patients in your heart

Electronic Patient Recordsand the new national

agenda:Where do Radiology

Management systems and PACS fit in today?

Patients in your heartPatients in mind

Patientsand families

Dr Charles Gutteridge Clinical Informatics

The scale of change


Have we reduced the mountain of suffering?


Do health costs matter?


It is global....


Productivity and growth


NPfIT - Spine Service Connections

Messaging (TMS & DTS)

DemographicsSCR Directories

Data transfer

Testenvts

•U

nstr

uctu

red

data

•C

hoos

e &

B

ook

•G

P 2

GP

•In

fras

truc

tur

e•

LRS

•E

TP•

PDS

•G

P Su

mm

ary

•PS

ISQ

•D

isch

arge

•Em

erge

ncy

Dep

t•

Hea

lthsp

ace

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utpa

tient

s•

Seal

ed

Env

elop

es•

Aler

ts•

Hea

lth /

Soci

al C

are

Inte

grat

ion

•Pa

thol

ogy

•C

omm

on

P2P

•Ad

mis

sion

s•

Out

of H

ours

•Am

bula

nce

•M

enta

l H

ealth

•N

HS

Dir

ect

•D

iagn

ostic

Im

agin

g•

NM

S N

atio

nal

Mon

itori

ng

Serv

ice

Data

Infrastructure

Messagessupported

Servicesprovided

Summary Care Record, Choose and Book, Electronic Prescription Service, Healthspace,GP2GP, NN4B, QMAS

SUS

Nationalapplicationssupported

Identity mgt

GP systems, Pharmacy systems,Hospital systems, Electronic Staff Record

Otherconnectedsystems

MoD, Home Countries,Other government systems

Reporting info

Prescriptions

Demographics

Care recordsMessaging

Identity managemen

t

Test &Training

environments

Reporting


Health IT use


Lesson 1 - Interoperability

It is possible to deliver systems nationally but:

Time frame is longLeadership challenge is greatInnovation gets left behind


Lesson 2 – Professional leadership

Professional engagement in solutions is critical:

Local works better than nationalNurse involvement is criticalUsability is a key factor


Lesson 3 - Innovation

IT and software innovation is a key to change but:

Innovation outstrips organisational capacity to introduce change

Innovation is costly for first in type usersInnovation disrupts established processes


Lesson 4 - Analytics

Analytics must be built in from the start:

Clinical data extraction is the key to use by doctors and academics

Performance management tools deliver engagement


Lesson 5 – User training

User training is key to good system performance and:

Is always underestimated and under delivered

System implementation has a stronger focus than sustainable use


Dr Charles Gutteridge Clinical InformaticsDr Charles Gutteridge Clinical Informatics

Are we clear about what we want to do?

Focus on changing care delivery


At present it is:

Centred on infrastructure

Led by professional groups

Digital solutions remain disconnected Clinical variation

% of high risk TIAs treated within 24 hours


The changed paradigm – local delivery


Wellness and self care

Defined by citizens

Innovative use of digital solutions

Information and knowledge

Comparison and choice

Apps and mobile devices

Opp0rtunities for care


• At the bedside

Care and treatment discussions

Safety

Quality

Productivity

Decision support

Video and application support

Training routines

Comparative information

Analytics


Digital care delivery

So how might we do that….?


5 challenges for a clinical leader

1.Knowledge and content management

2.Measurement and performance3.Patient experience at the frontline4.Innovation5.Education and training

Connecting the data

Pharmaceutical data


Data quality


Comparative OECD 2010 data

Country Scanners/million CT scans/1000Australia 42 94Canada 14 125Denmark 27 84France 11 138

UK 8 73US 34 228


Patient involvement


Teaching and education

Link the professions

Teach advanced informatics

Teach analytics

Teach performance management


patients in your heart

Documents

clinical data extraction

self care

hospital systems

pharmacy systems

radiology management

local works

heart patients

stronger focus