eHealth Strategy
Primary and Community Care
where next?
Paul Gray
Director of Primary Care & Community Care
To cover
1. The Government’s policy context
2. Revised eHealth Strategy
3. Prospects for primary and community care IT
Tomorrow
Paul Rhodes, eHealth Programme Director, on the
programme itself
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Policy context
The future model of health care
Current view
Geared towards acute
Hospital centred
Doctor dependent
Episodic care
Disjointed care
Reactive care
Patient as passive recipient
Self care infrequent
Carers undervalued
Low tech
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Evolving model of care
Geared towards long-term
Embedded in communities
Team based
Continuous care
Integrated care
Preventive care
Patient as partner
Self care encouraged
Carers supported as partners
High tech
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eHealth Strategy
Key principles
1. Much has been achieved – don’t rip-and-replace
unless necessary
2. Incremental progress – link to what exists
3. Work closely with clinicians and other users
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Where we are now with eHealth –big picture
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Where we’re trying to get to
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eHealth Strategy: What might be new?
Long list of desired investments, for example..
Secondary care: disparate, ageing patient admin systems
and few clinical systems
Electronic test requesting
CHI number use and Single sign-on
GP and community systems (IPACC)/ links with partner
agencies
National Child Health systems – in silos and paper-heavy
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eHealth Strategy: What might be new?
•
whole list can’t all happen – resource and
capacity constraints
•
prioritisation needed, and levering real benefit
from previous investment
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eHealth implications for primary and
community care
1. Efficient and effective flows of information to
support whole patient journey
• including links with partners, principally Local
Authorities and the voluntary sector
2. Information to support anticipatory care
3. Information to support patient involvement
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Examples: 1. Information to support
whole patient journey
Examples
• SCI Gateway referrals – 60,000 per month
• Emergency Care Summary – proving useful
in A&E, OOH and NHS24
• electronic Single Shared Assessment (eSSA)
in one or two Data Sharing Partnerships
Issues
• few discharge letters using SCI Gateway
• slow progress with eSSA
• confidentiality/ information governance
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Examples: 1. Information to support
whole patient journey
Information governance
•
•
Benefits barrier in existing eHealth systems
• For example, the storage of clinical letters in SCIStore from SCI-Gateway.
Potential barrier to eHealth innovation.
Approach
•
Study investigating key IG challenges
•
•
Staff Identification, authentication, and access control; Consent;
Clinical IF Ownership; Patient engagement; IG Frameworks
Report due Spring 2008
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Examples: 2. Information to support
anticipatory care
Examples
• Nairn project – working with Raigmore to spot
patients most likely to be re-admitted
• SPARRA – ISD’s prediction algorithm
Issues
• getting sufficient and accurate data
• incentives for primary care
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Examples: 3. Information to support
patient involvement
Examples
• Townhead Surgery, Irvine - Patient Online.
Secure web site: books appointments,
commented test results etc
More opportunities?
• further exploit the Internet? (SHOW gets 26
million hits per month from Internet)
•
•
individual care plans on patient’s secure
website? With access to trusted guidance?
trial of voluntary patient access to ECS?
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eHealth Strategy: next steps
Further consultation and analysis
eHealth Strategy Board – key meeting in
December
Draft for comment early 2008, finalised around
April
Make your views known!
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Key messages
1. Primary and community care is key to the patient care.
But whole patient care means information support
wherever the baton of care is passed.
2. Local decisions can mean central spend, but that might
be the wrong place for ensuring best value for money
from that spend. Equally, national decisions can have
local knock-on, so we want to get better at
understanding that.
3. Before considering new things to invest in we must
make sure all possible benefit is squeezed out of what
exists.
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Finally,
thanks to …
For sponsoring the conference
But more particularly for their useful work
around future for Child Health eHealth
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