Eddie Ritson / Jim O'Donogue - ECCH/TF3/S3 Group


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Eddie Ritson / Jim O'Donogue - ECCH/TF3/S3 Group

  1. 1. Telehealth – Benefits for the people of Northern Ireland Commissioner Perspective Eddie Ritson (ECCH) Provider Perspective Jim O’Donoghue (TF3 / S3 Group)
  2. 2. <ul><li>Improved quality of life, health & well-being </li></ul><ul><li>To be supported & enabled to self-care & to live as independently as possible </li></ul><ul><li>To be involved in decisions about them and to have some choice & control over their care & support </li></ul><ul><li>To have services which are integrated, flexible, proactive & responsive </li></ul><ul><li>To have services that are high quality, efficient & sustainable </li></ul>What do People Want?
  3. 3. NI Chronic Disease Challenge Department of Health (2008 ) Raising the profile of long term conditions care INIsPHO (2010) Making Chronic Conditions Count Population 1.8M H&SC budget £4.3Bn Rising to £4.66Bn in 2014/2015
  4. 4. <ul><li>Bring information to professionals, enabling more proactive, effective and co-ordinated community based care </li></ul><ul><li>Provide greater support for self-care and for carers </li></ul><ul><li>Part of a new way to manage increasing burden of chronic disease which is both more efficient and better quality </li></ul><ul><ul><li>“… investing to build the capacity to cope” </li></ul></ul>Vision for Remote Telemonitoring
  5. 5. <ul><li>Requirements </li></ul><ul><ul><li>Scaleable, mainstream service </li></ul></ul><ul><ul><li>end-to-end service adding clinical value </li></ul></ul><ul><ul><li>flexible enough to respond to individual needs and local circumstances </li></ul></ul><ul><li>Supporting the modernisation of service delivery </li></ul><ul><li>Framework to support other developments including telecare </li></ul>NI Remote Telemonitoring Service - Requirements
  6. 6. RTNI Service Requirements - Considerations National Local Clinical Outcomes Patient Experience Clinical Staff Financial Service Model Roles/Responsibilities Pathway Changes Delivery model Clinical outcomes Financial benefits Implementation costs
  7. 7. RTNI Service Requirements – Iterative Approach Commisioner Provider
  8. 8. Programme Structure <ul><li>6 year contract awarded March 2011 </li></ul><ul><li>Procurement, service definition and implementation process led by ECCH – a part of Public Health Agency </li></ul><ul><li>1 Service Definition, 5 customers </li></ul><ul><li>3,500 patients per annum </li></ul><ul><li>12 condition categories </li></ul><ul><li>2 - 52 week monitoring periods </li></ul><ul><li>>2.8 million monitored days </li></ul><ul><li>£18m investment </li></ul>
  9. 9. <ul><li>Comprehensive and robust Office of Government Commerce contract detailing all aspects of Authority and Contractor responsibilities </li></ul><ul><li>High level of detail of service definition & contractual requirements : </li></ul><ul><ul><li>Detailed definition of every aspect of the service to be provided (221 Authority requirements) </li></ul></ul><ul><ul><li>Detailed service levels and associated penalties (20 for ‘core’, 8 for ‘additional’ & a further 19 quality markers) </li></ul></ul><ul><ul><li>Extensive reporting, automated performance monitoring </li></ul></ul><ul><li>1 Service definition with 5 customers : </li></ul><ul><ul><li>Joint specification, governance and central infrastructure </li></ul></ul><ul><ul><li>5 local implementation plans </li></ul></ul><ul><ul><li>Provision of ‘Core’ and ‘Additional’ services </li></ul></ul>Unique Elements of RTNI - Managed Service Approach
  10. 10. <ul><li>Contract Structure </li></ul><ul><ul><li>6 year contract – Long term commitment </li></ul></ul><ul><ul><li>Flexibility : patient-days, monitoring periods, monitoring conditions </li></ul></ul><ul><ul><li>Bottom-up activity models per condition </li></ul></ul><ul><ul><li>3,500 patients per annum, 2.8m monitored days </li></ul></ul><ul><ul><li>Agreed charging regime </li></ul></ul><ul><ul><ul><li>Standing charge for service availability – risk sharing </li></ul></ul></ul><ul><ul><ul><li>Per patient day monitoring charge </li></ul></ul></ul><ul><ul><ul><li>Installation & de-installation charge </li></ul></ul></ul><ul><ul><li>All backed up by detailed and fully transparent financial model </li></ul></ul>RTNI Managed Service - Financial Model
  11. 11. <ul><li>Promotion of ‘logic’ and evidence base </li></ul><ul><li>Pilots are helpful but need to be strategically aligned, of sufficient scale and designed to be tested </li></ul><ul><li>Scaling an application is significantly more complicated than piloting and takes time </li></ul>Critical Success Factors - Learning to Date
  12. 12. <ul><li>Alignment with strategic and operational health and social care agenda </li></ul><ul><li>Securing local, clinical and corporate support and ownership is vital. Focus on quality, safety and patient experience – efficiency is a by-product </li></ul><ul><li>Design, procurement and implementation are complex – requiring regional leadership, drive and resourcing </li></ul>Critical Success Factors - Learning to Date
  13. 13. <ul><li>More & better targeted proactive support to patients. </li></ul><ul><li>Enabling them to: </li></ul><ul><ul><li>have greater control </li></ul></ul><ul><ul><li>learn more about their condition </li></ul></ul><ul><ul><li>live more independent lives </li></ul></ul><ul><li>Bringing timely information to professionals to inform patient-centred case management </li></ul><ul><li>Enabling: </li></ul><ul><ul><li>improvements in the quality of care & quality of life for patients </li></ul></ul><ul><ul><li>reductions in inpatient admissions </li></ul></ul><ul><ul><li>optimised use of staffing resources </li></ul></ul>Anticipated Benefits
  14. 14. Telehealth – Benefits for the people of Northern Ireland Provider Perspective Jim O’Donoghue (TF3 / S3 Group) TF3 Service Development and Deployment Director
  15. 15. RTNI – The Managed Service Model
  16. 16. <ul><li>Providing all aspects of a joined-up service involving people, process and technology </li></ul><ul><li>Responsible from Referral to discharge </li></ul><ul><li>Meeting defined service requirements & SLAs </li></ul><ul><li>Technology selection, maintenance and equivalence </li></ul><ul><li>Incentivised to generate service delivery efficiencies </li></ul>RTNI Managed Service - Provider Responsibilities
  17. 17. Service Delivery Components
  18. 18. RTNI Service Design Processes Pathway redesign Process definition SLA planning Stakeholder Engagement Solution design Technology selection IT Design Clinical processes Non-Clinical processes Training QA Planning Program Governance Clinical Governance Evaluation Service Readiness Solution Readiness Technology Readiness
  19. 19. Service Design – Collaborative Process Commissioner Provider
  20. 20. RTNI Service Delivery Processes Enrol Patients Patient plan Install Train Activate Review Triage Coach Educate Patient Support Carer Support Issue Mgmnt Performance Monitoring Reporting Asset Mgmnt Clinical Governance Program Governance Evaluation of outcomes Service Efficiencies Further Integration New Conditions New Services New Technology
  21. 21. Partnering to deliver integrated services Underpinned by a strong contractual framework
  22. 22. Partnering to deliver integrated services Underpinned by a strong contractual framework
  23. 23. <ul><li>Building a provider consortium </li></ul><ul><li>Form early – provide consistency through procurement and delivery </li></ul><ul><li>Define the consortium core values </li></ul><ul><li>Build relationships and trust </li></ul><ul><ul><li>Managed Service Model </li></ul></ul><ul><ul><li>Significant up-front investment on both sides to define requirements and operating model </li></ul></ul><ul><ul><li>Creates a service based, technology agnostic framework for identifying needs and solutions </li></ul></ul><ul><ul><li>Demands a high level of working in partnership </li></ul></ul><ul><ul><li>Asks the provider difficult but very good questions </li></ul></ul>Provider Lessons Learned to-date
  24. 24. Working together to deliver Thank You