ability to view key universal flags
(e.g. CPIS) and these are stored nationally
Extended SCR to hold information nationally but only
for where there is a clear clinical/safety case e.g.
discharge medications.
Clinical access to integrated digital care records and
summary care record though their native clinical
system
Clinical update to record information to be done
through native system which then populates the
integrated digital care record
Patient access to summary information (SCR) with
ability to drill down into integrated digital care
records. Ability to access through NHS Choices/ PHRs
Ability for patients to provide and contribute
information directly /through 3rd party tools (e.g.
wearables/apps). PHRs can combine this information
with that sourced from clinical systems
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SC
MH
Integration Platform
(e.g. xxxx)
Integration Platform
(e.g. Orion)
Summary Care Record
Flags (e.g.
CPIS)
Discharge
meds
Use of national assets for key
flags and key documents where
national access needed
MPI
Index
Demographics
Index to
IDCRs
Patient
Integration
Platforms
Patient
Open APIs between
IDCRs enable sharing
across these
Use SCR APIs to bring SCR
content into IDCRs
Expose access to IDCRs
through APIs
Specific key documents
provided up to SCR for
national access
GP record
ectract
Co
m
Acu
te
Open Source
Middleware
IDCR
SC
MH
adverse
reactions
Co
m
GP systems remain
main point of
curation of record Meds, allergies,
Integration Platform
(e.g. Graphnet)
Acu
te
GP
Systems
SC
GP
Systems
MH
GP
Systems
Co
m
GP
Systems
IDCR
IDCR
Acu
te
Referrals/
Discharges i.e.
transfers of care
(clinical
workflow)
Local Clinical
System
Creation of local integrated digital
care records to support clinical
access to detailed care record and
speciality information.
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Clinical
What’s the underpinning architecture?
Clinical access and
contribution to
integrated digital care
records and summary
care record through
their native clinical
system.
Patient access to
summary information
(SCR) with ability to
drill down into
integrated digital care
records. Access
through NHS Choices
and PHRs
PHR integration
platforms will enable
apps/PHRs access to
other APIs for – i)
transactions e.g. use
NHS referrals API to
book appointments
and 2) use APIs to
access information
from wearables etc
Patients also to be
able to contribute to
PHRs
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• Objective for today’s session
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–
–
–
–
Move off the talk into the concrete
Get local organisations onto this agenda
Understand what is already working well
Link into initiatives and activities designed to help you e.g.
Ripple project
– Feed into the Interoperability Board on priorities, and
what’s needed in terms of accelerators/blockers
– Be a “test-bed” for testing ideas, strategies etc from the
centre, informing them and prototyping and testing early
delivery and learning
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