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Achieving Benefits with Map of Medicine Pathways
- 1. Map of Medicine Cross care setting best practice care pathways and referral management
- 2. Overview About Map of Medicine Demonstration Benefits Localisation Successful programme implementation © 2013 Map of Medicine Ltd Commercial and in confidence 2
- 3. Introduction to Map of Medicine • Leading international provider of interdisciplinary, integrated care pathways and clinical decision support • Team consists of Clinicians, Health managers, Researchers, Pharmacists • Integrated with the major UK GP systems, including EMIS, TPP and INPS • Subsidiary of Hearst Corporation – Healthcare Group © 2013 Map of Medicine Ltd Commercial and in confidence 3
- 4. A partner in transforming care Map of Medicine supports the optimisation of patient care by providing easy access to comprehensive, evidence-based local guidance and clinical decision support at the point of care Decision support Instant access within clinicians’ workflow at the point of care Local 1,800+ customised pathways National 260 accredited pathways © 2013 Map of Medicine Ltd Commercial and in confidence 260 evidence-based, best-practice pathways 125 referral guides 4
- 5. Map Sidebar: One-click access EMIS Web © 2013 Map of Medicine Ltd Commercial and in confidence 5
- 6. What is the Map of Medicine Solution? © 2013 Map of Medicine Ltd Commercial and in confidence 6
- 7. Map Referrals © 2013 GP system integration: embedded within clinical workflow via Sidebar Locally relevant information: search for and identify the most appropriate local care pathway, referrals guidance, provider and patient information Standardised referral forms: updated centrally across a CCG One click access, referral forms are opened and auto-populated with the patients’ demographic and clinical information Live commissioning data: CCGs can easily track the volume and cost of GP referrals to local services, analyse usage, report on referrals by condition Save administration time - 20 days a month across a 40 practice CCG Empower GPs to consider cost of referrals at the point of care Map of Medicine Ltd Commercial and in confidence 7
- 9. Reducing unwarranted variation in care Locally-customised evidence based pathways ensure that all clinicians have easy access to the same information about best practice care and local service availability. In Devon, only one third of people with dementia receive a formal diagnosis. To improve this figure, a single, clearly defined local dementia pathway was designed to meet the needs of healthcare professionals, patients and their carers The pathway aimed to support GPs and their staff in improving dementia care, and improving the speed of dementia diagnosis. Following implementation, the following benefits have been realised: Professional relationships have been greatly improved between GP & specialist mental health providers, resulting in an overhaul of community mental health services Dementia prevalence rates have increased since implementation of the initial pathway (diagnosis rate 2011 32.6%, 2012 35.7%) Waiting times for memory assessment have dropped © 2013 Map of Medicine Ltd Commercial and in confidence 9
- 10. Reducing inappropriate referrals Map pathways include best practice referral information. These can be adapted to reflect local policy and service options, supporting consistent referral decisions, reducing inappropriate referrals and improving the quality of care for patients. In Merseyside, the CCG has used the Map to manage inappropriate referrals between primary and secondary care, achieving savings of over £0.5million in 2011-12. Specific examples of pathways include: Management of minor dermatological conditions, where referrals into secondary care were reduced by 36% from 2010-2012, releasing almost £200,000 for re-investment. Implementing a local dyspepsia pathway promoting use of H.Pylori testing in primary care, reducing need for unnecessary gastroscopy, and leading to a saving of £70,000 in avoided referrals in 2012. In Southampton, creation of over 100 local pathways has enabled significant financial savings as a result of a reduction in GP referrals. Across trauma and orthopaedics, gynaecology, haemotology, paediatric orthopaedics and endocrinology, there was a net decrease of 15% in the volume of GP referrals in 2011-2012 compared to the same period in 2010-2011. The quality of referrals improved by more than 50%, with the number of referrals rejected from secondary care falling to 112 for orthopaedics and to 56 in gynaecology © 2013 Map of Medicine Ltd Commercial and in confidence 10
- 11. Delivering care in the right setting Map pathways support redesign of services to deliver care in the right setting, moving services out of acute hospitals into the local community, thereby improving patient experience and reducing costs. Shifting services into the community: In Newham redesign of the Anticoagulation pathway has resulted in a Point of Care Testing service for stable patients in primary, rather than secondary, care. With 25 clinics available, 33% of patients are now being managed at this level, improving access for patients and saving Newham LHC approximately £300,000. In Western Cheshire, a local Cellulitis pathway was created to communicate the introduction of a new service to enable otherwise healthy adults to be treated with intravenous antibiotics in the community. This resulted in a reduction in the number of hospital admissions and a saving of £2,000 per patient. Right care, right time: in the Wirral, patients were waiting up to three months to be treated for Aged related Macular Degeneration. A local pathway helping to align primary care clinicians, optometrists and ophthalmologists resulted in a reduction in waiting and treatment times to within two weeks of referral, and delivered an associated 25% cost reduction and an overall saving estimated at £200,000 per annum. © 2013 Map of Medicine Ltd Commercial and in confidence 11
- 12. Achieving Benefits Experience in the UK and New Zealand with health economies averaging 250,000 patients have revealed considerable health community benefits for regions effectively standardising care across at least 6 clinical pathways. Local implementation of the Map of Medicine takes, on average, about 6 months to demonstrate savings. © 2013 Map of Medicine Ltd Commercial and in confidence 12
- 13. 2012 Benefits Analysis Breakdown of cost savings across PCTs using the Map in 2012 In 2012, 8 mature Optimising admissions for PCT in the UK, 4% elective care/procedures (£12m) 11% using Map of Medicine achieved Minimising outpatient referrals 21% (£4m) combined savings 64% of £19million* for Decreasing IP length of stay an average (£2.1m) population size of 250,000 patients. Local pathway development Between them, the savings (£0.8m) cost saving benefits across 32 pathways were analysed. For a 250,000 CCG, potential savings include £1.2m; £400k; 200k, £80k respectively *2011-2012 SUS. PCTs included Devon, Plymouth, Torbay, Southampton, Gloucestershire, Eastern & Costal Kent, Milton Keynes, and Medway © 2013 Map of Medicine Ltd Commercial and in confidence 13
- 14. Localisation
- 15. Localisation care maps can be customised to reflect local needs, practices and services local communities have their own view the view hosts all locally produced care maps and defaults to the regional or international version © 2013 Map of Medicine Ltd Commercial and in confidence 15
- 16. Local view © 2013 Map of Medicine Ltd Commercial and in confidence 16
- 17. Customising Three ways to customise: —1. Add administrative information in the local info tab contact details clinic information opening times —2. Edit a map and referral guide reflect locally agreed clinical protocols incorporate local service arrangements —3. Create a new map © 2013 Map of Medicine Ltd Commercial and in confidence 17
- 18. Customising - local info tab Worcester - Osteoporosis © 2013 Map of Medicine Ltd Commercial and in confidence 18
- 19. Customising – editing a care map Wirral - Osteoporosis © 2013 Map of Medicine Ltd Commercial and in confidence 19
- 20. Customising - locally created Worcester - Persistent pain management © 2013 Map of Medicine Ltd Commercial and in confidence 20
- 21. Key messages Southampton – Prostate cancer © 2013 Map of Medicine Ltd Commercial and in confidence 21
- 22. Local formulary Southampton – Female urinary incontinence © 2013 Map of Medicine Ltd Commercial and in confidence 22
- 23. Images Exeter– Basal cell carcinoma © 2013 Map of Medicine Ltd Commercial and in confidence 23
- 24. Patient information North Mersey – Clinical genetics – Female without cancer – Maternal family history © 2013 Map of Medicine Ltd Commercial and in confidence 24
- 25. Useful forms Worcester – Dementia © 2013 Map of Medicine Ltd Commercial and in confidence 25
- 26. Links to youtube clips Southampton – Vertigo © 2013 Map of Medicine Ltd Commercial and in confidence 26
- 27. Considerations for a successful implementation of the Map referral and pathway solution © 2013 Map of Medicine Ltd Commercial and in confidence 27
- 28. Gajan Srikanthan Map of Medicine Head of Clinical Strategy info@mapofmedicine.com
Editor's Notes
- Not just a software company working in healthcare. We are a healthcare company with expertise in authoring care pathways and guidance. Team of people is very important as you need expertise to support you in driving through appropriate content to your clinicians, with the appropriate access and the appropriate engagement We also work with a number of the colleges and professional bodies and will look to instill our expertise when delivering solutions to CCGs and practices
- Show the full sidebar and a full screenshot here – for BDM to speak around
- Referral review could involve: Systematic use of comparative information about GP and practice referral rates by specialty supported by more detailed audits at practice level including discussion of a sample of referrals to examine their content and appropriateness Generalists and specialists agreeing redesigned elective care pathways including consultant to consultant referral protocols.
- Video / Slides / Live Demo
- Default to the regional or international version if care maps haven’t been localised.
- Looking at the previous example of the Worcestershire Osteoporosis care map, they have localised by adding local information. The local info has an icon and a separate tab – (highlight the quick info, local info and the icon)– in this case they have added contact details for the different relevant specialities – geriatrics, rheumatology and endocrinology
- Wirral have adapted the international care map – changing the flow and tweaking the quick information. Here they have requested that the FRAT falls risk assessment be completed and faxed to the community therapy and falls prevention service. This information is in the Quick info tab, and there is no ‘local info’ tab – but they could have one as well.
- Worcester have written a new care map on persistent pain management. They have used the quick info tab, but used the local admin tab to add local information about the services available, eg in South Worcester the aims of the musculoskeletal integrated clinical assessment and treatment services.
- For the same care map, Southampton have provided these four key messages.
- Southampton have utilised the local formulary node – here giving first, second and third line recommendations for female urinary incontinence.
- In the Exeter Basal cell carcinoma pathway they have added a photo of Nodular BCC into the history and examination node. Useful to have direct access to images that have been approved by specialist physicians, especially for Dermatology.
- This Clinical genetics pathway from North Mersey includes a link to a questionnaire that should be printed out and given to the patient to complete before attending their outpatient appointment and a patient information leaflet
- Adding administrative information to an international pathway, using the ‘local tab’. In this Dementia pathway, links have been inserted including this Alzheimer’s Society Advance decision form which can then be printed off and filled out with the patient.
- You can link to youtube clips that have been recommended or endorsed by local specialists, eg this youtube screenshot to explain how to do the Epley manoeuvre for benign postural vertigo.