Decision Support
and a Technology-Enabled Workforce
Rural General Hospitals Conference
27th September 2016
Dr Ann Wales, Specialist Lead, Scottish Government eHealth
[email protected]
Overview
1. Challenges
2. How Decision Support tools are
addressing these challenges.
3. What are the opportunities for RGHs?
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•
Tools and techniques
Building confidence and competence in using
technology
Challenges
Clinical Strategy
• Increasing demand/diminishing resource
• Unwarranted variation and waste
• Ageing population
• Increasing complexity of care
Knowledge base
• 17 year gap between research and practice
• Doubling time for published healthcare
knowledge will be 73 days by 2030.
RGH Challenges
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•
•
•
Isolation
Distance
Limited access to specialists
Dealing with low volume high acuity cases
• Building confidence in decision-making top
priority in 2016 RGH VC education survey.
Decision Support Roadmap
Part of national eHealth Strategy
Role in Clinical Strategy - supporting Realistic Medicine
•
•
•
•
•
•
•
Reduce harm and waste
Reduce unnecessary variation
Informed management of risk
Personalised approach to care
Shared decision-making
Improve processes in hospitals
Build capacity in community and
primary care.
Reduce variation and waste. Manage risk
Antimicrobial prescribing
Sepsis
Polypharmacy
Improve processes in hospitals
Clicking on Evidence
link leads to evidence
sources.
7
Patient-Specific Decision Support
Patient-specific prompts based
on SIGN integrated into SCIDiabetes.
• Patients 3-4 times more
likely to be referred for
screening in line with
guidance.
• Small but significant
improvement in glycaemic
control.
Shared decision-making
Proposals in hand:
• Decision aid to support patient-clinician
conversations about insertion of grommets.
• Mobile app to monitor maternal risk
throughout pregnancy; facilitate clinician
-patient conversations.
RGH Opportunities
Development of Mobile Decision Support Handbook for RGHs.
Adapt and augment Lothian Adult Emergency Care Handbook.
“Top 20” Priorities for RGHs – e.g:
• Sepsis
• Deteriorating patient
• Chest pain
• Abdominal pain
• Acute respiratory infection
• Asthma
• Dementia
• Intoxication
RGH Opportunities
Handbooks Editorial Platform
Use
templates
and localize
Deliver
to web &
mobile
RGH Opportunities cont.
Proposal for mobile app suite for community
nurses and Advanced Nurse Practitioners in
community hospitals – extend to RGHs?
Examples of topics:
• Sepsis
• Wound care
• Continence care
• Palliative care
RGH Opportunities cont.
Build workforce capability in using technology.
2014-15 survey of technology skills needs (N=12,879)
Main value of technology is to support decision-making (78%)
Many already confident in using technology (68%)
Top priorities for further skills development:
• Using technology for shared decision-making with patients
(48%)
• Using technology for clinical decision-making (42%)
• Using teleheathcare and assistive technologies (41%).
RGH Opportunities cont.
How to use survey recommendations in your
learning and development plans?
Survey highlighted 4 capability domains:
• Generic digital literacy – Internet, MS Office,
Information governance, social media
• Technology for health literacy and shared
decision-making
• Using telehealthcare solutions
• Leadership and facilitation in using technology as
an integral part of care.
RGH Opportunities cont.
Get involved….
Workforce development to support
Technology-Enabled Care Programme.
• Mapping learning needs and existing learning
resources for TEC in health and care
partnerships.
• Facilitating spread of skills and change in
attitudes to TEC across partnerships.
RGH Opportunities cont.
NES
Board Learning
and
Development
Leads
Building a TechnologyEnabled Workforce
Higher
Education
Scottish Centre
for Telehealth
and Telecare
Priority in 2020 Workforce
Implementation Plan
Collaboration and coordination
TEC programme
SSSC
National collection of online
learning resources for technology
capabilities ???
Discussion
How can you make best use of the opportunities
to use decision support tools and to build
workforce capability in using technology?
Decision Support
and a Technology-Enabled Workforce
Rural General Hospitals Conference
27th September 2016
Dr Ann Wales, Specialist Lead, Scottish Government eHealth
[email protected]