Connecting Leeds Flickr.com/photos/62766743@n07

Dr. Tony Shannon

M.B. B.Ch. B.A.O. Ireland

Fellow of College of Emergency Medicine England

Fellowship in Informatics USA

MSc in IT Management England

NHS Connecting for Health England

Consultant in Emergency Medicine, Leeds Teaching Hospitals

Chief Clinical Information Officer, Leeds TH/Leeds NHS & Social Care

Director, Frectal Ltd

www.frectal.com

Key points

• Healthcare Change : Connect All

– People + Process + Information Technology

– Key role of Open Source

– Need for Open Standards

• Local/National/International

– Early Days

– Age of Enlightenment

– Leaders will emerge

Healthcare = Complex

Healthcare Challenge: People + Process + Technology

Thinking in silos Process versus IT Closed solutions

An International Challenge

Leeds TH 200+

Enterprise Wide

System x

Common Web UI

Integration Engine ESB

A B C

1

2

3

4

5

Core Process

Core Process

Core Process

Core Process

Core Process

Modular

SOA

Enterprise wide

System Y

Access/ SQL

State of the Market: A/ B /C

Healthcare Change: State of the Ecosystem Standards: Vendors: Innovators: Disconnect

International Standards

Local Innovators

eHealth Bodies

& Vendors

21st C NHS – Open Platform required

Assessment

Deliver Care Plan Care

21St Century Healthcare: OS Platform Required

200+

CUI Clinical Portal

TIE

A B C

1

2

3

4

5

PAS

Orders Results

Clinical Docs

Summary Care Record

Leeds TH: Starting Point & Options

LeedsTH EPR

Leeds EPR- HomePage

Leeds EPR - Results

Leeds EPR- Letters

Leeds EPR - (inc. Order Comms)

Leeds EPR- MPV

Leeds EPR- MPV

Leeds EPR- MPV

Leeds EPR- Reporting View

Leeds EPR Development

• Clinically Led

• User Centred

• Agile Development

– 2 weekly Sprints

• Joint NHS & Commercial SME Team

– Service Based Model

• Patient/Citizen centred record

• Information at the point of care

• To Support IH&SC teams

• Improve Outcomes and Services

• Built on Open Standards

Common Ground

LCR

Primary Care Secondary

Care

Social Care Community Care

Mental Health

Dataset: Locally Agreed ISA: First of type in UK

200+

LTH Clinical Portal

Integ Engine

A B C

1

2

3

4

5

Orders Results

ePrescribing

Summary Care Record

Leeds Care Record- Approach

Leeds Care Record

Leeds Care Record Viewer

TPP

LCR – for Direct Care EMIS

First of type in UK

Archetypes (Bricks)

Templates (Toys)

Interoperability Standard: Record Architecture

Generic

Specific

openEHR Archetype

• Clinically oriented • Reusable list of

clinical statements

• Maximal dataset • Can be coded with

terminologies e.g. Pulse, BP Leeds Care Record dataset End of Life Key contacts etc • Computable

Leeds Innovation Lab

• Leeds Lab

– People + Process + Technology

– Across Health & Social Care

– Live2Lab and Lab2Live

• OpenEHR Standards Based Platform

• Open NHS APIs

Further challenges

• System maturity – Politics & Requirements

• Business change – Organisational readiness

• Technology maturity – Host system ability to share data

– Maturity of Health IT market

Towards an ehealth ecosystem….

International Standards

Local Frontline Innovators

National eHealth Bodies

& Vendors

Regional

A Transatlantic VistA of Open Source

Leeds TH 200+

Enterprise Wide

System x

Common Web UI

Integration Engine ESB

A B C

1

2

3

4

5

Core Process

Core Process

Core Process

Core Process

Core Process

Modular

SOA

Enterprise wide

System Y

Access/ SQL

Current State of the Market

Healthcare Platform Services Consortium

• Short Version:

– Create an “App Store” for healthcare

• Long Version:

– Enable the acceleration

– Open, Standards based,

– Services oriented architecture platform

– new market for interoperable healthcare applications.

• Why?

– Improve the quality and decrease cost of health care.

Veterans Administration, US

NHS & VA 2013

UK & US OS EHR Camps

Assessment

Deliver Care Plan Care

21St Century Healthcare: OS Platform Required

Challenge # 1: Integration

Challenge #2: Code & Community

Challenge #3: UI & Usability

Opportunity #1: UI

• NHS CUI

• RCP Headings

Opportunity # 2: Service Layer

• Web Services

– MDWS

– VSA

– SMART

– VistA Evolution

• openNHS APIs

• Hackable Platform

Opportunity #3: Persistence

• M(umps)

• M(odels)

• A(rchetype)

Opportunities in Common Ground

• User Interface

– JS Frameworks

• Middle Tier

– Web Services

• Database & Persistence

robtweed.wordpress.com

10 Days: 1 Clinician: 1 Developer

ClinUiP.wordpress.com

20 Days: 2 Clinicians : 2 Developers

Transatlantic Team

Clinical Intelligence

Departmental Management

Patient Record

Data Entry

59

Leeds TH 200+

Enterprise Wide

System x

Common Web UI

Integration Engine ESB

A B C

1

2

3

4

5

Core Process

Core Process

Core Process

Core Process

Core Process

Modular

SOA

Enterprise wide

System Y

Access/ SQL

Current State of the Market

Towards an eHealth ecosystem

International Standards

Local Frontline Innovators

National eHealth Bodies

& Vendors

Regional

Key points

• Healthcare Change : Connect All

– People + Process + Information Technology

– Key role of Open Source

– Need for Open Standards

• Local/National/International

– Early Days

– Age of Enlightenment

– Leaders will emerge

Thank you

tony.shannon@frectal.com www.frectal.com

@frectally