Setting a Direction
Patient Online:
The Roadmap
16 th April 2013
Healthcare Computing
Dr Imran Rafi
Chair RCGP Clinical Innovation and Research
Centre(CIRC) http://www.rcgp.org.uk/patientonline
‘The power of information’
“By 2015, all general practices will be expected to make available electronic booking, cancelling of appointments, ordering of repeat prescriptions, communication with the practice..”
“All NHS patients will have secure online access, where they wish it, to their personal GP records by 2015”
• patient-online-access@rcgp.org.uk
Welcome
The programme is split into three phases:
Phase 1- Initiation and defining the scope of work (June - September 2012);
Phase 2- Specification development and initial delivery (October – December
2012);
Phase 3- support, training and education
2013-2015
• patient-online-access@rcgp.org.uk
Objectives: in the setting of a national policy
Guidance on what is needed to implement Patient Online in general practice
Guidance on the implications of implementing Patient Online in general practice
A plan for next steps (2013 to 2015)
• patient-online-access@rcgp.org.uk
The working groups (WGs)
•Defining the Offer
•Communicating the balanced benefits
•Information Governance and Safeguarding
•Support, Training and Education
•Supplier and Market Liaison
•Evidence and evaluation
• patient-online-access@rcgp.org.uk
WG1: Defining the offer (Ash)
Items specified include functionality that is already present in current systems and that many practices are already using or considering implementing as a first step in offering online access.
Resources will need to be identified to enable practices to take on these new work processes, such as password management.
Ash Practices
Services:
•Order medication
•Book and cancel appointments
•Results (with or without comments)
•Demographic changes
• patient-online-access@rcgp.org.uk
Moving on: Incremental progression
•
•Coded information e.g. immunisations, allergies, problem titles
•Letters to and from hospitals and clinics
•Entire record from today
•Entire record patient-online-access@rcgp.org.uk
What is the current status?
GP Practices, allowing online:
Booking and cancelling appointments
Capable/functionality Actual
98%
Access to medication/ ordering medication
98% provision
37%
40%
Access to records and letters
75% < 1%
• patient-online-access@rcgp.org.uk
WG2 :Communicating the balanced benefits
Technology as an enabler
Change Management
Enthusiasts, early adopters and the mainstream
Clinically and locally owned
Mix-and-match
Supporting partnership and trust, patient centric
• patient-online-access@rcgp.org.uk
Health inequalities and
Vulnerable Groups
Children
Adults with incapacity
Domestic violence
Health literacy
• patient-online-access@rcgp.org.uk
WG3:Information governance
Information governance risk register, identifies the vulnerability and potential mitigating factors
Identity management
Liaison with Caldicott IG review (e.g. Third party data)
Consent management
System and data security
Safe record keeping guidance
• patient-online-access@rcgp.org.uk
WG4: Support, training, education
Developing learning materials with partners for Practices and
Patients based on the final offer and any updated RCGP
Guidance
Developing and implementing a Training Needs Analysis process for Practices to assess need and review progress
Promoting and rolling out learning support and materials via the proposed Portal in partnership with key national and local groups
Regular review and evaluation to ensure new lessons are learned and applied and policy/service developments are incorporated
• patient-online-access@rcgp.org.uk
WG5: Industry perspective
NHS England should encourage innovation, diversity and development (should reduce risks to suppliers)
NHS procurement should incentivise
Mandate Patient Online through GP systems of choice
(GPSoc)
Suppliers need to offer guidance to practices
GP system suppliers need to provide functional options to give practices flexibility. (Should include patient – centric system design principles)
• patient-online-access@rcgp.org.uk
Objectives
Identify and understand the barriers and facilitators to providing online access to records and transactional services in ambulatory care
Assess the benefits and harms of online access to records and transactional services and how they affect the quality and safety of health care
• patient-online-access@rcgp.org.uk
Evidence
Online access to records potential enabler
Limited evidence of benefit
None of significant harm
Well designed and developed transactional services have greatest potential for benefits for patients and efficiency gains for providers
Wider international perspective
Croatia – no national access
Denmark – joined up since 1997, online detailed access 2000, used by 0.4%
England & France: SCR & DMP
Estonia – comprehensive system 3.6% access records
Greece – legislation but not available
Ireland –
Hospital slots & waiting times (24 hour patient access not realised)
Russia – private free system available – but patient access not a priority de Lusignan S, et al.,. Submitted for publication MEDINFO 2013
International Perspectives
Phase 3
Development of commercial framework to support practices
Completion of systematic review
Caldicott Information Governance review
•
Acknowledgments
Chairs of WGs: Libby Morris, Peter Short,
Sandy Gower, Simon de Lusignan
Stakeholder Group Members
Vice Chairs of WGs, WG Members, Support for
WGs
RCGP Health Inequalities Group
RCGP: Chris Gush, Arwen Wilcock, Gillian
Watson, Hannah Price, Lucy Wood
DHID: Henry Pares, Richard Ives, Richard
Haigh, Bruce Elliot, Toto Gronlund, Eileen
Phillips patient-online-access@rcgp.org.uk
