Dr Declan Woods - Connected Health


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GP Perspective on Connected Health

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Dr Declan Woods - Connected Health

  1. 1. Dr Declan Woods National Healthcare Conference 1st April 2014 Technology & Digital IT Forum-Connected Health
  2. 2. What is General Practice? • Vast majority of patients are managed within the community by GPs • The number of patients presenting to general practice is increasing from year to year • General Practice is the first point of contact with the health services for most patients • Cradle to grave
  3. 3. Current Technology in General Practice What technology is working well in General Practice? • GP Software • Healthlink – NIMIS – Lab Reports – eReferrals – Cancer, Early Arthritis – GP Out-of-Hours Messaging • PCRS
  4. 4. Caredoc Case Study • Excellent example of a fully integrated healthcare service with a complete electronic patient record • Award winning ICT platform developed over the last 15 years • Interoperable with other healthcare services
  5. 5. The Caredoc Organisation • GP Cooperative with 670 participating GP members • Not for profit company • Governed by a Board of Directors and Management Team, fully indemnified • Collaboration between GPs, HSE and Department of Health (since 1999)
  6. 6. What is Caredoc? Integrated Technology Platform
  7. 7. Joined up and integrated A focus on patient care needs Delivers high quality appropriate healthcare services Easily navigable for patients & staff ICT Interoperable, scalable & adaptable Caredoc’s approach
  8. 8. Caredoc patient centric ICT System • Seamless flow of electronic data through the patient journey • Data precedes the patient • Clinical Decision Support Software • Special Patients Notes / Care plans • IT connectivity to Treatment Centres and Mobile Units • Technology devices: Workstations, Laptops, Tough books and Tablets. • Linked to daytime G.P. Surgery software • Linked to the Acute Hospital Network – SLHK • Deaf/Hard of hearing texting service using 3G/GPRS mobile solution
  9. 9. Complete out-of-hours electronic Patient Record • Patient demographic details • Call handler notes • Nurse triage notes • Access to previous encounters (if the patient has been seen in the out-of-hours or CIT service) • Doctor consultation notes • Receptionist notes • “Special Patient notes” – important information about a patient (palliative care notes, drug notes etc – received from patients own GP) • Full auditable files • Event list – who interacted with the patient record • Complete log of all people who have accessed the file (both to add notes but also who viewed the file) • Nothing deleted from files – all information, even when altered, is available for audit
  10. 10. Implications for clinical practice Visibility & Accuracy • Information on patient interactions with healthcare services is captured in Electronic Patient Record database. Seamless flow of electronic data through the patient journey • Patient information is delivered in a timely and efficient manner. • Information precedes the patient. • Rules out unnecessary duplication. • Productivity is improved. • Provides clear visibility for the GP on their patients at all times. Information precedes the patient at each point of care
  11. 11. Caredoc Network • Network that covers the South East of Ireland (Carlow, Kilkenny, Waterford, Tipperary, Wexford, South Wicklow) – Approximately 834 system users – 13 Treatment centres – Users: Doctors, Triage Nurses, Clinical Nurses, Nurse Prescribers, Call Handlers, Receptionists, Administration – Mobile Units (Home Visits & CIT Visits) • Connectivity with the NEDOC , D-DOC and NoWDOC Out-of-Hours Services
  12. 12. The right care at the right time CAREDOC operates with The Nightingale Teleguides - an algorithm-based clinical decision support software (CDSS) tool . They are a set of symptom based, age and gender specific clinical algorithms, which enable the right person to reach the right level of care at the right time. Clinically Safe & Evidence-Based Improves efficiency of Remote Patient Management Reduces unnecessary A&E / GP visits Expert Clinical Decision Support Software
  13. 13. Challenges facing General Practice • Our aging population • Increasing life expectancy • The rise in complex chronic health conditions • Finite budget • Limited resources – Manpower • Lack of Individual Health Identifiers (IHI) for every citizen • Lack of ICT Interoperability and connectivity
  14. 14. What is required? • Increased collaboration between healthcare providers • Need for effective and appropriate care to be delivered by the most appropriate healthcare provider • Build services in the community • Integrated technology to support collaboration
  15. 15. Reality of Healthcare Services No single discipline can practice in isolation or meet all of the changing needs of patients today -- Interoperable ICT systems, collaborative research and healthcare partnerships are critical to avoid silos and improve patient care. HEALTHCARE PROVIDERS INDUSTRY RESEARCH & TECHNOLOGY COLLABORATION PATIENTS
  16. 16. eReferral & eDischarge ePrescribing & eMedication Management Research, Predict ive Modeling & Data Mining Enhanced connectivity Telehealth  New areas of interoperability and connectivity  Sharing of information more effectively  Expand the concept of healthcare through new services to create greater efficiencies  Individual Health Identifiers Examples of technology projects that need to be addressed: Next steps
  17. 17. eHealth Strategy 2013 • International experiences – Denmark – UK Whole system Demonstrator • eHealth can deliver better patient care, improved outcome and increased savings • Change management and collaboration • Investment in healthcare ICT – 0.85% of total healthcare budget relative to EU 2-3%