Informing Healthcare

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Informing Healthcare The Welsh way forward
Deborah El-Sayed Programme Manager Informing
Healthcare NHS Wales
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Bore Da
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Delivering Better Public Services for Wales
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The Road Map for Informing Healthcare The
destination is not in dispute but there are
choices about how to get there

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Developing and Implementing Informing
HealthcareNHS Wales A Corporate Approach

• Use Local Knowledge and expertise
• Single organisation solutions are not scalable
• Single national projects are high risk
• Understand the problem before specifying the
  solution
• Build on local developments BUT keep them
  separate from national deployment
• An All-Wales National Architecture Design Board

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Developing and Implementing Informing
Healthcare Using good governance to get
stakeholder commitment

• National Conferences with real time decision
  making
• Clinical Leadership of all Service Improvement
  Projects
• IHC Clinical Team National Local Networks
• All-Wales National Architecture Design Board
• International Advisory Board
• Chief Exec and Assembly sign off Business Cases

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Developing and Implementing Informing
HealthcareA Supporting Role for the Private
Sector in Delivering Public Services

• Working Together
• - Capacity and Capability
• - Skills transfer inward investment
• - Long term relationship responsive to
  clinical needs
• - Standardisation and Innovation
• - Value for Money

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Developing and Implementing Informing
HealthcareDesigning Healthcare Services for
Wales
How are Patients Going to Be Treated?
What Information is needed for safe care?
How will systems be deployed and managed?
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Developing and Implementing Informing
HealthcareDesigned for Life Determines Our
Priorities
National Technology Architecture Better
Management Sharing of Information
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Developing and Implementing Informing Healthcare
Characteristics of Service Improvement Projects
Clinical Leadership Patient Involvement Understan
ding the Healthcare Problem Design and
Development
Main Output Knowledge to create a specification
for an all-Wales solution (User Design and the
Informed Customer)
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Developing and Implementing Informing Healthcare
The Individual Health RecordIts a matter of
Healthcare Design not just Standardisation
Schedule resources and run processes - manage
beds, tests, theatres, etc
Footprint of an institutional system e.g.
hospital systems,GP system
System to support Mrs Jones?
Ensure coordinated, coherent care, etc
Support clinical tasks, manage workflow, etc
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Developing and Implementing Informing Healthcare
Support for the Three Perspectives of
Healthcare
Information
Individual Health Record
Care Management Systems
Events
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Developing and Implementing Informing Healthcare
The Individual Health RecordThe Information
that Matters Most ..

• Designed to support the overall care of the
  individual
• Provides the information most important to the
  overall safety, effectiveness, and efficiency of
  an individuals care
• Personal details (identity and preferences)
• Care relationships ( who is involved in the
  patient care)
• Information from health events e.g. discharge
  summary, op letters
• Overall current state of health e.g. current
  prescribed medication
• Accessed and used by both professional carers and
  the individual - with an Audit trail
• Works with Care Management Systems

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Developing and Implementing Informing Healthcare
The Individual Health RecordAn Incremental
Approach

• Build 1 Impacts on emergency care
• Provides a summary of the GP record in GP OOH,
  AE, ambulances to improve decisions
• Copies of electronic clinical communications
  letters etc
• Build 2 Impacts on chronic disease management
• Provides specific view of a record to
  professionals involved in providing long term
  care e.g. for a diabetic
• Enables scrutiny of care of populations of
  patients
• Supports intervention and optimisation of care
  e.g. CDM call centres
• Build 3 Impacts on Vulnerable groups
• Maternity record , child health records , elderly
• Build 4 Impacts on self management
• Provides patients with access to their own health
  record

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Developing and Implementing Informing
Healthcare Its complex not just complicated
The National Architecture is flexible and is
sustainable in the long term
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Developing and Implementing Informing Healthcare
One Representation of the National Architecture
?

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Developing and Implementing Informing Healthcare
Investment Objectives

• To support and coordinate the redesign of working
  practicesto deliver patient benefits- Service
  Improvement Projects
• To make a shared view of clinical care available
  across NHS Wales- An Incremental Approach -
  The Individual Health Record
• To create a world class technical
  infrastructure so that information can be shared
  securely irrespective of organisational
  boundaries- A National Technical Architecture

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Informing Healthcare - Progress in 2005 Gaining
Clinical Commitment and Creating a Collective
Patient Focus

• Supporting and Preparing Local Organisations Data
  Quality, e-Library, Training, National Licensing
  and Framework Contracts - Access to IT, Health
  Informatics Professional Development
• Clinical Engagement and Commitment National
  Conferences, Clinical Networks, National Design
  Board, Consultation and Critical Mass,
• Service Improvement Projects Diabetes,
  Medication, Safety, Discharge Referral, Test
  Results, My Health On-Line Protoype
• Individual Health Record Agreed Design,
  Information from GP Systems, Consent
  Model, Development Projects supporting
  Unscheduled Care, National Strategy for Local
  Care Management Systems

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Informing Healthcare - Priorities 2006/7

• National architecture - strategy for local
  national care management systems
• Private sector capability capacity
• Clinical communications increase availability
  of whats already there
• Building secure universal access to clinical
  patient information starting with what matters
  most
• Patient safety - through improving identification
  and medicines management

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Informing Healthcare - Priorities 2006/7

• New models of service provision particularly
  for those with long term conditions
• My Health On Line - Improve web based information
  available to carers and patients
• Access to clinical guidelines and knowledge
• Health Informatics Professional Development
• Even More Clinical Engagement Nurses GPs

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Developing and Implementing Informing Healthcare
Why are we adopting this approach??

• Better chance of delivering early benefits to the
  people of Wales
• Puts IHC Core Principles and Values into
  Practice
• Clear Line of Sight from Investment to Benefit
• We have gathered strong National and Local
  Clinical and Managerial support for it.
• Reduces Risk Better Governance
• Learning from Experience - we think it will make
  a difficult task more achievable

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