Moving Forwards with HealthSpace

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Moving Forwards with HealthSpace

• Gillian Braunold
• Clinical Director
• Summary Care Record HealthSpace

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HealthSpace Development

• Patient portal through which they have a secure
  on line domain for their transactions with health
  service
• Aligned with Choices
• Place to store records access on line
  electronic records-and also from which they can
  send information to their clinician

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What is HealthSpace

• Secure on line domain for patients for their
  transactions with the Health Service
• Offered through the Choices Portal
• Through high level registration authentication
  and authentication services can be offered to
  patients across a range of work streams

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My Health Information
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View and store clinical information about
themselves

• SCR
• Renal patient view piloting in Salford
• Diabetes record piloting in Salford
• Can choose to have letters about themselves
  copied to their HealthSpace account rather than
  through the mail

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• HealthSpace sets the portal and security standard
  through which other patient records can be
  enabled for patient viewing
• The full GP record where the GP wishes to make it
  available to patients
• Patients can store URL pointers to abnormal
  scan/x ray results
• The coded information in both Summary Care Record
  and GP records enable context sensitive knowledge
  support through on line access to approved
  databases and factsheets

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Communicator
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Enables a secure communication channel between
patients and clinicians

• This can enable updates to records both
  demographic and clinical and many of the features
  that follow
• The email addresses of both the clinician and the
  user remain hidden and communication is managed
  through webforms in HealthSpace
• The invitation to a patient to be communicator
  linked is under the control of the clinician

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Communicator Challenges

• Not all clinicians and all patients will want to
  use communicator
• Not to be used for urgent clinical communications
• Will this create a two tier service?

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• Can enable better continuity of care as patients
  are able to exploit this medium for support if
  they are unable to see the clinician.
• Time zone management if patient abroad
• Enables patients who otherwise may feel it is too
  risky to travel if they cannot keep in touch with
  their clinical team

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• Ordering repeat prescriptions
• From GP
• From pharmacist
• Patient and service experience enhanced as clear
  communication enabled and securely recorded

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Self Care
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Patient sending information to their clinician
and records

• Regular monitoring of physiological measures sent
  directly to clinical records
• Ability to send digital photo of their progress
  say in ulcer management
• Ability to receive back advice on medication
  levels following the sending of information

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Receive information securely

• If chosen as medium for communication HealthSpace
  can be used for
• Screening reminders
• Opportunity for patients to ask for information
  of relevance to their conditions to be sent to
  them
• Sending opportunities to help with research
• Conferences and self help groups

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Better Care
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Enables patients to contribute to management

• Ability to fill in pre consultation
  questionnaires
• Send choices regarding advanced directives
• Preferences when in hospital setting eg gender of
  clinician, dietary requirements, pastoral
  involvement
• Organ donor consent status

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Appointments
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Make appointments directly with the service

• Choose and book which enables authorised
  secondary care appointment booking directly by
  the patient
• Direct access to appointments in primary care
  through the HealthSpace portal into GP and other
  systems

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Privacy and Security
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Assures secure access

• View alerts generated within SCR
• Check consent status
• Approve carers to have access
• Limit carers view of HealthSpace against filters
• View who has last logged onto HealthSpace and when

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Potential business reengineering as a consequence

• Cognitive behavioural therapy on line with
  results directly back to clinician
• INR monitoring and results directly back to
  patient
• Managing larger case load as work smarter with e
  consultations in the mix
• Case conferences chaired by patient with key
  actions posted by patient into their section of
  SCR
• Extended hours offered by e-consultation
• Impact of communicator on the service provision
  to Residential care homes and how GPs and other
  clinicians can communicate directly with the
  carers there on behalf of patients

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When will this new functionality start?

• Salford diabetes record
• Communicator
• Patients sending messages to SCR

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How does patient access to records change our
perception of medical records?

• Fundamentally records move to being a resource
• Fears of clinicians
• Accuracy and workload if challenged
• The need to illuminate and explain the records
  and consequent workload
• Protecting patients from the uncertainties we
  shoulder on their behalf

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How does patient access to records change our
perception of medical records?

• Change in the relationship
• Patient access to information leads to control
• Partnership between patients and clinicians in
  management of care
• Resultant change in dynamic of service delivery
• Protection or paternalism?

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Legal Issues

• Data Protection act
• Check for 3rd party information
• Check that patient doesnt come to harm by seeing
  records
• How practical is that when records are
  continuously available to patients

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Moving Forwards with HealthSpace

• Gillian Braunold
• Clinical Director
• Summary Care Record HealthSpace