Transcript Feedback - NHS Networks

Patient Access to Records &
Transactional Services
(PARTS)
Welcome to the project launch.
Please note that this event will be recorded.
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Patient Access to Records &
Transactional Services
(PARTS)
Tad Matus
Chief Information Officer
What is “PARTS”?
Patient online access to GP services and records,
including:
• book appointments
• request repeat prescriptions
• access test results
• review medical history (consultations, diagnoses..)
• view letters : GP and other health professionals
• find out more about condition and treatment
• securely message clinicians
Currently…
• over half GPs have technical capacity to provide
electronic access to records but less than 1% do.
•70% could offer transactional services, 30% do.
Power of Information
Key Ambition:
“A change in culture and mind-set, so that our
health and care professionals, organisations and
systems recognise that the information in each
of our own care records is fundamentally about
us – and so that it becomes routine for us to be
able to access our own records online.”
Power of Information
Commitments:
• All NHS Patients will have secure online
access, where they wish it, to their personal GP
records by 2015
• Patients will be able to view online which GP
Practices offer online access to records by
2013
Project Aims
Establish demonstrator GP practice sites across
Kent, Surrey and Sussex to:
• Raise awareness of solutions, opportunities and
benefits
• Identify barriers to adoption and use
• Recommend actions to address these
• Inform and shape future roll-out strategies
nationally and locally
Products
1.
2.
3.
4.
5.
Benefits evaluation and case studies
Implementation Toolkit containing good practice
examples
Status report: implementation, usage and
attitudes
Follow-on recommendations to address risks
and issues
Local network of PARTS practices and local
champions
Objectives for Today
• Raise awareness of the project
• Explore the drivers for the project; why PARTS and
why now?
• Find out what’s already been achieved elsewhere
for patients, practices and the NHS
• Establish what GP systems can do / will do
• Bring key stakeholders to join the
discussion and get involved
“Systems” for Citizens
No Systems about me, without me
Toto Anne Gronlund
(and Philip Green)
The challenge
Seeing the patient as an active partner in
care is a major cultural shift
...but we can
feel there is
real life in
this.
The buzz is
as palpable as
these smiles.
Benefits Management
The paper chase
GP &
record
Then a
miracle
occurs
“The power of being practical”
JW99
The Elephant in the Room
Philip’s story
With thanks to Philip Green, the story teller,
and Pip Hardy and Tony Sumner
of Pilgrim Projects, who provided the
inspiration and technologies
The elephant in the room
Why is information important?
How much of the
patient’s time is spent on
worrying about not
having information ?
Up to 70%
of a professional’s
time is spent on
information
Information is one-sided power
Shared information is a relationship of trust
Patients and
information are the
two most under-used
resources in the NHS
Dr. Richard Fitton
Information
Governance is there
to protect the patient,
not the organisation
or the professional
Dame Fiona Caldicott
Cartoon with thanks to the British Medical Journal
The vision
Cornerstones to delivering transformation
Open Outcomes
World class Data
Text Text
Transparen
cy
Knowledge
for all
Customer choice
and control
Patient Voice
and Insight
Participation
16
Transparency and participation have
transformed customer service in other sectors…
so why not healthcare?
Online banking – a consumer success story
▪ Launched in the US in 1994 and in the UK in 1998
▪ Now >22M adult users (>50% of computer users)
Consumer applications offered with digital banking
Access to records
 Online banking offers
access to personal
bank account
applications in a secure
environment
 Healthcare equivalent:
access to the medical
record
SOURCE: Financial Fraud Action UK
Ability to transact
 Customers pay bills and
receive payments
 Healthcare equivalent:
ability to receive test
results
Ability to book
appointments
 Online banks offer real
time facilities to book
meetings and calls with
advisers
 Healthcare equivalent:
ability to email your
doctor
17
With thanks to live|work, Ealing PCT and the MS patients
Some observations by the G6
• If patients and people are not involved, how do we know
that we are defining, collecting, accessing, sharing,
analysing, using and reporting the right information to
enable safe, quality care.
• If we can’t see our records, how do we know they are
right?
• Who owns the data (does it matter) vs who has access to
the data.
• IG will become a patient responsibility too.
• Information can be a ‘service’, decision aids, online
selfassessment, peer groups, as well as record access
If Electronic Health Records
remain electronic versions of
the paper record, we will
continue to get the same
results as we did before, only
faster.
What is happening....
G6, patient members and patient organisations now
submitting ‘requirements’ for improvements to GP IT
systems
Patients joining System User Groups.
GP2GP programme is working in targeted areas to
increase patient awareness
Draft of Safe Record Keeping Guidance for patients now
complete – (BCS / G.Mynors)
NHS North producing guidance and supporting practices
and a diverse network of people supporting the RCGP
led collaboration
What will help....
•
•
•
•
•
•
•
Clinical leadership & trust in your patients
The factorial expansion of information
Being pragmatic and creating a sustainable approach
Systems that are accessible
A healthy dose of emotional intelligence
Transparency
Beacons like PARTS !
Power to the People
Paul Hodgkin on EHI, 2.10.2012 http://www.ehi.co.uk/insight/analysis/962/power-to-the-people.
“Well, you would be forgiven for thinking that right now patients have used their new
found health informatics just to look stuff up, seek out fellow suffers for mutual support,
and – if they are lucky – to order the occasional repeat prescription online.But behind
these mundane uses, a revolution is indeed gathering. Take a look at this infographic
from PatientsLikeMe, which shows how 29,000 people with MS experience their
illness and rate their medication.
This is new, people-generated knowledge. I was a GP for 25 years, but I had no idea
that ‘brain fog’ was one of the commonest symptoms for people with MS. It is only
when 29,000 people come together that this kind of knowledge emerges.”
“watching
the planet
develop a
nervous
system of
data.”
“The crowd-sourced
venture capitalizes
on humanity’s new
ability to collect,
analyze, triangulate
and visualize vast
amounts of data, in
real time”
These data-hungry gadgets also harness
“the power of connecting people with their
own data and getting them to see how that
could change their lives,” said Goetz.
http://www.wired.com/wiredscience/2012/10/big-data-is-transforming-healthcare/
Partnership working
Tailored for patients
The Android app has
been downloaded
about 100,000 times.
Since the launch, 3.3
million visits to kp.org,
or about 15% of total
visits to the site, have
come from mobile
devices, according to
Kaiser officials. About
3.9 million members,
or 63% of all eligible
members, are using
kp.org, according to
Kaiser.
My challenge to you
Help make the compelling case for a partnership
approach to health, wellbeing and care…and
unlock the vault of information
Language embeds behaviours and attitudes, so
please help build a new dialogue
Words Matter to Us
http://www.wordsmattertous.blogspot.co.uk
[email protected]
[email protected]
myRecord Project
Richard Ince
Project Manager
Anna Burns
Research Coordinator
Project insights

Clinicians’ fears of data-sharing with patients

countering those concerns

improve efficiency, safety and improve relationships

Use learning to inform ways of supporting change in
primary care
Changing cultures
Clinician referral
Engaged, empowered and informed
patients
Available resources
 www.myrecord.org.uk
 [email protected]
 [email protected]
Thank you
(Oct 2012)
PATIENT FEELINGS ON
ELECTRONIC
RECORDS ACCESS:
BENEFITS AND
CHALLENGES
Katie Wilson
User Involvement Projects Officer, Diabetes UK
Background
• The myRecord project commissioned Diabetes
UK to speak to patients who are in regular
contact with GP services – ‘users’ and ‘nonusers’
• The aim was to explore the feelings associated
with the ability to access their medical records
online
Method
• Five focus groups
– Greyfriars Surgery, Hereford
– St John’s Medical Practice, Lewisham
– Diabetes UK
• Semi-structured approach, using the same question
framework for all
• Participants were asked to think about;
– Good feelings about RA
– Difficult feelings about RA
– Potential benefits of RA (impact on time, accessibility,
quality of care)
Participants
• We spoke to 12 ‘users’
– range of medical conditions
• We spoke to 26 ‘non-users’
– 16 were people with diabetes
System users
• General enthusiasm – in principle, a good idea
– ‘Brilliant’ and ‘excellent’
• But, frustrated by administrative and technical
difficulties
• Current difficulties inhibiting full potential
System users – good feelings
• Control and empowerment
– the ability to ‘make informed choices’
– ‘Ammunition’ to get the care we need
• Trust
– No longer being ‘kept in the dark’
– ‘Puts you on an equal footing’
• Motivation
– Track trends, ‘see the whole picture’ and set clear goals
– An ‘incentive’ for improving health management
• Reassurance
– ‘holds the information you forget’
– Clarification
System users – difficult feelings
• Anxiety
–
–
–
–
Misinterpretation of information
‘needless worry’
Lack of detailed information or gaps in the record
Security – divided opinions
• Frustration
– ‘Clunky’ system
– Errors on records and ‘blocked’ information
System users - benefits
• Saves time and improves efficiency
– Reduces stress
– Saves ‘effort’ and ‘energy’ and is an ‘instant fix’
– ‘Incredibly convenient’
• Added value
– Enables preparation for appointments
• Quality of care
Non-users
• Initial reactions were fairly mixed
– Some expressed active hostility
– Some were indifferent
– Some could see the potential benefit, but had
concerns
– Some were very positive
• After discussions people were more positive,
although still sceptical about security
• Some remained indifferent
Non-users – good feelings
• Control and empowerment
– Increased ownership over their healthcare
– ‘Greater autonomy and independence’
– ‘Information is power’
• Trust
– Facilitating an ‘equal partnership’ with HCPs
• Motivation
– Care planning and goal setting (especially helpful for the
groups of participants with diabetes)
• A right
– ‘I want it because it is mine’
Non-users – difficult feelings
• Anxiety – information
– ‘I’d rather not know, what you don’t know won’t hurt
you’
– ‘I’m less concerned about the heavier stuff – the GP
can keep it to himself’
– Worry that information would lack context and a full
explanation
• Anxiety – security
– ‘opening the door’ to hackers
Non-users – benefits
• Time saving and efficiency
– Accessing information ‘when it suits you’
– ‘self service and on demand’
• Improving quality of care
–
–
–
–
More constructive appointments
Care planning and self management
Increasing knowledge and understanding
Help join up services and improve transparency
Closing comments
• Agreement that for the right people, records
access has the potential to be very beneficial
• Particularly useful for those with long term
conditions
• ‘A practical tool to help you help yourself’
• Important to manage expectations
THANK YOU
Even Patients Can Do IT…
18th October
2012
Yvonne M Bennett
Patient & PPG Secretary of
Haughton Thornley Medical Centre
Cartoon taken from www.mediclicks.net
… but it is not always easy

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We live in an age of technology but that doesn’t mean
everyone can use it
Some need more help than others but where from
We can use IT as a tool to manage our own & family
health
Self care doesn’t mean NO care
If we suffer from asthma, drug addiction, cancer etc
We can be educated in managing the condition by our
healthcare professional
There are 8760 hours in a year and we need to look after
ourselves and family for 8756 of those
Patient Perspective
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Being an active partner in the doctor/patient
relationship
A relationship based on trust
Having choices
Help the clinician to help me by having all
information available to hand NOW
Being a Happy Patient!
To do all this we need access to our medical
records
Our Practice
Website
www.htmc.co.uk
How do we get access to our records?
What can we do with access

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We can order repeat
prescriptions
We can check previous
medications
We can check
appointments
We can also cancel
appointments
(We could make
appointments before)
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


We can check results
We can check x-ray
reports
We can read letters
We can print anything
we think may be of use
e.g. medication list,
blood results
Photographs



A photo showing an operation scar with a possible
infection
A photo showing a leg ulcer
This can be monitored to see how the scar is
progressing
The Advantages
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Doctor/Patient relationship.
Take an active role in your
own healthcare together
with the doctor
On Holiday
Seeing a Consultant in a
hospital outside the area
Receiving care in the
community
Family members living in
another part of the world
Emergency
Time – repeat prescriptions,
appointments, results,
letters
Disadvantages

Forgotten History

Bad News

Abnormal Results

X-rays

3rd Party Information


Might not agree or like
with what’s been written
about you
Might be feeling worse
than before
Problems being solved

Children


Nursing Homes
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
Dr Amir Hannan from Haughton Thornley Medical Centres Dr Benjamin
Brown, Sarah Thew, Professor Iain Buchan from this University
Established a Local Care Records Board

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parent access until 10years and then discussions between child, parent
& GP
To deal with any complaints
“Grey


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
areas”
3rd party data
Foreign-speaking patients
Learning difficulties / memory problems
Coercion in the home / domestic violence
The Accident - 2011
Ambulance & A & E visit
Pre-op assessment & operation
Discharge letter (other services involved)
Hydrotherapy and Physiotherapy letters
8 Visits to Fracture Clinic
8 Letters
8 appointments at GPs
8+++ telephone calls
 Patient = 11hrs for apptts/40 mins telephone
 Doctor = 8 apt @ £25 = £200 NHS saving
 Other Patients benefit from 8 extra appointment
Hidden Cost




Everything has a cost
Time it takes to give Records Access and
keep the website up-to-date
Time, money. This event took time to plan,
set the room and funding to pay for
refreshments
Time people have given up to attend and
their time to get here
Putting people at the heart of care …
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NHS thinks patients have no life and a 10 minute
slot with a healthcare worker cost them nothing
We may choose to go to a specific hospital but with
‘speciality’ hospitals taking off we may have no
choice but to travel far.
Not everyone can claim travel cost
This doesn’t always mean they can easily afford it
but they are just above the threshold level
This isn’t just money but time as well. A journey
involving 6 busses (3 each way) is no use to anyone
feeling ill.
Self care – not NO care!
If you are living with a health condition, or
just want to learn how to look after yourself
better, visit www.htmc.co.uk and look at the
self care section. Remember the website is
Thank you for listening
[email protected]
www.htmc.co.uk
6 years experience of Haughton Thornley
Medical Centres offering patients access
and understanding of records
Dr Amir Hannan
Full-time General Practitioner, Haughton Thornley Medical Centres
Member of the Health Informatics Clinical Advisory Team, NHS NW
Clinical Director for the Patient Access to GP Online Services Advisory Group, NHS North
[email protected]
www.htmc.co.uk
Twitter @amirhannan
Better Care Better Health Better Life
Real-time Digital Medicine
Better Care Better Health Better Life
“If you treat an individual as he is, he will
remain how he is. But if you treat him as if
he were what he ought to be and could be,
he will become what he ought to be and
could be.”
Johann Wolfgang von Goethe
Better Care Better Health Better Life
Better Care Better Health Better Life
Better Care Better Health Better Life
Better Care Better Health Better Life
Haughton Thornley Medical Centres,
30th September 2012
Type of patient
How many have signed up
%
Diabetes
162/721
22%
Cancer
60/228
26%
Nursing home
30/30
100%
Pregnant
61/321
19%
Bengali patients
154/1571
10%
Total patients
1941/11924
16%
Better Care Better Health Better Life
www.htmc.co.uk
Better Care Better Health Better Life
Better Care Better Health Better Life
Number of patients signing up
for access to records per month
Better Care Better Health Better Life
What is needed
Learn from the past to plan for the present and the future
Less procrastination, more delivery
Define requirements – details matter
Clinical / Managerial engagement
Patient engagement
Media engagement
Practice-based web portal / smartphone app linked to
national repository
Money
People and ideas matter so invest in them
Better Care Better Health Better Life
6 step plan
1.
2.
3.
4.
5.
6.
Clinical, managerial & patient champions
Facilitators
Information needs
Strategy for starting
Collaborate and share experience
Evaluate
NHS North Patient Access to GP Online Services
Advisory Group
Better Care Better Health Better Life
Twitter
Better Care Better Health Better Life
Better Care Better Health Better Life
Isn’t it time YOU got access to YOUR records and
started using it to improve YOUR health and
enter the world of REAL-TIME DIGITAL MEDICINE ?
Dr A Hannan
[email protected]
Twitter @amirhannan
Better Care Better Health Better Life