E HEALTH – ENABLING HIGH QUALITY AND CO-ORDINATED CARE FOR PEOPLE LIVING WITH LTC’s<br />
CONTENT<br />Some key challenges<br />Integrating Care – supporting MDT’s<br />Reshaping delivery of Older People’s Care<b...
HEALTHCARE DEMAND IS GROWING<br />A new Ninewells<br />Hospital by 2031!<br />
ANGUS CHP – PATIENT PROFILE<br />    Virtual Wards focusing on <br />Tier 4 , Innovative Step Down <br />Services are key ...
ENSURE OUTCOMES ARE DELIVERED….<br />Project <br />Definition<br />Statement<br />Benefits <br />       Statement<br />Pro...
RESHAPING CARE FOR OLDER PEOPLE – OUTCOMES 1<br />
RESHAPING CARE FOR OLDER PEOPLE – OUTCOMES 2<br />
User<br />Device<br />Access<br />TECHNOLOGY ENABLING INTEGRATED CARE<br />Applications<br />Security<br />Service<br />Co...
IHI CARE CO-ORDINATION MODEL<br />Person Centred<br />For people with multiple needs<br />Personalised Multi-channel inter...
INTEGRATED CARE(VIRTUAL WARDS) - THE CHALLENGE<br /><ul><li>Emergency admissions and associated bed days not hitting HEAT ...
Challenge around Health Population Management (HPM)
Lack of effective collaboration between Health and Social Care
Alignment of e Health with key HEAT T6-T12 outcomes
Key improvement areas:</li></ul>Reduce all age Emergency Beds<br />More effective HPM<br />Standard operating procedures<b...
ePharmacyProgramme<br />
SUPPORTING THE NEW COMMUNITY PHARMACY CONTRACT<br />Acute Medication Service eAMS (& ETP):<br /><ul><li>eAMS enables the g...
SOME IDEAS FOR THE FUTURE<br />Telepharmacy Electronic Dispensing and Payment Processing for NHS24, OOH Pharmacy & Pandemi...
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eHealth – Enabling High Quality and Coordinated Care for People with Long Term Conditions

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The Atos Origin Alliance will provide an overview of how eHealth can support the delivery of high value, coordinated and personalised care for people living with Long Term Conditions. There will be particular focus on how we can support the Reshaping of Older People’s Care pathway from a whole systems perspective.

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eHealth – Enabling High Quality and Coordinated Care for People with Long Term Conditions

  1. 1. E HEALTH – ENABLING HIGH QUALITY AND CO-ORDINATED CARE FOR PEOPLE LIVING WITH LTC’s<br />
  2. 2. CONTENT<br />Some key challenges<br />Integrating Care – supporting MDT’s<br />Reshaping delivery of Older People’s Care<br />E Pharmacy current and future opportunity<br />The benefits<br />
  3. 3. HEALTHCARE DEMAND IS GROWING<br />A new Ninewells<br />Hospital by 2031!<br />
  4. 4. ANGUS CHP – PATIENT PROFILE<br /> Virtual Wards focusing on <br />Tier 4 , Innovative Step Down <br />Services are key to success! <br />Macro Integrator<br />NHS Tayside and Angus Council<br /> 724<br />2%<br />LTC<br />Population<br />North West<br />187<br />North East<br />191<br />South<br />346<br />LEVEL 4<br />INTENSE <br />CASE <br />MANAGEMENT<br />VIRTUAL<br />WARD<br />ANTICIPATORY<br />CARE PLANS<br />PATIENT <br />PASSPORTS<br />CASE<br />MANAGEMENT<br /> 10148<br />28%<br />LTC<br />Population<br />LEVEL 3<br />CASE<br />MANAGEMENT<br />North West<br />2631<br />North East<br />2673<br />South<br />4844<br />PRO-ACTIVE<br />CONTACT<br />SUPPORTING<br />SELF CARE <br />70%<br />LTC <br />Population<br />LEVEL 2<br />SUPPORTED <br />SELF CARE<br /> 25372<br />North West<br />6577<br />North East<br />6684<br />South<br />12111<br />PRO-ACTIVE<br />CONTACT<br />SUPPORTING<br />SELF CARE <br />LEVEL 1<br />HEALTHY<br />COMMUNITIES<br /> 72487<br />66%<br />Overall<br />Population<br />North West<br />18790<br />North East<br />19096<br />South<br />34601<br />LTC’s<br />Asthma<br />6101<br />COPD<br />2056<br />Diabetes<br />4698<br />HBP<br />16423<br />CHD<br />5318<br />Obesity<br />11854<br />
  5. 5. ENSURE OUTCOMES ARE DELIVERED….<br />Project <br />Definition<br />Statement<br />Benefits <br /> Statement<br />Project <br /> Status<br /> Report<br />Is used for:<br />Stating your case for change<br />Current state analysis<br />Evidence / Data<br />Envisaged Change<br />Summarise benefits<br />Is used for:<br />Define benefits in detail<br />Define appropriate measures<br />Summarise enabling changes ( PP&T)<br />Summarise milestone tracking<br />Is used for:<br />Report on delivery progress.<br />Report on Benefits Realisation against plan.<br />Escalate to Project Board or EMT for decision, support etc<br />Multi- disciplinary Project <br />Board, Clinical and <br />Finance essential <br />
  6. 6. RESHAPING CARE FOR OLDER PEOPLE – OUTCOMES 1<br />
  7. 7. RESHAPING CARE FOR OLDER PEOPLE – OUTCOMES 2<br />
  8. 8. User<br />Device<br />Access<br />TECHNOLOGY ENABLING INTEGRATED CARE<br />Applications<br />Security<br />Service<br />Complex <br />Case<br />Management<br />Collaboration Tools<br />Staff ID<br />Virtual<br />Database<br />Case<br />Management<br />Clinical Portal<br />RBAC<br />PMS<br />GP<br />Community<br />Health&<br />Social<br />Pro-active<br />Contact<br />TELEHEALTH<br />PREDICTIVE RISK<br />TELECARE<br />BUSINESS ANALYTICS<br />Prevention<br />Integration Platform<br />
  9. 9. IHI CARE CO-ORDINATION MODEL<br />Person Centred<br />For people with multiple needs<br />Personalised Multi-channel interface<br />Family, associated assets<br />Family<br />Social Care<br />Peer Groups<br />Carer/s<br />Voluntary<br />Goals(G)<br />Co-ordination(C)<br />PATIENT<br />IDENTIFICATION<br />OUTCOMES<br />Value<br />Proposition<br />Service<br />Delivery<br />Service<br />Design<br />Supporting with enabling technology<br />CARE CO-ORDINATOR<br />Predictive Risk<br />Tools<br />GP Systems<br />Community Information Systems<br />Telehealth<br />Telecare<br />Performance Management<br />Business Analytics<br />
  10. 10. INTEGRATED CARE(VIRTUAL WARDS) - THE CHALLENGE<br /><ul><li>Emergency admissions and associated bed days not hitting HEAT T12 target..
  11. 11. Challenge around Health Population Management (HPM)
  12. 12. Lack of effective collaboration between Health and Social Care
  13. 13. Alignment of e Health with key HEAT T6-T12 outcomes
  14. 14. Key improvement areas:</li></ul>Reduce all age Emergency Beds<br />More effective HPM<br />Standard operating procedures<br />Effective MDT working<br />Effective medication concurrence<br />
  15. 15. ePharmacyProgramme<br />
  16. 16. SUPPORTING THE NEW COMMUNITY PHARMACY CONTRACT<br />Acute Medication Service eAMS (& ETP):<br /><ul><li>eAMS enables the generation and delivery of 1.6M electronic prescription messages per week at all of Scotland’s 1000 GP Practices and used in all 1200 Pharmacies. This improves patient safety through assurance for patient and medication item selection and allows for significant efficiencies to be achieved in payment processing ( £3.2M+ pa in efficiency savings for National Services Scotland.)</li></ul>Chronic Medication Service eCMS<br /><ul><li>eCMS improves the care of patients with long term conditions through a systematic approach to their care, enables eligible people to register with a community pharmacy of their choice, to have a personalised Pharmaceutical Care Plan record created and monitored and to have ‘serial’ prescriptions to be created to cover up to a years worth of medication. The medication will then be dispensed and monitored in their registered pharmacy. Reduces patient visits to GPs and reduces the number of paper prescriptions plus improves medicines management & reduces the drugs budget.</li></ul>Minor Ailment Service eMAS<br /><ul><li>eMAS aims to support the provision of direct pharmaceutical care within the NHS by community pharmacists to members of the public with a common self-limiting condition. enables eligible people to register with a community pharmacy of their choice and have their common conditions treated, including prescribing, by their community pharmacist on the NHS without the need to visit a GP and enabled by a revolutionary remuneration process</li></li></ul><li>LOOKING FORWARD TO A BETTER FUTURE<br />
  17. 17. SOME IDEAS FOR THE FUTURE<br />Telepharmacy Electronic Dispensing and Payment Processing for NHS24, OOH Pharmacy & Pandemics – Trial withUniversity of Aberdeen<br />ECS + PCRs arethe makings of anational patient summary record<br />ECS<br />PCRs<br />Patient<br />Registration<br />Service<br />InformationServicesDivision<br />Remote Electronic Prescribing (iPrescribe) mobile prescribing and pharmacy services – prototype 2011/12<br />ePharmacy<br />Message<br />Store<br />Payment process<br />PharmacyCareRecord<br />ePay rules engine<br />Scanning and message processing<br />Complianceblister pack technology ???<br />End to End Medicines & Compliance Management in NHSS – better dispensing and Pharmacy care informationsystems…add secondary care ePrescribing and compliance product to provide a unique medicines management service improving patient care and reducing costs through reducing re-admissions to secondary care and managing the drugs budget<br />Delivering beneficial change and efficiency gains and using innovative ways of sharing, developing and implementing to benefit the full patient journey<br />
  18. 18. INTEGRATED CARE(VIRTUAL WARDS) - THE BENEFITS<br /><ul><li>Test of change demonstrators commenced March 2011 following introduction of PEONY2…
  19. 19. Enabling technology being fully utilised
  20. 20. Aligning with local improvement initiatives eg CMR in Angus, Case Management and ACP’s across Tayside..
  21. 21. Envisaged benefits across Patient Access, Service Redesign and Patient Experience:</li></ul>Drive effective attendance at A&E<br />Reduction in unscheduled bed days<br />Effective discharge models<br />Focus on the right patients<br />Increase value multi-disciplinary team time<br />Net CRES of £1.5-2.0m per annum.<br />
  22. 22. INTEGRATED CARE(VIRTUAL WARDS) - THE APPROACH<br /><ul><li>Next future state workshop brought together over 70 integrated care professionals and patient groups…
  23. 23. Followed up be local sessions in CHP areas…
  24. 24. NHS Tayside worked with partners to develop new HPM toolset – PEONY2
  25. 25. Test of Change Demonstrators set up in each CHP
  26. 26. Wider collaboration with Social Care, Voluntary Sector and Social Care
  27. 27. Align outcomes with LDP, HEAT and Reshaping of Older People’s services</li></li></ul><li>SUMMARY<br /><ul><li>A whole system approach is key..
  28. 28. Identify high impact projects and prioritise resource..
  29. 29. Fully align with LDP and national outcome requirements
  30. 30. Quality improvement with associated CRES takes priority..
  31. 31. Early engagement of whole system stakeholders essential..
  32. 32. Build on best practice evidence and focus on reducing unwarranted variation…
  33. 33. Small steps, quick wins…</li>

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