Health and Social Care
Integration
ASSIST
Wrightington
08/10/09
Health Care Drivers and Informatics Responses
Health Care
Health Informatics
Themes
World Class
Commissioning
Quality
FTs
NHS
Ts
ICOs
FTs
Community
Provider
ICOs
ISPs
Community
Provider
Social
Care
Advancing quality, CQUINS, patient reported
outcome measures, clinical audit, NICE,
NHS evidence, Care Quality Commission,
Assurance, Patient Safety
Modern, responsive, seamless, mobile,
strengthen commissioning role, clear data
flows, IT infrastructure and assets,
business-like, leadership, capability and
capacity, confidence and competence,
business continuity, assuring the process
Organisational
Changes
Flexibility, innovation, enterprise, social care
Foundation Trust status, Local Government,
Private Sector, Independent, Voluntary Sector
Integrated Care, Pathways, Interoperability,
CATS, ISTCs, Diagnostics, Contracts, Public,
Person centred
The
Economic
Downturn
Save to Invest, Zero Growth from 11/12, Start
Now, Innovation, Quality, Productivity,
Prevention, Cost efficiencies, shared services
Economies of Scale, Linking finance, HR and
Activity Data, Incentives, Effectiveness, New
Processes, Infrastructure, Waste, Green
Healthier
Horizons
Case for change, 10 compelling reasons,
Scenario planning, new relationship between
public and NHS, Clinical Pathway Groups, 7
Strategic enablers, collaboration, raising game
Leadership, listening understanding, Innovate,
Partner, manage systems, 10 Touchstones
I will…., Equality and Diversity
WCC
3rd Sector
Leadership, partners, intelligence, public
Engagement, clinical engagement, knowledge
Management, Needs assessments, investment,
Markets, data flows, continuous improvement,
Quality, procurement, contracts, management
of systems, transitions and interoperation
Transformin
g
Community
Services
Independent
Provider
FTs
Quality, Innovation, Productivity and Prevention.
High quality
Care for All
Information, Clinical Leadership, Partnerships,
Health, Populations, Personalised, Quality,
Cost effective, Safety, Publish, Feedback,
Excellence awards, Knowledge, Care Quality,
Commission, Observatory, Innovate, Integrate,
Interoperate, Community Services, People
Mental Health Trusts
and
Topics
Knowledge
Management
The National
Perspective
Leadership
A New
Relationship
Information
Governance
Working With
Partners
Global
Review
Innovation
Data to
Intelligence
Record
Systems
Supporting
Concepts
Primary
Care
Community
Mental
Health
Hospitals
Requirements
& Content
PACS
Regional Care National
Record
Programme
Interoperability
£
Workforce
UnScheduled
Care
Shared
records
Interim
Solutions
Infrastructure
Service
Management
Working with Partners
Partners
•
•
•
•
•
•
•
•
PATIENTS/SERVICE USERS
SHA
Commissioner
Providers
Social Care
Wider local government - NWEGG
Private Sector
Third Sector
Informatics Objectives for
Working with Partners
•
•
•
•
•
•
•
•
Develop membership and contacts with Association of Directors of Adult Social
Services and North West Electronic Government Group
PCTs/LHCs to either confirm that they have appropriate connection between
networks at a local level or have enabled/sponsored Councils to achieve N3
connection or to have firm plans in place to complete that by March 2011.
PCTs/LHCs to have a plan for interoperability with partners which may be through
National and Regional Care Records (CFH) solutions or more specific local initiatives
PCTs/LHCs to assist their local government partners with the introduction of the NHS
Number and to be actively achieving that or have a firm managed plan.
PCTs/LHCs have a programme of process changes which aims to release the type of
benefits described in some LHCs, Wigan for example claim benefits in the area of
bed management, Hospital Discharge, Managing Long Term Conditions in the
community, Unscheduled Care/ Intermediate Care and Hospital at Home Initiatives,
Multidisciplinary working and Safeguarding
PCTs understand and can work with partners on their responsibilities under Contact
Point for Children
PCTs to have a partnership plan in place to explore opportunities to share resources
with Local Authorities (wider public sector) in the pursuit of efficiencies
To find out if there is an appropriate forum/mechanism to discuss working with private
and third sector organisations
Architectures
Lorenzo Release Progression
Social Care Systems Across NW
OLM Carefirst
H
Northgate Swift
Paris
RAISE
Lancs in house ISIS
Core Logic Frameworki
SAP Social Care
O
Not known
I
C
B
G
D
R
X
EE
K
P
A
M
L J
W
V
Q
U N
F
T
S
S
Target Solution Model – Lorenzo Everywhere
Different goals – different models
Social and Health Care Integration
NHS
Led
Method
“Dominance”
MIM/
Spine
Local
Other e.g.
Click Through
NHS
A
E
I
Social Care
B
F
J
Neutral
C
G
K
None
D
H
L
Car
e
Trus
t
Shared Record/
Communication
Application
Spine
Social Care/
LA Led
Potential Roadmaps
(Need a similar view for TPP &Lorenzo)
September 2010
NHS – Lorenzo R4
April 2010
November 2009
May 2009
NHS – Lorenzo R3
Click Through/
context passing (URL)
SHA
Portal
NHS – Lorenzo R2
NHS – Lorenzo R1.9
NHS – Spine TMS
(PDS)
Social
Care?
November 2008
NHS – Lorenzo R1
Neutral System
NHS - EPR
Integration Engine
NHS - PAS
Social Care
Content/process development
NHS – Spine TMS
An Example Road Map
• Regardless of technical solution
–
–
–
–
–
–
–
Infrastructure and networks (N3)
PDS enable and connect social care system
Agree joint governance for project, developments and service
Agree overall joint business strategy
Establish Information Governance framework
Agree shared business content and processes
Set Data Quality standards then deliver to them
• Technical solution Road Map
– Introduce a shared Integration layer which links health and social care systems
– Migrate users to integration layer
– Local deployments of LRC R1, R2 – introduce assessments (and produce
outputs)
– At LRC3 – develop a joint workflow
– Introduce a “click through” process between Lorenzo and Social Care system
– Migrate from local integration layer to Spine services
Enablers
•
•
•
•
•
•
•
•
Infrastructure and networks (N3)
Business analysis
Content
Integration
Data Quality
Information Governance
Project, Development and Service Governance
Integration at interim stage and longer term
SMART PROPOSED!!! Not
agreed
What
By Whom
By When
PCTs/LHCs to either confirm that they have appropriate
connection between networks at a local level or have
enabled/sponsored Councils to achieve N3 connection by
March 2010 or to have firm plans in place to complete
that by March 2011.
PCTs
March
2010
PCTs/LHCs to have a plan for interoperability which may
be through National and Regional Care Records (CFH)
solutions or more specific local initiatives
PCTs/LHCs to assist their local government partners with
the introduction of the NHS Number and to be actively
achieving that or have a firm managed plan.
PCTs
March
2010
PCTs
March
2010
PCTs/LHCs have a programme of process changes
which aims to release the type of benefits described in the
Wigan example.
PCTs
March
2010
PCT
March
2010
SHA
March
2010






Bed management
Hospital Discharge
Managing Long Term Conditions in the community
Unscheduled Care/ Intermediate Care and Hospital at
Home Initiatives
Multidisciplinary working
Safeguarding
PCTs to have a partnership plan in place to explore
opportunities to share resources with Local Authorities
(wider public sector) in the pursuit of efficiencies
There is an appropriate forum/mechanism to discuss
working with private and third sector organisations on the
subject of informatics and information requirements either
at national (preferred) or regional level in the North West
Example from London
London’s Roadmap
HSCI Prototype - Proof of Concept
BT Rio
Community
Health
System
EMIS
GP
System
Internet
BT
e-SAP
System
NB – these slides from London are not yet finalised and subject to change but
included to show their thinking
Newham Whole System Demonstrator
BT Rio
Community
Health
System
EMIS
GP
System
?
BT
e-SAP
System
BT
Integration
Engine
Spine
TMS
OLM
Care First
Social Care
System
BT LSP
Spine
Services
Existing
Systems
Later Demonstrators…..
BT
RiO Mental
Health
System
BT
e-SAP
System
BT Rio
Community
Health
System
BT
Integration
Engine
BT
Cerner
Millennium
System
BT LSP
BT
INPS
GP
System
EMIS
GP
System
Spine
TMS
Other NHS
Compliant
Social Care
Systems
Core Logic
Social Care
System
OLM
Care First
Social Care
System
Spine
Services
Existing
Systems
Long Term Vision for London
BT Rio
Community
Health
System
BT
RiO Mental
Health
System
Spine
SCR
EMIS
GP
System
Other NHS
Compliant
Social Care
Systems
BT
e-SAP
System
BT
Integration
Engine
Spine
TMS
BT
Corelogic
Social Care
System
SPR
BT
Cerner
Millennium
System
BT
INPS
GP
System
BT LSP
OLM
Care First
Social Care
System
Spine
Services
Existing
Systems