BEN Event - 8th October - Personalised Healthcare Revolution

1. The IT Challenges of Healthcare
Personalisation
Gayna Hart, Quicksilva
© Copyright Quicksilva 2009

2. Speaking of IT in Health…
1999
OCT • Quicksilva incorporated
• National Programme for IT initiated by the DoH
2002
DEC
2003
• Consultancy to NHS CFH NPfIT
JAN
2004 • NHS HL7 Toolkit created, NHS Naked Prescriber
MAY delivered, NHS Choose & Book Unplugged developed
2005
JUN • Spinal Tap® launched
2006
• Spine-in-a-Box® launched
NOV
2007
• Compliance-in-a-Box® service launched
NOV
2008 • National Institute for Health Research
AUG SharePoint site
2008
SEP • Managed Support service launched
2008
OCT • Gloucestershire Hospitals diabetic retinopathy
screening programme SharePoint site
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© Copyright Quicksilva 2009
IT Challenges

3. Possible IT Challenges
• moving and storing data
» between sites
» on the move
• alerts and triggers
• sharing knowledge
• informatics, predictive
modelling
• procuring IT, contracting
for IT, buying IT
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© Copyright Quicksilva 2009
IT Challenges

4. Possible IT Challenges
• moving and storing data
» between sites
» on the move
• alerts and triggers
• sharing knowledge
• informatics, predictive modelling
• procuring IT, contracting for IT,
buying IT
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© Copyright Quicksilva 2009
IT Challenges

5. Challenges? – it’s all about…
• DATA – the challenge to IT is to deliver it
• Capacity
• Security
• Information
• Knowledge
• Ownership
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© Copyright Quicksilva 2009
IT Challenges

6. What data are we talking about here?
• We call it “patient data”
» but is it the patient’s?
» or is it the NHS’s?
• Who uses it?
» frontline staff
» secondary uses
• Where is it stored?
» across the NHS domain
» private sector
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© Copyright Quicksilva 2009
IT Challenges

7. The Spine Debate
• National Care Records debate
» single centralised source
» agreement sought since 2003
» consultation…or lack of it
» privacy issues
» cost over-runs
» still raging…
• 10 Aug 2009 – Tory plans
» “dismantle central architecture”
» contract buy-out
» alternatives…Google Health?
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© Copyright Quicksilva 2009
IT Challenges

8. NHS Spine
• National Care Record System
» Summary Care Record
• Spine Services
» Personal Demographics
» Choose and Book
» Electronic Prescriptions
» Laboratory
» Common Assessment
So…do we kill off the Spine?
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© Copyright Quicksilva 2009
IT Challenges

9. Data – Capacity
• Can the Spine cope?
» traffic capacity
» Service Level
Agreements
• Local networks
» Images – been around
for a while
• Beyond?
» Europe
» cross-sector
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© Copyright Quicksilva 2009
IT Challenges

10. Data - Security
• Legitimate Relationship
» is this my patient?
• Role Based Access Control
» what you have and what you know
» Smartcard plus PIN
• Sealed Envelope
» whole or partial file
» emergency access
» implications of breaking seal
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© Copyright Quicksilva 2009
IT Challenges

11. Data – Information
• Needed at the point of delivery
» GP
» A&E
» Out-of-Hours
» Mobile
• Information Technology is there
to deliver…
» …information
» at what price?
» evolution/reuse
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© Copyright Quicksilva 2009
IT Challenges

12. Data - Knowledge
• Data sharing across domains
» Health
» Social Care
» Justice
• Predictive modelling
» e Prescribing
» drug development
» epidemiology
» patients at risk
» “cross-selling”
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© Copyright Quicksilva 2009
IT Challenges

13. What data are we talking about here…again?
• We call it “patient data”
» but is it the patient’s?
» or is it the NHS’s?
• Who uses it?
» frontline staff
» secondary uses
• Where is it stored?
» across the NHS domain
» private sector
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© Copyright Quicksilva 2009
IT Challenges

14. Data - Ownership
• Who owns the data?
» Patient?
» NHS?
» Pharmacists?
» Suppliers?
» Service providers?
» Collection agencies?
data pseudonymised for secondary uses
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© Copyright Quicksilva 2009
IT Challenges

15. Joined-Up…thinking?
• Sharing information to build
knowledge
» within the NHS
» cross-sector
» from private sector
» with private sector
• Can we be open enough while
still protecting the individual?
• …and can we afford it?
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© Copyright Quicksilva 2009
IT Challenges