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© Nuffield Trust 
12 November 2014 
Integration and information 
Dr Martin Bardsley 
Nuffield Trust
© Nuffield Trust 
Why the current interest in integrated care? 
•Rising levels of chronic disease and ageing population 
•Increasing levels of hospital admissions and readmissions, especially among the elderly and vulnerable, and children 
•Economic hard times, and unsustainable health and social care economies 
•And too often we still do not get it right in terms of care co- ordination, care planning, communication with families 
•Interest in preventive solutions that reduce the need for future care 
•Integrated information systems seen as key element of integrated care
© Nuffield Trust 
Integration 
Sara Shaw, Rebecca Rosen and Benedict Rumbold What is integrated care? An overview of integrated care in the NHS Research report. Nuffield Trust June 2011
© Nuffield Trust 
The power of information 
“What's measured is what matters”/ (what's measured improves) “In the absence of information people make stuff up” Information helps people do their jobs better. Good information flows from operational need - do not collect data for the sake of it To use information effectively need to look beyond the single encounter to episodes of care and sure information systems can talk to each other - consistency (inter-operability)
© Nuffield Trust 
Data are everywhere… 
GP 
Local Authority 
Commissioner 
A&E 
OP 
IP 
Pharmacy 
Community 
Health 
Services 
Up there 
Housing 
Council 
Tax 
Council 
Social 
Services 
Social care 
provider 
Ambulance 
NHS Direct Control 
Commissioning data ...
© Nuffield Trust 
Tomb raiders?
© Nuffield Trust 
Health and social care timeline – an individual’s history
© Nuffield Trust 
Use of linked person level data 
Audit and Quality Improvement Patient safety (e.g. monitoring drug side effects or surgical mortality rates) Public Health programmes (immunisation; monitoring cancer rates) Evaluate Services (are they effective and cost effective?) Planning services (e.g. ICU bed availability; pandemic flu plans; manage changing patterns of demand) Manage Performance (e.g. readmission targets; health outcomes indicators) Resource allocation Research
© Nuffield Trust 
Testing for gaps in care
© Nuffield Trust 
Emergency admissions for cases where nursing started 8-14 days before death
© Nuffield Trust 
But you know all that 
from Making It Happen the Power of Information 
Key ambitions 
•Information used to drive integrated care across sectors 
•Electronic care records increasingly used as the source of information to improve care across sectors 
•Information recorded once at first contact and share securely..
© Nuffield Trust 
So what is the rate limiting step…. 
•Access to the technology and having the right hardware/software tools 
•Ability to integrate care records across services /provider to achieve value 
•Uptake of the technology/ awareness and skills 
•Ability to use existing information 
•Priority given to developing and using information tools
© Nuffield Trust 
Promoting better integrated information from Making It Happen the Power of Information
© Nuffield Trust 
12 November 2014 
www.nuffieldtrust.org.uk 
Sign-up for our newsletter www.nuffieldtrust.org.uk/newsletter 
Follow us on Twitter: Twitter.com/NuffieldTrust 
Martin.Bardsley@nuffieldtrust.org.uk

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Dr Martin Bardsley: Integration and information

  • 1. © Nuffield Trust 12 November 2014 Integration and information Dr Martin Bardsley Nuffield Trust
  • 2. © Nuffield Trust Why the current interest in integrated care? •Rising levels of chronic disease and ageing population •Increasing levels of hospital admissions and readmissions, especially among the elderly and vulnerable, and children •Economic hard times, and unsustainable health and social care economies •And too often we still do not get it right in terms of care co- ordination, care planning, communication with families •Interest in preventive solutions that reduce the need for future care •Integrated information systems seen as key element of integrated care
  • 3. © Nuffield Trust Integration Sara Shaw, Rebecca Rosen and Benedict Rumbold What is integrated care? An overview of integrated care in the NHS Research report. Nuffield Trust June 2011
  • 4. © Nuffield Trust The power of information “What's measured is what matters”/ (what's measured improves) “In the absence of information people make stuff up” Information helps people do their jobs better. Good information flows from operational need - do not collect data for the sake of it To use information effectively need to look beyond the single encounter to episodes of care and sure information systems can talk to each other - consistency (inter-operability)
  • 5. © Nuffield Trust Data are everywhere… GP Local Authority Commissioner A&E OP IP Pharmacy Community Health Services Up there Housing Council Tax Council Social Services Social care provider Ambulance NHS Direct Control Commissioning data ...
  • 6. © Nuffield Trust Tomb raiders?
  • 7. © Nuffield Trust Health and social care timeline – an individual’s history
  • 8. © Nuffield Trust Use of linked person level data Audit and Quality Improvement Patient safety (e.g. monitoring drug side effects or surgical mortality rates) Public Health programmes (immunisation; monitoring cancer rates) Evaluate Services (are they effective and cost effective?) Planning services (e.g. ICU bed availability; pandemic flu plans; manage changing patterns of demand) Manage Performance (e.g. readmission targets; health outcomes indicators) Resource allocation Research
  • 9. © Nuffield Trust Testing for gaps in care
  • 10. © Nuffield Trust Emergency admissions for cases where nursing started 8-14 days before death
  • 11. © Nuffield Trust But you know all that from Making It Happen the Power of Information Key ambitions •Information used to drive integrated care across sectors •Electronic care records increasingly used as the source of information to improve care across sectors •Information recorded once at first contact and share securely..
  • 12. © Nuffield Trust So what is the rate limiting step…. •Access to the technology and having the right hardware/software tools •Ability to integrate care records across services /provider to achieve value •Uptake of the technology/ awareness and skills •Ability to use existing information •Priority given to developing and using information tools
  • 13. © Nuffield Trust Promoting better integrated information from Making It Happen the Power of Information
  • 14. © Nuffield Trust 12 November 2014 www.nuffieldtrust.org.uk Sign-up for our newsletter www.nuffieldtrust.org.uk/newsletter Follow us on Twitter: Twitter.com/NuffieldTrust Martin.Bardsley@nuffieldtrust.org.uk