Eunice E Muir
Scottish Government
eHealth Clinical Lead
SG eHealth Strategy 2011-17
&
NHSScotland Nurse, Midwife &
AHP (NMAHP’s) eHealth Network
LEASONS FROM eHealth HISTORY
• If you computerise a mess, the outcome
will be a bigger mess
• Focus on improvement, not IT for the
sake of it
• Try to spend 25% of project costs on IT
• Need top down and bottom up approach
SG eHealth Strategy 2011-17
•six national strategic aims
•each reflected in local Health Board eHealth
Plans
•Supported by common progress measures
Time to exploit previous investments –
focus on helping bring about real service
improvement
NMAHP’s/eHealth/Care Delivery
• It is time to build what NMAHP’s want
• NMAHP’s do not want to be passive
consumers of technology
• Establish partnerships around better
functionality and devices
• Facilitate adoption of technology as a
constituent of quality and safety measures
eHealth governance
NMAHP eHealth Network
•Established July 2012
•Integrated within eHealth structure
•NMAHP representation at Assoc. Director level
from Boards, HEI’s, Prof Bodies
•ToR’s approved
•Meets quarterly via Teleconf and face-to-face
•Leadership Summit + Workshop Learning Event
•Links to 5 Countries eHealth Partnership
STRATEGIC eHEALTH AIMS
To use information and technology in a coordinated
way to:
1. Maximise efficient working practices, minimise
wasteful variation, bring about savings and value
for money
2. Support people to communicate with NHSS,
manage their own health and wellbeing, and to
become more active participants in the care and
services they receive
3. Contribute to care integration and to support
people with long term conditions
Patient
Portals
Patient
Portals
Email
and SMS
Websites
Improving
Information
One-way
communication
(NHS to patient/person)
Patient
Portals
Self Check-in
Kiosks
Appointments
and
repeat
prescriptions
Email and SMS
Reminders
Two-way
communication
(to & from patient/person)
Home
Monitoring
Peer
support
Social
Media
Patient
Portals
Online
forums
co-created Key Information Summary
• e-form, mostly filled in automatically with information
held in GP practice electronic patient record
• co-created by GP practice with patient
• targeted for people most likely to need anticipatory/ outof-hours care
• available electronically to NHS 24, ambulance,
community teams, A&E
KIS content
Section 1 – “Special Note”
– Free text field of 2048 Characters
– Expiry Date
– Patient, Carer and involved staff details
– Other demographics (eg. next of kin)
Section 2 – Current Situation
– Medical Information and Diagnosis
– ACP / Self Management Plan agreement
– Home Oxygen
Section 3 – Care and Support details
– Homecare support
– Incapacity / Guardianship
– Power of Attorney
Section 4 – Resuscitation
– DNACPR
– CYPADM (Children Resuscitation)
– Current and Preferred Place of Care
– any special instructions
Status: all prep work done; roll-out from April; part of GP contract
Future:
Patient/carer access via web/ App, with section for self completion?
Extensible to other contributors to care?
STRATEGIC eHEALTH AIMS
To use information and technology in a coordinated
way to:
4. Improve the availability of appropriate information
for healthcare workers and the tools to use and
communicate that information effectively to
improve quality
5. To improve the safety of people taking medicines
and their effective use
6. Provide ‘near real-time’ management information
in support of local decision making
Data Sharing Technologies Board
•
•
•
Representatives from Local Authorities and Health Boards.
Membership will be extended to include other public bodies
(eg Police) and Third Sector
Transition from national “one size fits all” approach to a
series of locally led initiatives
Three strands of business:–
–
–
stewardship of the legacy National eCare IT
promote innovative and pragmatic information sharing
initiatives that result in better outcomes for service users
develop and oversee the implementation of the Health &
Social Care IT Strategy.
clinical portal
• ‘virtual’ electronic patient record – not
about large national database
• electronic window to information held in
different places, fetched and viewed by
clinician on an as-required basis
Greater Glasgow & Clyde
NHS Lanarkshire trial
• ECS accessed for 405 admissions
• for 67 patients (22%) ECS contained additional info
for 23 (35%) of those patients potential harm was
avoided courtesy of ECS access
+ a separate comparison of 30 referral letters - drugs
vs. actual current prescription - found 119
discrepancies
Where they were……
• Very supportive of Scottish Patient Safety Programme
work streams (General Ward, Peri-Operative, Medicines Management,
Critical Care and Leadership) and Leading Better Care Clinical Quality
Indicators (Falls, Pressure Ulcers, and Food, Fluid and Nutrition)
• But meant laborious manual data collection by clinical
staff
• Feedback lags – needed more real time analysis and
reporting of data directly to front line staff.
• got front-line clinical staff to develop local meaningful
indicators
• developed LANQIP - web-based tool
• supports the collation, analysis, real-time reporting and
feedback
• gives feedback to clinical teams regarding clinical practice,
tailored to their needs
• Increased efficiency and “buy in” from clinical teams by
eliminating manual burden
• Improve data quality through the increased sense of data
ownership and how it relates and impacts clinical practice
Range of feedback reports
The future? More of the same… but with
increasing role for mobile devices
Eunice E Muir
Scottish Government
eHealth Clinical Lead
SG eHealth Strategy 2011-17
&
NHSScotland Nurse, Midwife &
AHP (NMAHP’s) eHealth Network