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Primary Care Expo 2019: all slides

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Slides from the day's presentations. See the agenda document for more details.

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Primary Care Expo 2019: all slides

  1. 1. Matthew Williams Programme Manager Primary Care Innovations Wessex AHSN
  2. 2. Wifi Smartphone Broadband Tablets Wearables Social Media Smart Watch Connected Home Smart Appliances Laptop Implementing Innovation – My Journey
  3. 3. Implementing Innovation - Standardisation
  4. 4. Implementing Innovation - Standardisation
  5. 5. Implementing Innovation – Standardisation in NHS
  6. 6. Video - Explaining Primary Care Demonstrator sites https://wessexahsn.org.uk/videos/show/229
  7. 7. Implementing New Technologies - NHS Technology can improve patient outcomes Technology can provide cost & time efficiencies for the NHS Generate little evidence on the full-scale potential Implemented without rigour, disciple or evaluation Innovations tested in isolation from complementary services Reach and impact are the biggest challenges No shortage of innovation in the NHS
  8. 8. Wessex AHSN Primary Care Demonstrator Sites Tier 4: Spread - Supporting the adoption of an innovation at system level Tier 3: Efficacy Trial - Determining whether the product or service is better than the alternative; comparative outcomes. Generating evidence of sufficient quality to present to NICE Tier 2: Functional Trial - Confirming that a product or service works as intended; i.e. does it function in primary care and impact the ‘need’ at all? Tier 1: Needs Validation - Confirming that the ‘need’ identified by the innovator is real, i.e. is there really a problem or opportunity to tackle? Provide opportunity to combine new technologies with changes in service delivery Primary Care Providers from: GP, Community Pharmacy, Community Services, Mental Health, Optometry, Dentistry Explore demonstrator sites at locality, federation and system level supporting STP, CCG and PCN
  9. 9. Wessex AHSN Primary Care Demonstrator Sites
  10. 10. Primary Care Innovations Programme Current Projects
  11. 11. AyogoT2D Description: • The Ayogo App to promotes confidence and enhance self- efficacy for those living with T2D • Behavioral management and educational content from multiple sources (NHS, Diabetes UK, Leicester Diabetes Centre). Benefits: • Patients gain confidence in self management of their condition resulting in better health outcomes. • They are also regularly signposted to relevant healthcare services, most specifically Retinal Screening, Foot Checks and attendance on structured education course (Desmond). Current Status: • Three pronged evaluation is currently in progress with results due to be completed Summer 2019. • Patient surveys • Practice data on attendance of 3 key services • App Usage data Tier 2: FunctionalTrial - Confirmingthat a product or service works as intended; i.e. does it function in primary care and impact the ‘need’ at all? Locations being tested: 7 Practices across SE Hampshire
  12. 12. Cardionetics Description: • 24/48 hour ambulatory ECG monitor designed specifically for use in Primary Care to assist in the early detection of cardiac arrhythmia in adults. Benefits: • Investigation for patients with symptoms of heart disease, such as palpitations, dizzy spells, shortness of breath, and fainting. • Tests to be undertaken and analysed in general practice, which can reduce the number of referral. • Improved local treatment for patients and cost savings for the NHS. Current Status: • Provision of hardware to practices and training has been completed as well as initial usage. • We have now started to collate data for evaluation. Tier 2: FunctionalTrial - Confirmingthat a product or service works as intended; i.e. does it function in primary care and impact the ‘need’ at all? Locations being tested: Park & St Francis Surgery St Mary’s Surgery
  13. 13. Diasend Description: • Diasend is a tool designed to work with a wide range of glucometers, to download blood glucose level data into a standard format. • A ‘plug in’ cloud based solution that seamlessly uploads and stores all diabetes patient data centrally. Benefits: • Self-monitoring of blood glucose (SMBG) in type 2 diabetics has a positive impact on HbA1c and long-term effects of the disease. • The detailed record of blood glucose levels taken over months, that will be available through use of the Diasend tool, can assist clinicians and patients with the identification of blood glucose trends. • Resulting direct alterations in treatment regimes help to manage diet and nutrition plans and inform exercise schedules. Current Status: • 94% of Paediatric Clinics and 85% of Adult Clinics currently use Diasend in Diabetic Review Clinics in Secondary Care. • Provision of Diasend hardware directly to primary care practices within a CCG where the device is already utilised within the local secondary care facility. • Project evaluation will focus on project implementation process as well as product success indicators. Tier 2: FunctionalTrial - Confirmingthat a product or service works as intended; i.e. does it function in primary care and impact the ‘need’ at all? Locations being tested: (TBC) One CCG and one PCN Proposed
  14. 14. Primary Care Digital Exemplars Description: To develop the digital maturity at two GP practices and develop a framework for other sites to achieve the same standard. AHSN Role is to : • Facilitate the adoption of digital innovations in the sites • Evaluate the project, contributing to the framework for Southampton City CCG GP sites to adhere to for achieving Digital Exemplar status. Benefits: • Improved online resources • Access to digital innovations to improve quality of care through preventative treatment. Current Status • AHSN arranges innovation demos at steering groups for sites to ask practical and clinical questions to ensure the innovations are meeting an unmet need • AHSN implements innovations on site and coordinates evaluation activities with AHSN colleagues and external evaluators R-Outcomes Locations being tested: St. Mary’s Surgery Shirley Health Centre
  15. 15. Dermicus Description: Teledermatology Solution provided through an intuitive phone- based Application as well as a web based platform for referrals. Benefits: • Reduced timescale of referral to consultant dermatologists. • Reduction in unnecessary face-to-face consultations, with side benefit of reduced cost of travel to patients/environment. • Increased primary care awareness of results and associated competencies. • Provide future solution for remote consultation Current Status • The Dermicus platform is scheduled to launch 3 initial Champion Site in July 2019 • Subsequent rollout to the remaining GP locations on the Island. • This will be initially evaluated by AHSN 6 months after launch. • Further work will then be done with integrating the platform with NHS systems with a view to further spread and adoption. Tier 3: EfficacyTrial - Determiningwhether the product or service is better than the alternative; comparative outcomes and costs. Generatingevidence of sufficient quality to present to NICE Locations being tested: All 16 general practices on the Isle of Wight plus central dermatology centre at Lighthouse Medical.
  16. 16. Lifelight Description: • Lifelight uses a camera on an iPad to scan a patient’s face and provide a reading of vital signs (blood pressure, oxygen saturation, heart and respiration rates) within 40 seconds – entirely contactlessly. • The AHSN is able to provide valuable real-world evaluations to demonstrate how Lifelight is more effective than current methods of taking clinical observations and how it can lead to preventative care measures. Benefits: The benefit for patients is that there will be a foundation of evidence to determine where Lifelight is most effective and why. • For example • Taking vital signs before a GP appointment so there is more time to discuss conditions or symptoms • Taking vital signs of a patient on a ward while they are sleeping to avoid disturbing them • Hosting Lifelight in dental practices or care homes could spot something such as high blood pressure a patient may not have known about until their next GP appointment Current Status • Lifelight implemented at Dorset dental practice SmileKind for a Health Education England funded Quality Improvement project • Becoming part of the innovations trialled in the Primary Care Digital Exemplars Tier 3: EfficacyTrial - Determiningwhether the product or service is better than the alternative; comparative outcomes and costs. Generatingevidence of sufficient quality to present to NICE
  17. 17. Mind Over Matter Description: • Mind over Matter is developing technology that gives you more control over the brain health that you can expect in your retirement years. • It aims to delay the onset and slow down the progression of dementia in millions across the world. • The equipment is designed to be used in either the waiting room or consultation room during the NHS Health Check visit (available to anyone aged 40-74 and registered with a GP) with risk scores displayed during the consultation. Benefits: The technology comes in two parts: • A device that works out the health of the your brain tissue (known as white and grey matter) by imaging your brain activity. • An app that helps you to lead the life that reduces your chances of developing dementia. Lifestyle changes could PREVENT one third of people from developing dementia. Current Status Wessex AHSN supported in gaining approval for Digital Health Catalyst funding and is supporting this innovation with sourcing a practice for feasibility study and coordinating clinical and patient focus groups. Tier 2: FunctionalTrial - Confirmingthat a product or service works as intended; i.e. does it function in primary care and impact the ‘need’ at all? Locations being tested: Currently planning towards Tier 2 Feasibility study in Q3 2019/20
  18. 18. 3. Current Footprint CCG Number of Demonstrator Sites Isle of Wight 16 Southampton 2 South East Hampshire 7 West Hampshire 1 Portsmouth 16 (TBC) North Hampshire TBC - One PCN Primary Care Digital Exemplars PCDS Current Footprint
  19. 19. Primary Care Innovations Next Steps Deliver on existing projects Build Portfolio of willing Demonstrator Sites Develop across various Primary Care Providers Identify Innovations ready for Primary Care Match Innovation with correct location For more information – email: Matthew.Williams@wessexahsn.net
  20. 20. Common Approach to Children’s Health http://www.catchapp.co.uk @catchapp_uk Primary Care Innovations EXPO Elevator Pitch
  21. 21. DERMICUSTeledermatology Platform: www.dermicus.com Company: www.gnosco.com Contact: philip@gnosco.se For fast and secure diagnosis of skin cancer and wound management
  22. 22. Healthy.io Web: https://healthy.io Twitter: @Healthyio1 Primary Care Innovations EXPO Elevator Pitch Smartphone enabled home testing • Early intervention • Reduced health inequalities • Digital self-management • Population health savings
  23. 23. Website - www.droplet-hydration.com Facebook - https://www.facebook.com/DropletUK/ Twitter - https://twitter.com/Droplet_UK Dehydration is an problem which increases risks of infections and falls, putting extra demands on GPs, carers, and Hospitals. Droplet® is the first visual and verbal hydration aid created to tackle this challenge • Droplet monitors the frequency of drinking. If the patient forgets to drink, Droplet’s flashing lights and voice messages are an instant reminder. Droplet has been awarded entry onto the 2019 NHS Innovation Accelerator programme. Primary Care Innovations EXPO Spearmark Health Ltd introducing
  24. 24. Pharmacy is Changing
  25. 25. Pharmacist role in Community pharmacy improves adherence to treatment regimens pharmacists are a valuable, easily accessible resource for advice and support helping patients take ownership of their health Answer questions about related health related conditions Offer guidance on the proper use of medications
  26. 26. Community pharmacy as a retail business Pharmacy Cuts?Retail stores closing down Online services to your door step People don’t want personalised service People know what they want People have access to information  Amazon ?
  27. 27. HOW WHAT WHEN WHERE HW3 Community pharmacy needs to change and innovate into a new service model
  28. 28. WHAT-Social Media (SM)
  29. 29. What about services ?  Bank services  Post Office  Goods are available online  Telemedicine  Safe environment to exchange information  DVLA is a great example  Patient needs that safety  Supply model doesn’t work no more
  30. 30. Customers need more information
  31. 31. What’s pharmacy done for innovation Websites SCR NUMSAS Medication delivered to your door steps or to your convenient store
  32. 32. Innovation
  33. 33. www.askhala.com
  34. 34. Integration
  35. 35. NHS 111
  36. 36. Latest updates https://www.chemistanddruggist.co.uk/news/pharmacies-gp-dmirs-14-pounds-per-consultation
  37. 37. www.fourteenfish.com Making appraisals easy for you and your organisation
  38. 38. HORIBA UK Ltd ‘Microsemi CRP’ Near-Patient Testing Analyser http://www.horiba.com/uk/medical/products/point-of-care/microsemi-crp/ Primary Care Innovations EXPO Elevator Pitch  Only analyser currently on market capable of a combined FBC & CRP measurement from a whole blood sample  Results available in just 4 minutes  Ideal for GP surgeries & community hubs  Can assist to streamline existing patient pathways  Promotes more judicious antibiotic prescriptions  Earlier sepsis detection  Reduction in pressure on local acute sites  Please come and see us in the Mayflower Suite or contact enquiries.uk@horiba.com for further details
  39. 39. What if all the workforce in a region was all in one place? What if… you could give them access to vacant shifts across your ICS that meet their skills? you only had to go through one recruitment process and receive a passport to work in all other organisations in the ICS? you could develop a more mobile workforce with greater diversity of skills by giving people access to work in different ways and different parts of your ICS? you could access volunteers and 3rd sector services through the same passport to book a package of support? Why wouldn’t you do that? We are, and you can too! Lantum.com Transforming the workforce with technology ourdorset.nhs.uk
  40. 40. Lifelight www.Lifelight.care Primary Care Innovations EXPO Elevator Pitch
  41. 41. Liva Healthcare Website www.livahealthcare.com Facebook https://www.facebook.com/LIVAHealthcareUK/ Twitter https://twitter.com/LIVAHealthcare Linkedin https://www.linkedin.com/company/livalife/ Primary Care Innovations EXPO Elevator Pitch
  42. 42. INNOVATION AND PRIMARY CARE 2019 Dr Anthony Leung Partner, Badgerswood Surgery
  43. 43. Video - Working together to improve anti-coagulation in Atrial Fibrillation https://wessexahsn.org.uk/videos/show/187
  44. 44. Video - BBC South Today News new mobile ECG devices that detects irregular heart rhythms https://wessexahsn.org.uk/videos/show/227
  45. 45. Video - MISSION COPD - an innovative approach to respiratory care (full version) https://wessexahsn.org.uk/videos/show/171
  46. 46. Respiratory COPD Carousel - 5 Month Results REAL OUTCOMES Dr Anthony Leung TOTAL BEFORE MEAN TOTAL AFTER 5 MONTHS MEAN ANNUALISED % REDUCTION ON ANNUALISED FIGURES STEROID/ ANTIBIOTICS USE FOR CHEST 31 1.63 10 0.55 24 23 UNSCHEDULED GP VISITS 61 3.21 10 0.55 24 61 111/OOH CALLS 2 0.125 0 0 0 100 A&E ATTENDANCES FOR CHEST 6 0.31 0 0 0 100 HOSPITAL ADMISSIONS FOR CHEST 1 0.05 0 0 0 100
  47. 47. PATIENT ENGAGEMENT PATIENT SUPPORT Dr Anthony Leung
  48. 48. AHSN A VISION FOR HEALTH IN BORDON NEW TOWN Dr Anthony Leung • Carousel Clinics • QA Respiratory • Atrial Fibrillation • NHH Haematology • Alivecor • Dementia Friendly Surgery • MSD & Ayogo • Lifelight • Demonstrator Site
  49. 49. AYOGO Dr Anthony Leung AYOGO
  50. 50. BORDON HEALTH HUB PATIENT SUPPORT Dr Anthony Leung
  51. 51. Video - The Role of Community Pharmacists in Supporting CVD Care https://wessexahsn.org.uk/videos/show/232
  52. 52. A VISION FOR HEALTH IN BORDON NEW TOWN Dr Anthony Leung STRETCHING OUT GP TIME
  53. 53. PARTNERSHIPS BORDON LOCATION Patient Focus •- Highest clinical standards •- Travel together •- Moral Compass Partners - Most efficient way for system - Pull not push - Win-win (Right design) Toolkit - Multi-disciplinary (> medical) - Diversification - Commitment yet nimbleness Evolution - Continuously learn & adapt - Can-do - Self-actualisation Culture - Take responsibility - ‘Proud to work here’ - Celebrate Success
  54. 54. PRIMARY CARE IN CRISIS:
  55. 55. SO WHAT BORDON LOCATION Savings to System Good PRGood Clinical Outcomes • Collaborate w/ Hospitals • Engage Patients • Enable Innovators • Fire up Staff
  56. 56. UK MEDICAL INNOVATION AWARDS INNOVATION
  57. 57. DEVELOPING YOUR IDEA DEVELOPING YOUR IDEA
  58. 58. ALL ABOUT PEOPLE ALL ABOUT PEOPLE
  59. 59. MONEY INNOVATION • Concept / Pre-seed • Seed Capital • Angel Investor Funding • Venture Capital Financing (Series A, B, C Rounds, etc) • Mezzanine Financing • IPO (Initial Public Offering)
  60. 60. EXEMPLAR GOOD MEDIA COVERAGE Dr Anthony Leung • Press • GP Nationwide Partnership Review • Goldberg report • Commonwealth report
  61. 61. Mind over Matter Dr Melissa Kapoor melissa@mind-medtech.com www.mind-medtech.com Primary Care Innovations EXPO Elevator Pitch
  62. 62. Mush Sarah Hesz- Co-Founder sarah@letsmush.com @mushmums www.letsmush.com Primary Care Innovations EXPO Elevator Pitch
  63. 63. OurPath www.ourpath.co.uk – Mark Davies mark@ourpath.co.uk @Mark_T_Davies Primary Care Innovations EXPO Elevator Pitch
  64. 64. quiqsolutions.com admin@quiqsolutions.com 01948 841116 A paperless approach for: • Quality Assurance • CQC Compliance • Audits QUIQSOLUTIONS • Surveys • Policies • Action Plans
  65. 65. RIVIAM Digital Care Paul Targett, Managing Director Paul@riviam.com www.riviam.com Primary Care Innovations EXPO Elevator Pitch Working with referrers, providers and citizens to improve lives through the delivery of digital, ​co-ordinated care
  66. 66. Accelerating digital primary care transformation at scale-what does it take? Dr Ruth Chambers OBE, Clinical lead for Staffordshire STP’s technology enabled care services (TECS) programme, digital workstream board
  67. 67. •Improved clinical outcomes •Quality/savings targets attained •Wealth creation eg patients stay in work •Upskilled patients & workforce •Patients stay independent Technology enabled care underpinning general practice at scale - the future Patient populations Outcomes Current Practice NHS/patient/public Commissioning/ providers NHS /social care Cluster Re-Design Technology enabled care under-pinning service re-design
  68. 68. Manage Your Health A new App for managing your long term conditions Available now on: Search for ‘Manage Your Health’
  69. 69. 79 Setting up Skype (clinician/patient) • Practice/other protocol: patient selection; patient consent; key steps • Champions – doctor, nurse, administrator • IT help – lift firewall, load Skype • Confirm medical defence cover • Organisational support: IG, connectivity, Caldicott Guardian
  70. 70. Skype in practice • GP practices to care homes (pictured) via Skype • Consultant to care home via Skype • Skype asthma reviews • Community pharmacist link to frail patient recently discharged from hospital & carer with meds use review
  71. 71. 5. Person selects and purchases own technology to support or improve their own health and/or social care and/or lifestyle habits: they may include goal setting, reminders, records of feelings/bodily measurements etc, action plans, information about best practice. They may or may not share their personal information/record keeping generated by the technology (eg health app) with a health/social care professional. 4. Shared delivery by individual professional with patient/carer: TECS initiated & delivered by health /social care professional who updates other health/social care professional(s) or teams involved in the patient’s care (ie giving information rather than interactive decision making between professionals). It might be that a patient requested the inclusion of their personal technology such as an app in their health or social care, that the initiating health/social care professional has adopted; with shared care plan agreed by patient, that optimises patient responsibility for their own care. 3. Shared multidisciplinary protocol with one TECS operator: ≥2 clinicians/ social workers, of different disciplines, in same organisation or setting; sharing (delegated) responsibility for providing TECS directly (≥1 mode of technology) for continuing care of same patient/≥ 1 conditions via agreed care plan. (This might be by the most senior/expert defining patient pathway and endorsing TECS protocol(s) for others to provide with real time support eg advice in person/by email; with shared care plan agreed by patient, that optimises patient responsibility for their own care.) 2. Shared sequential responsibility: ≥2 clinicians/ social workers, in different organisations/settings interface; so one hands over responsibility to the other for providing TECS directly (same mode of technology or different) for continuing care of same patient/same condition via agreed care plan.(This might be by the most senior/expert defining the patient pathway and endorsing the TECS protocol for others to provide with real time support eg advice in person/by email; with shared care plan agreed by patient, that optimises patient responsibility for their own care.) 1.Shared real time responsibility by ≥2 clinicians/ social workers, in different organisations/settings share TECS directly (same mode of technology or connected if different) for delivery of an agreed shared care plan of same patient/ same condition at same treatment phase (clinicians/ social workers have agreed responsibility via shared care plan agreed by patient, that optimises patient responsibility for their own care) Extent of responsibility for delivery of integrated & connected care via TECS
  72. 72. LTC pathways & Technology enabled care Patient –self care Evidence base Clinical teams Focus on ‘hot spots’ using data Technology - modes Digital innovation Minimise duplication – shared care plan Workforce training/ upskilling Digital Clinical Champions Developing confidence, competence, capability, continuity and capacity for delivery of technology enabled care General practice digitally able teams General practice TECS – accessible and available to all
  73. 73. Health Education England definition “Digital literacies are those capabilities that fit someone for living, working, learning, participating and thriving in a digital society.” What is digital literacy? @NHS_HealthEdEng
  74. 74. www.england.nhs.uk Comparison of 19 practices where 24 general practice nurses participated in digital upskilling programme; modes of TECS used before and after their action learning set (ALS) Case Study Staffordshire STP TECS
  75. 75. Benefits vary according to the practice and their adoption of specific mode of TEC and purpose. By February ’19, of 152 general practices across Staffordshire: 92 practices were using Facebook 21 practices undertaking video-consultations 28 practices using interactive telehealth 11 practices promoting apps 80 practices using ‘AliveCor’ for AF screening (smart phone compatible portable handheld ECG heart rate monitor) 23 practices undertaking online clinical consultation triage What do we seem to have achieved? Technology-enabled care services by general practice teams provided as routine patient care including via apps, video-consultation, telehealth, social media, GP Online. Expected / achieved benefits: enhanced productivity (practice teams); patient empowerment to self care and thus improved clinical outcomes; minimised unwarranted clinical variation; increased patient convenience.
  76. 76. Making digital delivery happen at scale in general practice settings Aim – Adopt technology enabled care as usual practice Scope – Which type(s) of technology will you use to achieve planned outcomes/ what LTCs and adverse lifestyle habits will you focus on/ what population health & wellbeing? Resources – Who/what do you/teams need – infrastructure, equipment, competence, practical support, capacity, communication, integrated working, clinical consultation triage? Outcomes – Improve patient /clinical management of long term conditions/adverse lifestyle habits – efficiently and effectively
  77. 77. Whzan Digital Health & IoT www.whzan.com paul.westbrook@whzan.com Primary Care Innovations EXPO Elevator Pitch
  78. 78. The Development People Contact: Lucy Hadley Email: lucy@thedevelopmentpeople.co.uk Website: www.TDPhealthcareplus.co.uk Twitter: @TheDevPeople Primary Care Innovations EXPO Elevator Pitch
  79. 79. mg.khan@writtenmedicine.com @WrittenMedicine Accessible Medication Information for Partners Academic evidence shows we; • Increased patient safety by 55% • Improved communication from 38% to 89% • Improved adherence by 82% • Improved patient experience by 80% ALL
  80. 80. YOURmeds www.yourmeds.net Dr Nitin Parekh (nitinp@marsoftware.co.uk) Primary Care Innovations EXPO Elevator Pitch
  81. 81. The Digital revolution in Primary Care Dr Mark Kelsey GP CCIO for HIOW Digital Transformation Programme Clinical Lead for Wessex Care Records Chair Southampton CCG
  82. 82. What is the digital revolution in health? • Think about how you use technology in your daily lives • Now think about how you or your patients can use technology to manage their health • What would the NHS be like if Amazon, Google or Uber ran it?
  83. 83. •41.8 million adults (aged 16 and over) used the Internet daily in Great Britain; •51% of users looking for health related information, •only 15% of adults made an appointment with a doctor or a health practitioner via a website in 2016 ONS reported in 2016 that:
  84. 84. • 85% of households in Great Britain with at least 1 adult aged 65 or over had an Internet connection in 2016, • fewer than 30% of adults over 65 years used the Internet for health-related purposes • 59% of people with no internet access at home said that they didn’t need it because they weren’t interested or saw no use for it • Several reports and academics have argued that it is people living with long-term conditions that would benefit the most from accessing eHealth tools in the management of their health
  85. 85. http://nhs.goodthingsfoundation.org
  86. 86. http://nhs.goodthingsfoundation.org
  87. 87. ‘just installing computers without altering the work and workforce does not allow the system and its people to reach this potential’ Dr Robert Wachter
  88. 88. Southampton Primary Care Exemplar • Explore what interventions are most successful in improving the uptake of existing projects • Test out the implementation of new innovations • Ascertain what future digital developments are necessary to meet the changing demands on primary care.
  89. 89. Long Term Plan • In ten years’ time, we expect the existing model of care to look markedly different. • The NHS will offer a ‘digital first’ option for most, allowing for longer and richer face-to-face consultations with clinicians where patients want or need it. • Primary care and outpatient services will have changed to a model of tiered escalation depending on need. • Senior clinicians will be supported by digital tools, freeing trainees’ time to learn. • When ill, people will be increasingly cared for in their own home, with the option for their physiology to be effortlessly monitored by wearable devices. • People will be helped to stay well, to recognise important symptoms early, and to manage their own health, guided by digital tools.
  90. 90. ‘The future is already here — it's just not very evenly distributed.’ - William Gibson
  91. 91. Integrated Health and Care Records Clear and consistent information governance arrangements across HIOW •Health and Care professional will have easy access to a richer set of shared data in near real-time •Citizens will have access and be able to contribute to their own record •Health and Care professional in HIOW will have access to data in the Dorset Care Record Information Governance Comprehensive longitudinal care record accessible at the point of care. •A more integrated approach to Information Governance •A joint group to overcome barriers to sharing •Removing confusion and complexity in issues relating to data sharing Digitisation and Infrastructure Foundation for information being recorded and viewed digitally at the point of care •Wider use of common system technologies such as video conferencing •Enhancing digital maturity to better enable local system transformation •Reducing reliance on paper records and fax machines to improve patient safety Intelligence and Analytics Better use of data to to drive substantial improvements in health and care •Improve the health of our population by planning services around our population needs rather than providing a “one size fits all” service. •Helping care professionals quickly identify patients which would most benefit early intervention. •Improve understanding of the quality of care delivered across different parts of HIOW Digital Access and Empowerment Enabling patients to interact with their record and collaborate in their care •To have safe, on-line access, to their own health data •The ability to use a range of on-line services to book appointments, seek medical advice (e.g. 111, e-consult) and interact with health and care professionals •To enable patients to take a more proactive role in managing their care Public and Clinical Engagement Ensuring involvement of professionals and citizens in the development of our digital plans •Greater awareness across our population of the digital alternatives to the traditional means of accessing health and care services. •Improving the confidence of our care professionals in the use of digital solutions •Easing pressure on care professionals by use of digital solutions.
  92. 92. Digital Access and Empowerment – GP Contract Requirements • All practices will ensure at least 25% of appointments are available for online booking by July 2019. 2019 • New registrants will have full online access to prospective data from April 2019 2019 • All practices will be offering and promoting electronic ordering of repeat prescriptions and using electronic repeat dispensing for all patients for whom it is clinically appropriate, as a default 2019 • All patients will be able to order repeat prescriptions electronically as a default from April 2019. 2019 • All patients will have online access to their full record, as the default position from April 2020. 2020 • All practices will need by April 2020 to have an up-to-date and informative online presence, with key information being available as standardised metadata for other platforms to use (for example the Access to Service Information (A2SI) Directory of Services Standard); 2020 • All practices will be giving all patients access online to correspondence by April 2020, as the system moves to digital by default (with patients required to opt-out rather than in); 2020 • All patients will have the right to digital-first primary care, including web and video consultations by April 2021 2021
  93. 93. Digital Access and Empowerment – LTP Targets • Patients able to participate/register interest for health research via NHS App 2020 • Every patient with a long-term condition will have access to their health record through the Summary Care Record accessed via the NHS App 2020 • By 2020, we aim to endorse a number of technologies that deliver digitally-enabled models of therapy for depression and anxiety disorders for use in IAPT services across the NHS 2020 • Cancer patients able to access care plans, assessment and HWB info & support 2021 • Summary Care Record functionality will be moved to the PHR held within the LHCR systems, which will be able to send reminders and alerts directly to the patient. 2023 • People will have access to their care plan and communications from their care professionals via the NHS App 20/21 • Online Digital GP Consultations available for all patients 23/24 • Digitally re-designed hospital support (outpatients). Reduction in Op appointments by 30% 23/24 • All women will be able to access their maternity notes and information through their smart phones or other devices. 23/24 • All women will be able to access a digital version of the ‘red book’. 23/24
  94. 94. GP Online consultations • National funding 2017-19 • Hampshire & IOW wide procurement Oct 2017 • 100 live practice March 2018 • Currently 146/182 live practices • Utilisation remains low in many practices though...
  95. 95. Electronic Prescription Service • Part of NPfIT – so started 2002 • Very slow development and uptake nationally… • 2016 aspirational target of 60% prescriptions to be sent • We are now approaching 90% prescriptions in most areas • Only around 40% patients have adopted though… • How does this link with Patient Online / NHS App?
  96. 96. What is a Local Health and Care Record? 114 A LHCR is a group of health and care organisations working collaboratively to create an information sharing environment to help service improvement. Shared records are not new, there are currently over 60 instances of shared record solutions in operation today, but they vary in terms of the scope of data and the range of their uses and not operating to common standards. In spring 2018, NHS England and the Local Government Association (LGA), invited proposals from NHS and local government partner organisations to participate in the Exemplar programme.
  97. 97. Who are the Wave 1 LHCRs? The five first wave LHCRs are: Greater Manchester, One London, Thames Valley & Surrey, Wessex and Yorkshire & the Humber. They will: • Ensure information is collected consistently and made available across local areas to support joined up and safer care. 115 • Enable people’s information to be accessed by their health and care team, safely and securely, as they move between different parts of the NHS and social care. • Build on and learn from existing local initiatives.
  98. 98. LHCR draft milestones • Citizen access and contribution • Joining across boundaries – Dorset / HIOW • Comprehensive longitudinal record – Depth and breadth of data • Realtime structured data – for secondary use / intelligent use – research ready
  99. 99. Lessons… • It’s easy to innovate in primary care… in a small way! • It’s much harder to spread innovation even when you can prove the benefits… • Having the right support infrastructure helps
  100. 100. Questions?
  101. 101. Hampshire & Isle of Wight STP Innovation Hub Dr Sunil Rathod Wessex AHSN Primary Care Innovations Expo 3rd July 2019 119
  102. 102. • Provide a forum where:  Knowledge of existing pilots and products used are shared  New ideas and products are assessed and evaluated  Digital Leads contribute local knowledge to assess suitability and fit with individual organisations  Cross organisational solutions can be assessed  Solutions can be considered for pan Hampshire adoption Purpose
  103. 103. • Reduce duplication - target resources to robustly pilot, evidence and adopt (or reject) ideas and products • Work with suppliers in a cohesive way • Support local innovations - access to technology experts and a framework supported by the STP • Support, not stifle, momentum and enthusiasm at a local level • Support health and care professionals to make informed decisions about technology • Achieve better value for money by implementing at scale where practical • Provide common tools for services and patients that are robust, well supported and sustainable Goals
  104. 104. • Report directly to the HIOW STP Digital Transformation Portfolio Board • Representation from: • Acute • Community and Mental Health • Primary Care • Social Care • Ambulance • CCGs • Local Authorities • Wessex Academic Health Science Network Membership and Governance
  105. 105. • The Innovation Hub has provided a valuable forum for sharing a complex digital agenda across multiple trusts • Sounds simple but keep abreast of everything that is happening is a challenge • 28 different solutions have been reviewed and product overviews shared • A Video Consultations pilot took place and supported securing of NHSE funding for Southern Health and Solent to be the first to implement patient video consultation Achieved

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