Real-Time Digital Medicine

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  • Real-Time Digital Medicine

    1. 1. Real-Time Digital Medicine Dr Amir Hannan Full-time General Practitioner (www.htmc.co.uk) Information Management & Technology clinical lead, NHS Tameside & Glossop Primary Care IT lead, NHS North-West (www.northwest.nhs.uk) Map of Medicine clinical lead, NHS North-West Member of the HealthSpace Reference Panel, NHS Connecting for Health (www.healthspace.nhs.uk) Member of the Clinical Leaders Network (www.cln.nhs.uk) [email_address] Cartoon taken from www.mediclicks.net Addenbrookes Hospital Cambridge 17 th February 2009
    2. 2. Summary <ul><li>Addenbrookes Access to Health Records </li></ul><ul><li>Why did I start sharing records with my patients? </li></ul><ul><li>The “best” PHR /EMR in the world…. </li></ul><ul><li>Partnership of Trust </li></ul><ul><li>Paradigm Shift in Healthcare </li></ul><ul><li>Building the next generation healthcare system </li></ul><ul><li>How do we enable patients to access their records </li></ul><ul><li>www.htmc.co.uk </li></ul><ul><li>What can patients see? </li></ul><ul><li>What are patients doing with access to their health records </li></ul><ul><li>Time for YOU to get access to YOUR health records </li></ul>
    3. 4. <ul><li>Shipman murdered his patients. </li></ul><ul><li>Fictitious “diseases” added to patient notes after they had died. </li></ul><ul><li>Thought to have used morphine which he collected in other people’s names. </li></ul><ul><li>Ramifications felt throughout the world! </li></ul>Why ? <ul><li>Sit down protest in the surgery </li></ul><ul><li>No IT system </li></ul><ul><li>Patients to see </li></ul><ul><li>Job to do… </li></ul>
    4. 5. Rebuilding TRUST in me and the Medical Profession
    5. 6. The “best” Personal Health Record / Electronic Medical Records in the world…. … is about to get better…
    6. 7. Partnership of Trust
    7. 8. The Paradigm Shift in Healthcare <ul><li>IT based health care system </li></ul><ul><li>Internet </li></ul><ul><li>Increase in health literacy </li></ul><ul><li>Patient access to Electronic Health Record </li></ul><ul><li>Patient choice </li></ul><ul><li>Choice leads to better outcomes </li></ul>
    8. 9. But there are concerns <ul><li>In general, the first reaction is anxiety, worry and avoidance  </li></ul><ul><li>Patients seeing our muddles, red herrings, poor typing, inappropriate phrasing         </li></ul><ul><li>Patients seeing 3 rd party info that they should not see          </li></ul><ul><li>Patients seeing something that would cause them serious harm          </li></ul><ul><li>It will increase litigation against us </li></ul><ul><li>We don’t have time to promote records access and do all the other things we have to do         </li></ul><ul><li>Patients will take longer boring on about minor irrelevancies in the record         </li></ul><ul><li>Patients will come more often, worried well          </li></ul><ul><li>Patients won ’t understand what we write          </li></ul><ul><li>Clinicians will have to change the way we write          </li></ul><ul><li>We will not be able to speculate about diagnoses any more: th is pt may have MS, wait+see 
          </li></ul>
    9. 10. Who’s helping us? <ul><li>PATIENTS </li></ul><ul><li>General Medical Council </li></ul><ul><li>The Medical Defence Organisations </li></ul><ul><li>Information Commissioner’s Office </li></ul><ul><li>EMIS / PAERS </li></ul><ul><li>Department of Health </li></ul><ul><li>NHS Connecting for Health </li></ul><ul><li>National Information Governance Board </li></ul><ul><li>Local Care Record Development Board </li></ul><ul><li>NHS Tameside & Glossop </li></ul><ul><li>NHS North-West (formerly known as NW SHA) </li></ul><ul><li>Local Medical Committee </li></ul><ul><li>Self Help Groups </li></ul><ul><li>Patients and the Public </li></ul><ul><li>International Council for Medical & Care Compunetics (www.icmcc.org) </li></ul><ul><li>Primary Healthcare Specialist Group, British Computer Society </li></ul><ul><li>Map of Medicine </li></ul><ul><li>MPs </li></ul><ul><li>Patients know best (of course!) </li></ul><ul><li>Etc etc etc </li></ul>
    10. 11. So let’s build a system that supports clinicians, patients and the system! Supports Summary Care Record Supports HealthSpace Supports Google Health / HealthVault Supports patients and GPs Let’s have a blended approach
    11. 12. Why does Records Access matter? <ul><li>Record access complements and enhances most of the processes of care   </li></ul><ul><li>Research suggests that full record access: </li></ul><ul><ul><li>is safe, </li></ul></ul><ul><ul><li>is popular with patients (wouldn’t you like to have access whenever and wherever you were?) </li></ul></ul><ul><ul><li>improves patient confidence in themselves and their clinicians, </li></ul></ul><ul><ul><li>enables patients to improve the accuracy of their records, </li></ul></ul><ul><ul><li>improves the efficiency of consultations </li></ul></ul><ul><ul><li>probably improves preventative and self-care.  </li></ul></ul><ul><li>Record access is also recommended as it: </li></ul><ul><ul><li>Improves communication with patients </li></ul></ul><ul><ul><li>Supports copying letters to patients </li></ul></ul><ul><ul><li>complies with the Data Protection Act </li></ul></ul><ul><ul><li>is recommended for patient safety </li></ul></ul><ul><ul><li>improves the process of obtaining informed consent </li></ul></ul><ul><ul><li>is necessary for information governance </li></ul></ul>
    12. 13. So how do we do it?
    13. 14. Are you e MPOWER ed yet ? <ul><li>e </li></ul><ul><li>M edical </li></ul><ul><li>P atient and the P ublic </li></ul><ul><li>c O mmunication </li></ul><ul><li>W orld wide web </li></ul><ul><li>E lectronic </li></ul><ul><li>R ecord </li></ul>
    14. 15. Feature List for Patients
    15. 16. Feature List for Clinicians / Staff
    16. 17. Haughton Thornley Medical Centres www.htmc.co.uk
    17. 18. Haughton Thornley Medical Centres www.htmc.co.uk
    18. 19. Haughton Thornley Medical Centres www.htmc.co.uk
    19. 20. Haughton Thornley Medical Centres www.htmc.co.uk
    20. 21. Haughton Thornley Medical Centres www.htmc.co.uk
    21. 22. Haughton Thornley Medical Centres www.htmc.co.uk
    22. 23. Haughton Thornley Medical Centres www.htmc.co.uk
    23. 24. Haughton Thornley Medical Centres www.htmc.co.uk
    24. 25. Using HealthSpace
    25. 26. Using HealthSpace
    26. 27. Map of Medicine via NHS Choices
    27. 28. Map of Medicine via NHS Choices
    28. 29. Haughton Thornley Medical Centres www.htmc.co.uk
    29. 30. Haughton Thornley Medical Centres www.htmc.co.uk
    30. 31. Haughton Thornley Medical Centres www.htmc.co.uk
    31. 32. What do patients see?
    32. 33. Patient access to GP record
    33. 34. Patient Access to GP record
    34. 35. Book appointment online
    35. 36. Patients or their families can order repeat prescriptions on-line Can easily see what patients are taking and not taking Blue i button gives further information directly from the repeat script explaining what the medication is for Up-to-date repeat prescriptions Order Repeat Medication
    36. 37. Information re Aspirin
    37. 38. Information re Aspirin
    38. 39. Information re Aspirin
    39. 40. Information re Aspirin
    40. 41. Ordering repeat prescriptions
    41. 42. Access GP record
    42. 43. GP record - Summary screen
    43. 44. GP record - Summary Screen
    44. 45. GP record - Summary screen
    45. 46. GP record - Summary screen
    46. 47. Consultations
    47. 48. Links to diabetes
    48. 49. Foot care for diabetes
    49. 50. Results
    50. 51. Information re blood tests
    51. 52. Letters
    52. 53. Pictures
    53. 54. Medication
    54. 55. Real-time Digital Medicine from a patient perspective
    55. 56. Patients CAN and ARE making a difference
    56. 57. Benefits beyond compliance and concordance being felt <ul><li>Dear Amir,  </li></ul><ul><li>I am currently carrying out a records management audit at the PCT. On my travels around the PCT, the Fracture Liaison and Osteoporosis Nurse was telling me about patients from your practice who when attending to see the nurse were bringing copies of their records and reports that they had accessed from home. The nurse was very grateful as this helped in the treatment and tests that were undertaken and saved her a lot of time and also occasionally gave information that meant that either a re-scan was not undertaken again or was not necessary and therefore this prevented unnecessary appointments. I said I would pass on the positive comments to you.    </li></ul><ul><li>Regards Rob Anker  </li></ul><ul><li>Records Manager </li></ul><ul><li>Tameside and Glossop PCT </li></ul>
    57. 58. The Map of Medicine in the Real World for patients with access to their records <ul><li>“ thought the web site was very good and was easy to use. It made me think about my illness and different things that my doctor could have or should have done to help my condition. It made me feel as if my doctor could have done more than just give me anti depressants. It will be good for more illnesses to be added. I think websites like this one has helped me manage my illness better” (patient with full access to GP electronic health record) </li></ul><ul><li>“ I've had a look at the website and thought it very good. Some of the terminology may be a little difficult for some people especially if you have been recently diagnosed and don't know the jargon” (patient with full access to GP electronic health record) </li></ul><ul><li>“ I had a quick look at the glaucoma one. Content very good and well summarized but not suitable for patients at all. I think only the most well informed / literate patient will be able to make sense of the information and way it is presented.” (patient with access full access to GP electronic health record and works as a consultant ophthalmologist) </li></ul><ul><li>“ I accessed that informative site.  It was very clear, and about the best information I have had up to now.  I would imagine, though, for people of a less hardy disposition, it would prove to be a bit frightening, to see the facts put so boldly before them.  Again, there is no alternative for persons like myself taking a more holistic route to combat this disease, and with that in mind, there appears no hope.  The last option on the list is adjuvant therapy.   To face the fact that this disease is now &quot;incurable&quot; can be daunting.  But if you look at it from another angle, so is asthma, diabetes and arthritis.  It’s how you look at a problem and interpret it.” (patient with breast cancer with metastatic disease and who has full access to GP electronic health record) </li></ul><ul><li>“ I found the site very interesting easy to use, also easy to understand as well. I did find my condition and found that I have had all that the experts have said, have experience all that” (patient with full access to GP electronic health record) </li></ul>
    58. 59. These are NOT just a handful of patients
    59. 60. These are NOT just a handful of patients <ul><li>We have over 600 patients over 3 years now having access to their records in our practice alone </li></ul><ul><li>Young, old, English, Foreign, rich, poor, IT-savvy, not so IT-savvy – very few exceptions </li></ul><ul><li>Not a single problem </li></ul><ul><li>40 practices offering the same service around the country with more than 60% enabled to do so (all EMIS practices) </li></ul><ul><li>Complements the Summary Care Record by NHS Connecting for Health </li></ul><ul><li>Patients wondering why everybody else is not doing it ! </li></ul><ul><li>www.htmc.co.uk has been built so that it can be deployed in another practice, across a PBC or PCT. 95% of the information is as relevant to patients in Cambridge as it is to my patients in Hyde ! We are now linking to local Providers too! </li></ul>
    60. 61. Conclusion <ul><li>e MPOWER ed patients need access to their medical records AND high quality information about their care AND how to manage it. </li></ul><ul><li>www.htmc.co.uk is a platform that enables you to do this </li></ul><ul><li>e </li></ul><ul><li>M edical </li></ul><ul><li>P atient and the P ublic </li></ul><ul><li>c O mmunication </li></ul><ul><li>W orld wide web </li></ul><ul><li>E lectronic </li></ul><ul><li>R ecord </li></ul>
    61. 62. Isn’t it time YOU got access to YOUR records and started using it to improve YOUR health and enter the world of REAL-TIME DIGITAL MEDICINE ? Dr A Hannan [email_address] for the latest information and to sign up for my blog please see www.htmc.co.uk

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