LTC Lunch & Learn: Information sharing for care coordination, 29 April 2015
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LTC Lunch & Learn: Information sharing for care coordination, 29 April 2015 with Adam Hatherly, Senior Solution Architect, Health & Social Care Information Centre. Information Sharing for Care Coordination. Wednesday 29 April 2015 Hosted by Beverley Matthews, Long Term Conditions Programme Lead, NHS Improving Quality, Adam Hatherly, Senior Solution Architect, Health and Social Care Information Centre and Christine Wike, NHS Improving Quality. Learning outcomes will include: Guidance on mapping out your business and technology environment and understanding what information flows you need Understanding the "patterns" of interoperability; selecting patterns and building a sharing "roadmap" Understanding national systems and standards which can help you. - See more at: http://www.nhsiq.nhs.uk/improvement-programmes/long-term-conditions-and-integrated-care/long-term-conditions-improvement-programme/webinar-series/previous-webinars.aspx#sthash.0uO8KBsy.dpuf
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LTC Lunch & Learn: Information sharing for care coordination, 29 April 2015
- 1. WELCOME Wednesday 29 April 2015 Webinar Information Sharing for Care Coordination
- 2. Information Sharing for Care Coordination Wednesday 29 April 2015 12.30pm – 1.00pm Adam Hatherly Senior Solution Architect, Health & Social Care Information Centre Christine Wike NHS Improving Quality & Beverley Matthews LTC Programme Lead, NHS Improving Quality
- 3. Beverley Matthews LTC Programme Lead NHS Improving Quality Beverley.matthews@nhsiq.nhs.uk
- 4. www.england.nhs.uk LTC Year of Care Commissioning Programme: 4 • 5 Early Implementer sites • 35 Fast Followers • Whole Population Datasets • Implementation Guide • Simulation Modelling • Specialist Support Team
- 5. www.england.nhs.uk LTC Framework Improvement Programme: 5 Organisational & Clinical Processes Informed and engaged patients and carers Health & Care Professionals committed to partnership working Commissioning • Information and technology • Case finding & risk stratification • Care Planning • Safety and Experience • Guidelines, evidence and national audits • Care Delivery • Self Management • Information and Technology • Group and Peer Support • Care Planning • Policies for carers • Voluntary sector patient & carer support • HSC Integration • Multi Disciplinary Teams • Culture • Workforce • Technology • Care Co- ordination • Care Planning • Needs Assessment and Planning • Joint Commissioning • Metrics and Evaluation • Service User and Public Involvement • Contracting and Procurement • Care Planning • Tools and Levers The table below sets out some of the key components needed to deliver the central aim for LTC Framework - Person Centred Coordinated Care
- 6. Long Term Conditions Dashboard http://ccgtools.england.nhs.uk/ltcdashboard/flash/atlas.html Long Term Conditions House of Care Toolkit http://www.nhsiq.nhs.uk/improvement-programmes/long-term-conditions-and-integrated-care/long-term- conditions-improvement-programme/house-of-care-toolkit.aspx Simulation Model http://www.simul8.com/viewer/download.htm #LTCyearofcare #LTCimprovement @NHSIQ Tools and Resources:
- 7. For registration details, email LTC@nhsiq.nhs.uk LTC Lunch & Learn Series ….coming soon… Date Webinar Hosted by Bev Matthews & 1 May 2015 12:30 – 13:30 Information as a Therapy Mark Duman MRPharmS Director Monmouth Partners 6 May 2015 12:30 – 13:30 Prevention & Effective Interventions in Frailty Helen Lyndon Nurse Consultant Older People, Clinical Lead Frailty, NHS England 27 May 2015 12:30 – 13:30 Primary Care Workforce for the 21 Century Webinar Sharon Lee Primary Care Workforce Facilitator South Kent Coast CCG 4 June 2015 12.30 – 13.30 Home Checks/Prevention Peter O’Reilly & Geoff Harris Manchester Fire & Rescue Service 9 June 2015 12 noon – 1pm Health 1000 Rob Meaker Barking, Havering & Redbridge
- 8. Information Sharing for Care Coordination • Mapping out your business and technology environment and understanding what information flows you need. • Understanding the “patterns” of interoperability; selecting patterns and building a sharing roadmap. • National Systems and Standards which can help. of Care foundation. Today’s Learning Outcomes
- 9. Information sharing for care coordination Lunch and Learn WebEx 24th April 2015 Adam Hatherly, Senior Solution Architect, HSCIC
- 10. Learning Objectives • Mapping out your business and technology environment and understanding what information flows you need • Understanding the “patterns” of interoperability: Selecting patterns and building a sharing roadmap • National Systems and Standards which can help
- 11. Definition • Interoperability: “The ability to safely share and make use of shared information and services, regardless of the systems in use, and who supplied them” Presentation Information Application Technical Interoperability e.g. Common look-and-feel, standard headings, etc. e.g. common information, definitions, clinical coding, etc. e.g. sharing of functionality, common integration patterns, etc. e.g. common networks, shared technology capabilities, etc. • The Main focus for this session is the Application / Technical aspects for real-time sharing of patient information
- 12. Establish your vision and scope Inter-regional/ national Regional Institutional Departmental • Information sharing typically operates at different levels of detail (richness) at different scales
- 13. Mapping out the local landscape • Understanding where you are starting from • Identifying what can be re-used or built upon National Systems And Services Ambulance Service CSU GPs Community Trust Hospice Acute Trust <<Clinical Portal>> <<TIE>> <<PAS>> <<EPR>> OOH <<OOH>> Local Authority <<Mental Health>> <<Palliative Care>> <<Social Care>><<Mental Health>> <<Data Warehouse>> PDS C&B DBS SCR <<Other Specialties>> Various Systems <<Community>> <<Order Comms>> <<Order Comms>> Prisons <<EPR>> NHS Mail <<EPR>> <<111>> <<School Data>> <<Patient Portal>> <<MH Care Plans>> <<Email>> EPS <<GP Comms>> <<GP Comms>> <<CAD>> <<Data Warehouse>> <<MI & Risk Strat>> <<Triage>> CMS DOS SUS (PbR) SCRa <<Data Warehouse>> <<A&E>> <<MIU>> <<Scanning>> <<Scanning>> <<PAS>> <<Bed Mgmt>> MPI <<Triage>> <<DW>> DTS <<PTS>> <<ITK>> <<ITK>> <<Scanning>> <<Palliative Care>> <<Palliative Care>> <<Manual Processing>> Voluntary & Charitable Sector <<Various Orgs>> Various Systems <<VCS System>> <<Reporting> >
- 14. Identify Information Sharing Needs • There will not be a single “silver bullet” solution. • Map out the most important information flows. • This will allow a “roadmap” to be developed to progressively build the sharing capabilities over time. • Some examples might be: – Mental Health: Sharing standardised mental health “personal assessments” across integrated teams working in the community trust and the local authority. – Child Protection: Unscheduled care services (including A&E and the Ambulance Service) want to know if a child who presents for care is subject to a child protection plan. This includes cases where the mother is pregnant, and the unborn child requires protection. – End of Life Care: Manage the sharing and co-ordination of patient’s end of life care preferences between all services providing end of life care. • Once you have identified the needs, you can start to discuss specific content to be shared, and approaches for sharing it.
- 15. Define and agree new information flows • Map out how the information sharing process will work, and review with business stakeholders – e.g.: A COPD patient goes for a regular review of their condition with the case manager in the CREADO team, and takes along some recent test results, which feed into a discussion as part of reviewing their care plan. The patient and clinician discuss the results and agree some new and updated actions/needs, which the clinician updates in the patient’s care plan in the shared COPD record. 2 1 The care plan is automatically synchronised with the clinical systems used by the GP, community, OOH and A&E teams. Care Plan The patient is given an updated hard-copy of their self-care plan. CREADO Clinician Shared COPD Record Self- Management Plan (Paper) Care Plan SyncA Timescale LONG In Current Plans? NO Interaction Care Plan SyncA 3 GPCommunity 3 OOH 3 A&E 3 CREADO = Community Respiratory Exacerbation And Discharge Outreach. Focused on preventing readmission
- 16. Introducing Patterns • A “pattern” is a formal way of documenting a solution to a design problem in a particular field of expertise – this case sharing clinical information between systems. • Patterns are not mutually exclusive: many real solutions will use more than one pattern. • Solutions may evolve from simpler to more complex patterns over time. • Some patterns will be better for specific sharing needs than others – there is no “one size fits all”. • Some patterns will scale better to larger populations. • Some patterns require additional capabilities or services to be in place.
- 17. Summary of Patterns Sys A B Data A B Src Con Con Src Brk Con Single Shared Application Click-Through Send point-to point / Broadcast Message Broker Src Rep Con Con Portal Store and Notify Shared Repository Registry Repository Ptl A B N Do cu m en t So ur ce Src Rep Con ceSrc Rep Reg Con http://developer.nhs.uk/library/architecture/integration-patterns/information-sharing-patterns-summary/
- 18. Messaging TLSMA System A System B Supporting Capabilities Endpoint Directory Organisation Directory User Directory Reference Data SSO RBAC Messaging Standards Registry Citizen Identity Patient Index DSA Repository Relationship Service Consent Service PKI Subscription Service N3 Internet Broker / Middleware
- 19. Building a Roadmap • It is not realistic to wait for national standards and capabilities before beginning to address local sharing challenges. • Equally, once national capabilities and standards are in place, it will take some time for these to be adopted by system suppliers. • Local organisations also need to build roadmaps that allow them to progressively migrate to using more mature patterns, and national capabilities when they are in place, and it makes sense to do so. • For example, a locality may build a roadmap for sharing a specific type of information (e.g. care plans): Simple notification and click-through patterns to provide access to plans held in clinical systems Implement a shared repository and submit plans to it Link the repository with a region-wide registry to link up with other repositories across a wider region Link the region-wide registry into a national registry to allow records to be located nationally.
- 20. National Systems and Standards • National Systems: – N3: Private Network – NHSMail: Secure Email – Smartcards: Authentication and Role Based Access Controls – PDS: Demographics/NHS Number – SCR: Summary Care Record – GP2GP Transfers – Choose and Book/eReferrals – Electronic Prescriptions Service – CPIS: Child Protection Information System – Secondary Uses Service / Hospital Event Statistics • National Standards: – Clinical Coding: READ2, CTV3, SNOMED CT – Information Standards: SCIE (formerly ISB), Data Dictionary – Interoperability: Messaging Specifications (ITK), Documents (CDA) – Clinical Safety – Security • Emerging Standards: – HL7 FHIR
- 21. Interoperability Toolkit • The NHS Interoperability Framework (also known as the Interoperability Toolkit or “ITK”) is: – National standards – Implementation guides – Accreditation scheme • Supports interoperability within local orgs and across local health communities. • The ITK is not a piece of software • Moving away from bespoke interfaces – Reducing complexity and therefore expenditure • Publishing a series of common specifications – Policing the deployment through ITK accreditation – Bring a level of standardisation to the market
- 22. NHS England Interoperability Framework Information Governance References standards, policies and guidance responsible for ensuring quality, security and lawful use of information shared between systems. Identifiers Used for the unique identification of: patients and service users; NHS and non-NHS organisations, services, workers and locations; and other physical and non-physical entities requiring unique identification, e.g. physical products and communication endpoints. Codes and Terms Used to assert the precise meaning of data to enable the consistent recording, querying and interpretation of information. Document Headings Standard headings for organising data for entry and display particularly structuring free text contents which in turn can convey the clinical and business meaning in a human readable form. Data Structures (logical) Used to create consistent dataset definitions that can be re-used across different implementation standards or technologies. Message Structures (physical) Used to create implementation specifications that define how datasets are realised by different implementation standards and / or technologies. Communication Patterns Describes the re-usable architectural approaches for sharing health and care information. Technical Transport (physical) Interface mechanism by which data is exchanged between sending and receiving endpoints. • Work is ongoing (supported by HSCIC) to produce a range of guidance and resources to support local information sharing.
- 23. Questions?
Editor's Notes
- Map out the organisations involved, key information sharing needs
- Map out the organisations involved, key information sharing needs
- Nothing will exactly “fit” into these patterns – they are abstract and explain typical approaches – real implementations may differ from the exact characteristics outlined here. Not necessarily exhaustive.
- Questions?
- Questions?