© fujitsu services 2005 royal college of radiologists pacs & teleradiology group 15 th november...
TRANSCRIPT
Royal College of Radiologists PACS & Teleradiology Group
15th November 2005
© Fujitsu Services 2005
Creative Tensions in Healthcare ProvisionDr Lester RussellChief Medical Officer, Fujitsu
2 © Fujitsu Services 2005
“I need someone expert in the art of extreme torture – do you know PowerPoint?”
Royal College of Radiologists PACS & Teleradiology Group
15th November 2005
© Fujitsu Services 2005
Standardisation
Interconnection
Personalisation
Royal College of Radiologists PACS & Teleradiology Group
15th November 2005
© Fujitsu Services 2005
What’s happening
in England?
5 © Fujitsu Services 2005
What’s happening in England?
“No, the computers are up. We’re down.”
6 © Fujitsu Services 2005
The Five Clusters
•The programme has divided the country into five geographical areas, or "Clusters".
•A Local Service Provider (LSP) has been appointed to implement IT systems for the NHS in each Cluster
Key
Cluster LSPMain Health Systems
Supplier
Southern Fujitsu Cerner
London CCA IDX
North East Accenture iSoft
Eastern Accenture iSoftNorth West & West
Midlands CSC iSoft
7 © Fujitsu Services 2005
Southern Cluster
12
3
4
5
67
There are 7 Strategic Health Authorities in
the Southern Cluster:1. Kent & Medway
2. Surrey & Sussex
3. Thames Valley
4. Hampshire & Isle Of Wight
5. Avon, Gloucestershire & Wiltshire
6. Dorset & Somerset
7. South West Peninsula
8 © Fujitsu Services 2005
Basic Demographics
The Southern Cluster includes:• 81 primary care trusts • 63 hospital trusts • 35 social services
Organisation Type Cluster Total
Acute Teaching Trusts 5
Large Acute Trusts 12
Medium Acute Trusts 17
Small Acute Trusts 7
Acute Specialist Trusts 3
Mental Health &
Community
19
Primary Care Trusts 81
Ambulance Trusts 12
Total 156
© Fujitsu Services 2005
PACS Deployment – Overall Status – 4th November
• 40 Initial Engagement Meetings completed
• Live Services:• West Dorset – PACS
• Salisbury – PACS + locally-hosted RIS
• Maidstone & Tunbridge Wells – CR / MasterPage / Printers
• Dartford & Gravesham – CR / MasterPage + Data Centre-hosted RIS
• Poole – CR
• Milton Keynes – PACS
• James Paget (EEM Cluster) – PACS
• PACS Cluster Data Store – fully operational (6,089,130 images at 4 th November)
• RIS Data Centre Applications and Databases – operational (4 SHA domains in use)
• James Paget – data centre connection 2nd November
• Royal Surrey – RIS commenced service on 4th November
• Poole – RIS 7th November
• Gloucester – RIS 7th November
• Dartford & Gravesham – PACS 8th November
© Fujitsu Services 2005
• Equipment delivered and implementation proceeding at:• East Kent, Ashford & St Peter’s, Gloucestershire, Plymouth Academy,
Royal Surrey, Royal Cornwall
• Equipment on order for:• NOC, North Hampshire, Maidstone & Tunbridge Wells, Plymouth,
Brighton & Sussex (frozen), East Somerset, UHCW (NWWM Cluster), Medway
PACS Deployment – Overall Status – 4th November
11 © Fujitsu Services 2005
Service Status
Cumulative Images
0
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
12 © Fujitsu Services 2005
Mission
The role of Fujitsu as a Local Service Provider (LSP) is to
enable healthcare organisations to improve and maintain health.
13 © Fujitsu Services 2005
Health productivity – the critical quotient
$max
14 © Fujitsu Services 2005
Health productivity – the critical quotient
€max
15 © Fujitsu Services 2005
Health productivity – the critical quotient
¥max
16 © Fujitsu Services 2005
Health productivity – the critical quotient
£max
17 © Fujitsu Services 2005
Healthcare productivity
The people of the UK should not be asking, “How many events for the pound?” but rather, “How much health for the pound?”
Donald Berwick - President, Institute for Healthcare Improvement, Cambridge MA
Measuring NHS productivity - BMJ Vol. 330 30th April 2005
18 © Fujitsu Services 2005
Healthcare productivity
“In five years’ time, you will be your data.”
Prof. Martin Severs – Chairman, Information Standards Board
19 © Fujitsu Services 2005
Enabling change - achieving health benefits
Smart deployment of IT systems
Service redesign
Realisation of health benefits
20 © Fujitsu Services 2005
Enabling change - achieving health benefits
Smart deployment of IT systems
Service redesign
Realisation of health benefits
Modernisation
Royal College of Radiologists PACS & Teleradiology Group
15th November 2005
© Fujitsu Services 2005
Standardisation
Interconnection
Personalisation
22 © Fujitsu Services 2005
Future trends
Standardisation vs.
Localisation
23 © Fujitsu Services 2005
Future trends
Localisation“Our National Health Service is also a very local health service – and therein lies one of its key strengths.…what works in one place may not necessarily work in another. The local challenge is to shape services to match the characteristics, needs and priorities of the communities they support….”John Reid, Secretary of State for Health
Our NHS – Where Next? South West Peninsula Strategic Health Authority 2004
24 © Fujitsu Services 2005
Future trends
Standardisation
•Patient confidence•Medical risk•Medico-legal risk•Transfer of data •Care across different settings and by different providers
Royal College of Radiologists PACS & Teleradiology Group
15th November 2005
© Fujitsu Services 2005
Standardisation
Interconnection
Personalisation
26 © Fujitsu Services 2005
Future trends
Interconnection vs.
Fragmentation
27 © Fujitsu Services 2005
Future trends
Fragmentation of providers•Purchaser/provider split•Paid-for (but not necessarily provided-by) the NHS•NHS as a commissioner•Increased competition
28 © Fujitsu Services 2005
“If you don’t like change, you’re going to like irrelevance even less.”
General Eric Shinseki, Chief of Staff, US Army
29 © Fujitsu Services 2005
Future trends
Interconnection •Home-care, primary, secondary and tertiary care•Scheduled and unscheduled•Urgent care and planned care•Healthcare, social care and education
Royal College of Radiologists PACS & Teleradiology Group
15th November 2005
© Fujitsu Services 2005
Standardisation
Interconnection
Personalisation
31 © Fujitsu Services 2005
Future trends
Personalisation vs.
Commoditisation
32 © Fujitsu Services 2005
Future trends
Comparative clinical outcomes analysis•Away from block contracts•Towards Payment by Results (PBR) - really payment by activity•Through Practice Based Commissioning (PBC)•To payment by outcome
33 © Fujitsu Services 2005
Future trends
Commoditisation•Robust measures of quality •Quality comparisons•Value-for-money approach to commissioning •Personal health choices driven by quality
34 © Fujitsu Services 2005
Future trends
Personalised care•Away from secondary care organisations’ menu-driven approach •Towards primary care organisations, as a proxy for patient-driven care •To patient making choices – including out-of-hospital care
35 © Fujitsu Services 2005
National and regional healthcare
The enduring functional unit of the NHS is the referral network
which surrounds the patient.
36 © Fujitsu Services 2005
Key point summary
1. Standardisation – Consistency of service, transferability of data.
2. Localisation – Services which are responsive to local needs.
3. Interconnection – Care is deliverable in different settings.
4. Fragmentation – Competition amongst providers.
5. Personalisation – Care packages tailored to the individual.
6. Commoditisation – High quality, low cost, high modularity.
37 © Fujitsu Services 2005
Advances in technology Ray Kurzweil NewScientist.com 24 September 2005
38 © Fujitsu Services 2005
Advances in technology
“We won’t experience 100 years of technological advance in the 21st century; we will witness in the order of 20,000 years of progress when measured by the rate of progress in 2000, or about 1,000 times that achieved in the 20th century”
Ray Kurzweil, Inventor and writer
39 © Fujitsu Services 2005
“..and that’s why we need a computer.”
40 © Fujitsu Services 2005