geoff wedgwood beyond 2010

People-Powered HealthIn the West Midlands

HealthCare in the UK presents many big

challenges

Obesity, for example ...

23% of UK 5-year olds are overweight

1 in 3 UK Teenagers are

overweight

1 in 6 are obese

Annual Cost of Obesity to the NHS: £4.2 Bn

Annual Cost of Obesity to the UK

£15.8 Bn

Foresight Report, Oct 2007: “Tackling Obesities: Future Choices”

Underlying trends are clear …

Annual Cost of Obesity to Society by 2050: £50 Bn

Foresight Report, Oct 2007: “Tackling Obesities: Future Choices”

… and are set to continue

And Obesity is just one example ...

Big Healthcare Challenges in the West Midlands

2008

• Better navigation• Increasing public

confidence• Improving innovation• Reducing inequalities

• Reducing variability in quality & safety

• Increasing the sustainability of services

In the West Midlands, we wanted to adapt our

approach to tacklingbig challenges such

as these

We believed in combining what already

worked well with new and more creative ways of

doing things …

… such as Digital Healthcare

… to enable more sustainable models of

care to emerge

Old Model of Care

(Digital Healthcare rare)

New Model of Care(Digital Healthcare the norm)

• Focus on Acute Conditions • Focus on Long Term Conditions

• Reactive Management • Prevention & Continuing Care

• Hospital Centred • Embedded in Homes & Communities

• Disjointed Episodes • Integrated with People’s lives

• Doctor-dependent • Shared record - Team-based

• Patient as passive recipient • Patient as partner

• Self-care infrequent • Self-care encouraged & supported

Adapted from Prof. Jeremy Wyatt, Institute of Digital Healthcare, University of Warwick

The potential of Digital Healthcare

Digital Healthcare never more appropriate

• Better navigation• Increasing public

confidence• Improving innovation• Reducing inequalities

2010

Relatively flat resources + rising demand & costs = funding gap- A productivity challenge of doing “better for less” (QIPP) -

• Reducing variability in quality & safety

• Increasing the sustainability of services

2008

• “The re-design of health services supported by appropriate digital technologies”

• “The application of appropriate information or communication technologies to the promotion of health, prevention & management of disease & delivery of health services”

What is Digital HealthCare?

Not a new idea …

Source: Prof. Jeremy Wyatt, Institute of Digital Healthcare, University of Warwick

Lifeline

Relevant Activities

Candidate Tech

Healthy

Health Promotio

n

IP-based, Web, TV,

Kiosks, Apps,

Consoles, Serious Games

Symptoms

Screening

IP-based, Web,

Phone, Tele

Monitoring, SMS

Diagnosis

Test Choice &

Inter-pretatio

n

Tele-Medicine

, Decision Support,

EHRs

Long Term

Condition

Prognosis; Drug

Choice & Dose, Self-Care

Prescribing

Alerts, SMS, Tele

Health, Prediction Rules,

EHRs

End of Life

Supported Self-

Care

Virtual Ward /

Hospice

Adapted from Prof. Jeremy Wyatt, Institute of Digital Healthcare, University of Warwick

Appropriate Digital TechnologiesAcross the Healthcare Lifeline …

Digital Healthcare needs to operate across many types of boundary to unleash its potential

To achieve this, we’re buildingan open digital healthcare

ecosystem with a range of new, local healthcare services …

… services capable of improving the lives & health of the region’s

5.5M Citizens

… services designed to support the region’s 147,000 Staff in delivering safe, high quality,

innovative healthcare services

… local health services

that leverage the power of

technology, but are designed

around people

NHS localA local digital healthcare ecosystem

for People-Powered Health

NHS local EcosystemUnderlying Principles

NHS local EcosystemUnderlying Principles

• NHS local is an umbrella brand for a “bottom-up” approach to transforming service delivery

• NHS local curates the best services from an “ecosystem” of partners and provides others itself, all through a common, open platform

• Ecosystem = co-creation, collaboration, participation & sharing = “Big Society”?

• Engaging, informative & interactive user journeys, designed around the needs of local users, not providers

NHS local EcosystemUnderlying Principles

• Supportive of local people, their networks, successes & challenges: reflects the region’s diversity

• Local resources, services, tools & applications

• Complements & works with national services

NHS local EcosystemUnderlying Principles

• An open, standards-based platform, at the heart of Service Transformation & Delivery

• Not centrally-driven - interoperable, “Connect All” to reflect local priorities, open APIs, driven by data

• Iterative, built to evolve and encompass transactional services – eLearning, TeleHealth, EHRs, etc.

NHS local EcosystemUnderlying Principles

• Uniquely, a single, integrated framework of services for both local citizens and staff, creating a partnership between them

• Available through the places, services & channels that Staff and Citizens already know, & our dedicated online Hub

NHS local EcosystemUnderlying Principles

The Hub

Benefit (Stage I)

1. Reduces Training Costs

Big Challenge

Sustainability of Services

Benefit (Stage I)

2. Showcases Best Practice

Big Challenge

Reduced variability in quality / safety

Benefit (Stage I)

3. Enables Greater Dialogue between Staff & Citizens on quality of care

Big Challenge

Reduced variability in quality / safety

Benefit (Stage I)

4. Shows patients how others in their situation are “doing it”

Big Challenge

Better Navigation

Benefit (Stage I)

5. Brings care pathways to life

Big Challenge

Better navigation

Benefit (Stage I)

6. Provides a channel for Staff & Patients to share views openly, and receive responses

Big Challenge

Improved Public Confidence in Health System

Benefit (Stage I)

7. Breaks down barriers between Staff & Citizens – “what it’s really like”

Big Challenge

Improved Public Confidence in Health System

Benefit (Stage I)

8. Projects a friendly, open and accessible face of the health service to Citizens

Big Challenge

Improved Public Confidence in Health System

Benefit (Stage I)

9. Fosters a culture of innovation in Staff and celebrates it

Big Challenge

Innovation

Benefit (Stage I)

10. Makes local health services more accessible and attractive to traditionally “hard to reach” groups

Big Challenge

Reducing Inequalities

The NHS local Digital Healthcare Ecosystem is an enabler for addressing

Big Healthcare Challenges & QIPP

Benefits

Key Service Benefits: Stage IBig Challenges Q I P P NHS local Benefit Area

Sustainability of services * 1. Reduces training costs

Reduced variability in quality/safety * * 2. Broadcasts best practice

Reduced variability in quality/safety * * 3. Enables greater dialogue between staff & citizens on quality of care

Better navigation * 4. Shows patients how others in their situation are “doing it”

Better navigation * 5. Brings care pathways to life

Improved public confidence in health system

* * 6. Provides a channel for staff & patients to share views openly, and receive responses

Improved public confidence in health system

* 7. Breaks down barriers between staff & citizens – “what it’s really like”

Improved public confidence in health system

* 8. Projects a friendly, open and accessible face of the health service to citizens

Innovation * 9. Fosters a culture of innovation in staff and celebrates it

Reducing inequalities * * 10. Makes local health services more accessible and attractive to traditionally “hard to reach” groups

QIPP: Quality, Innovation, Productivity, Prevention

Benefits will deepen & widen as the NHS local Digital Healthcare Ecosystem

moves into Stage II (early 2011)

Benefits

A Staged Approach

Stage I Stage II

Un-integrated Informatics / TeleHealth / Digital Services

Integrated Informatics / TeleHealth / Digital Services

TeleHealthCare: pilots, stand-alone … TeleHealthCare: beyond pilots, integrated

Digital Healthcare Ecosystem (NHS local): Digital Healthcare Ecosystem (NHS local):

• Informal Training • Formal Training (eLearning)

• Showcase best practice • Online Communities of Practice empowered to execute best practice

• Embryonic Collaboration & Engagement • Deep Collaboration & Engagement

• Dissemination of data to drive Quality • Quality & Services powered by Open Data

• Powered by Information, across system boundaries

• Powered by Transactions, across system boundaries (especially self-service)

• Tangible but potential framework for change, scalable test bed for Service Reform (Health White Paper), “Patient Revolution” (Information Strategy /Choice Agenda)

• Tangible and actual framework for change, scaled delivery vehicle for Service Reform (Health White Paper), “Patient Revolution” (Information Strategy / Choice Agenda)

• Efficiency & Financial Savings

Thank You

Geoff WedgwoodProgramme Director, Digital Healthcaregeoff.wedgwood@westmidlands.nhs.ukM: 07751 407645

www.nhslocal.nhs.uk