1. Connecting Leeds
Flickr.com/photos/62766743@n07

2. Dr. Tony Shannon
M.B. B.Ch. B.A.O. Ireland
Fellow of College of Emergency Medicine England
Fellowship in Informatics USA
MSc in IT Management England
NHS Connecting for Health England
Consultant in Emergency Medicine, Leeds Teaching Hospitals
Chief Clinical Information Officer, Leeds TH/Leeds NHS & Social Care
Director, Frectal Ltd
www.frectal.com

3. Key points
• Healthcare Change : Connect All
– People + Process + Information Technology
– Key role of Open Source
– Need for Open Standards
• Local/National/International
– Early Days
– Age of Enlightenment
– Leaders will emerge

6. Healthcare = Complex

7. Healthcare Challenge: People + Process + Technology
Thinking in silos Process versus IT Closed solutions
An International Challenge

8. Leeds TH
200+
Enterprise
Wide
System x
Common Web UI
Integration Engine
ESB
A B C
1
2
3
4
5
Core Process
Core Process
Core Process
Core Process
Core Process
Modular
SOA
Enterprise
wide
System Y
Access/
SQL
State of the Market: A/ B /C

9. Healthcare Change: State of the Ecosystem
Standards: Vendors: Innovators: Disconnect
International Standards
Local Innovators
eHealth Bodies
& Vendors

10. 21st C NHS – Open Platform required

11. Assessment
Deliver Care Plan Care
21St Century Healthcare: OS Platform Required

12. 200+
CUI Clinical Portal
TIE
A B C
1
2
3
4
5
PAS
Orders Results
Clinical Docs
Summary Care
Record
Leeds TH: Starting Point & Options

14. LeedsTH EPR

15. Leeds EPR- HomePage

16. Leeds EPR - Results

17. Leeds EPR- Letters

18. Leeds EPR - (inc. Order Comms)

19. Leeds EPR- MPV

20. Leeds EPR- MPV

21. Leeds EPR- MPV

22. Leeds EPR- Reporting View

23. Leeds EPR Development
• Clinically Led
• User Centred
• Agile Development
– 2 weekly Sprints
• Joint NHS & Commercial SME Team
– Service Based Model

24. • Patient/Citizen centred record
• Information at the point of care
• To Support IH&SC teams
• Improve Outcomes and Services
• Built on Open Standards

25. Common Ground
LCR
Primary Care
Secondary
Care
Social Care
CommunityCare
MentalHealth
Dataset: Locally Agreed
ISA: First of type in UK

26. 200+
LTH Clinical Portal
Integ
Engine
A B C
1
2
3
4
5
Orders Results
ePrescribing
Summary Care Record
Leeds Care Record- Approach
Leeds Care Record

27. Leeds Care Record Viewer

28. TPP
LCR – for Direct Care
EMIS
First of type in UK

29. Archetypes (Bricks)
Templates (Toys)
Interoperability Standard:
Record Architecture
Generic
Specific

30. openEHR Archetype
• Clinically oriented
• Reusable list of
clinical statements
• Maximal dataset
• Can be coded with
terminologies
e.g.
Pulse, BP
Leeds Care Record dataset
End of Life
Key contacts
etc
• Computable

31. Leeds Innovation Lab
• Leeds Lab
– People + Process +
Technology
– Across Health & Social Care
– Live2Lab and Lab2Live
• OpenEHR Standards
Based Platform
• Open NHS APIs

32. Further challenges
• System maturity
– Politics & Requirements
• Business change
– Organisational readiness
• Technology maturity
– Host system ability to share data
– Maturity of Health IT market

34. Towards an ehealth ecosystem….
International Standards
Local Frontline Innovators
National eHealth Bodies
& Vendors
Regional

36. A Transatlantic VistA of Open Source

37. Leeds TH
200+
Enterprise
Wide
System x
Common Web UI
Integration Engine
ESB
A B C
1
2
3
4
5
Core Process
Core Process
Core Process
Core Process
Core Process
Modular
SOA
Enterprise
wide
System Y
Access/
SQL
Current State of the Market

38. Healthcare Platform Services Consortium
• Short Version:
– Create an “App Store” for healthcare
• Long Version:
– Enable the acceleration
– Open, Standards based,
– Services oriented architecture platform
– new market for interoperable healthcare applications.
• Why?
– Improve the quality and decrease cost of health care.

40. Veterans Administration, US

41. NHS & VA 2013

42. UK & US OS EHR Camps

44. Assessment
Deliver Care Plan Care
21St Century Healthcare: OS Platform Required

45. Challenge # 1: Integration

46. Challenge #2: Code & Community

47. Challenge #3: UI & Usability

48. Opportunity #1: UI
• NHS CUI
• RCP Headings

49. Opportunity # 2: Service Layer
• Web Services
– MDWS
– VSA
– SMART
– VistA Evolution
• openNHS APIs
• Hackable Platform

50. Opportunity #3: Persistence
• M(umps)
• M(odels)
• A(rchetype)

51. Opportunities in Common Ground
• User Interface
– JS Frameworks
• Middle Tier
– Web Services
• Database & Persistence
robtweed.wordpress.com

52. 10 Days: 1 Clinician: 1 Developer
ClinUiP.wordpress.com

53. 20 Days: 2 Clinicians : 2 Developers

54. Transatlantic Team

55. Clinical Intelligence

56. Departmental Management

57. Patient Record

58. Data Entry

59. 59

60. Leeds TH
200+
Enterprise
Wide
System x
Common Web UI
Integration Engine
ESB
A B C
1
2
3
4
5
Core Process
Core Process
Core Process
Core Process
Core Process
Modular
SOA
Enterprise
wide
System Y
Access/
SQL
Current State of the Market

61. Towards an eHealth ecosystem
International Standards
Local Frontline Innovators
National eHealth Bodies
& Vendors
Regional

63. Key points
• Healthcare Change : Connect All
– People + Process + Information Technology
– Key role of Open Source
– Need for Open Standards
• Local/National/International
– Early Days
– Age of Enlightenment
– Leaders will emerge

64. Thank you
tony.shannon@frectal.com
www.frectal.com
@frectally