The document discusses NHS Lanarkshire's plans to develop a clinical portal that will pull together a patient's clinical information from various systems into a single view, addressing issues around fragmented records and information sharing between services. It aims to provide clinicians with a complete patient record regardless of where data was created or stored. The portal is intended to improve care coordination and reduce risks around late intervention or lack of awareness of a patient's full clinical history.

1. A Digital 20:20 Vision
Justine Westwood, NHS 24 and SCTT

2. BACKGROUND
• NHS 24 took on responsibility for SCT
in April 2010
• SCT Strategic Framework 2010-2012
• NHS 24 took on responsibility for
National Telecare Programme in April
2011
• Telecare Action Plan 2011-2012
• NHS 24 Strategy Development 2012

3. CONTEXT
• SGHD 2020 Vision
• Quality Strategy
• Digital World (SG Digital Strategy; NHS 24 Horizon
Scanning)
• Public Sector Finances
• Scotland and Health and Demography of Scotland
• Christie Commission
• SGHD e-Health Strategy (and emerging Citizens e-
Health Strategy)
• Health and Social Care Integration
• Manifesto commitments (cancer; health inequalities;
early years)
• National Telehealth and Telecare Strategy

4. NHS 24 STRATEGY – RECENT
PROGRESS IN PAST 3 YEARS
• Strong performance and delivery
• Creativity and innovation
• Expansion of and accelerating development
of channels and services
• Unscheduled care OOHs now only one of a
wide range of services
• Recognised as contributing more to NHS
Scotland and NHS Boards
• Reputation of organisation positive

5. SCTT – RECENT PROGRESS
IN PAST 2 YEARS
• Telestroke Networks – covering 11 Health Boards
• Paediatrics – Unscheduled Care / Decision Support;
Maternity Telehealth
• Long Term Conditions – Pulmonary Rehabilitation; Home
Monitoring
• Mental Health – Forensic Psychiatry; Dementia Support for
Care Homes
• National Infrastructure
• Education and Training
• DALLAS
• Europe – Regional Telemedicine Forum; Momentum; CASA;

6. NHS 24 STRATEGY – KEY MESSAGES
FOR NEXT 3 YEARS
• Continue to improve, expand and develop
services – expect continued growth in services
and channels
• “Multichannel NHS Services” – bigger than just
NHS 24
• Role of NHS 24

7. KEY MESSAGE (1) – IMPROVE, EXPAND,
DEVELOP INCLUDING…
NHS inform Care Information Scotland
CBT Living Life Computerised CBT
Taking Measures MSK
Patient Reminder Service Perinatal Advisory Service
Web cam Web chat
Life Begins @ 40 STV Health Centre
Digital TV SMS text
Facebook Twitter

8. KEY MESSAGE (2) – MULTICHANNEL NHS
SERVICES
• NHS in Scotland ‘going multichannel’
• More collective approach across NHS in Scotland
(and Health and Social Care; and Public Services)
• More joined up, more focussed, collective effort
and ownership
• NHS 24 vital player
• Supporting SGHD

9. internet
phone TV
mobile Telecare
Face
2
video
Face
SMS

10. KEY MESSAGE (3) – ROLE OF NHS 24
• National Asset
• Delivery of services
• Leading
• Facilitating
• Resource supporting NHS Scotland
• Horizon Scanning discipline
• Research and Development
• Academia and Industry links and partnership
• Across Health and Social Care
• Across Public Services
• Europe
• Enterprise
• Innovation

11. NATIONAL TELEHEALTH AND TELECARE
STRATEGY
• Reflect Scottish Government’s 2020 vision
• Identify vision for Telehealth and Telecare in
Scotland
• Proposed priorities of
– Health and Wellbeing
– Empowering People
– Improving Value
• Identify what success will look like

12. SCTT Action Plan will ….
• respond to the National Strategy clarifying
the contribution SCTT can make;
• respond to the recommendations made by
Audit Scotland;
• respond to the requests made by Health
Boards and Local Authorities;
• progress well defined opportunities;

13. Scottish Centre for
Telehealth and Telecare
Strategy 2012-2015

14. NHS LANARKSHIRE CLINICAL PORTAL
Sean Brennan, NHS Lanarkshire
LTC Info Hub and Clinical Portal Programme Manager

15. The world of Tannochbrae

16. The world has changed
Visits
GP/practice
nurse
Is visited at home
Nurse or care worker
midwife etc
Visits Out
Attends A&E Patients
In-Patient

17. Goes to the
Pharmacy
NHS 24
online
Attends as
Uses the
an
Home Health Visits
Inpatient
Care Guide GP/practice
nurse
Calls OOH
Calls 999 service Visits Out
Patients Is visited at home
by GP, nurse, social
/ care worker,
midwife etc
Calls NHS
24 Visits a
walk-in
centre
Visits the Attends
dentist A&E

18. Business Drivers

19. Why the Clinical Portal ?

20. Poly-Record !
Illustration kindly provided by NHS Redbridge

21. Falling through the cracks
• Victoria Climbie – 12 chances to save her life
in 10 months not taken
• Previous tragedies – the common threads are
– Late intervention
– Lack of information sharing
– No one person with accountability
– Over stressed front line workers

22. • Lord Laming re Victoria Climbie
– (Recommendation 78) Within
a given location, health professionals should
work from a single set of records for each child. (paragraph 11.39)
– (Recommendation 90) Liaison between hospitals
and
community health services plays an important part in
protecting children from deliberate harm.
• Baby Peter Inquiry
– “The Inspection found that record keeping is inconsistent
and sometimes of poor quality. This means that vital
information which might help to form a complete picture
of a child’s safety and welfare is not available.

23. Separate Applications with islands of clinical information

24. A Clinical Portal will pull together documents
and data to create a complete record –
regardless of where that information was a)
P created Presentation layer (Clinical
or b) stored. It will also enable Portal)
A seamless links to other clinical systems.
PAS
S
or
Diary
P
M
S OCS
Plans
HEPMA
LABS PACS MiDiS Cancer Diabetes

25. NHS Lanarkshire: Clinical Portal
• What is a clinical portal ?
• What do clinicians want to see in their portal?
• How will this be delivered and when?
• How is clinical data captured in an increasingly paperless or
paperlight NHS?
– Digital Pens
– Tablets/Direct computer input
– Other