Transcript Setting a Direction

Patient Online:
The Roadmap
16th April 2013
Healthcare Computing
Dr Imran Rafi
Chair RCGP Clinical Innovation and Research
Centre(CIRC)
http://www.rcgp.org.uk/patientonline
‘The power of information’
“By 2015, all general practices will be
expected to make available electronic
booking, cancelling of appointments,
ordering of repeat prescriptions,
communication with the practice..”
“All NHS patients will have secure online
access, where they wish it, to their
personal GP records by 2015”
•
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Welcome
The programme is split into three phases:
Phase 1- Initiation and defining the scope
of work (June - September 2012);
Phase 2- Specification development and
initial delivery (October – December
2012);
Phase 3- support, training and education
2013-2015
•
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Objectives: in the setting of a
national policy
Guidance on what is needed to
implement Patient Online in general
practice
Guidance on the implications of
implementing Patient Online in general
practice
A plan for next steps (2013 to 2015)
•
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The working groups (WGs)
•Defining the Offer
•Communicating the balanced benefits
•Information Governance and Safeguarding
•Support, Training and Education
•Supplier and Market Liaison
•Evidence and evaluation
•
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WG1: Defining the offer (Ash)
Items specified include functionality that
is already present in current systems and
that many practices are already using or
considering implementing as a first step
in offering online access.
Resources will need to be identified to
enable practices to take on these new
work processes, such as password
management.
Ash Practices
Services:
•Order medication
•Book and cancel
appointments
•Results (with or without
comments)
•Demographic changes
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Moving on: Incremental progression
•Coded information
e.g. immunisations,
allergies, problem
titles
•Letters to and from
hospitals and clinics
•Entire record from
today
•Entire record
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What is the current status?
GP Practices,
Capable/functionality Actual
allowing online:
provision
Booking and
98%
37%
cancelling
appointments
Access to medication/ 98%
40%
ordering medication
Access to records and 75%
letters
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< 1%
WG2 :Communicating the
balanced benefits
Technology as an enabler
Change Management
Enthusiasts, early adopters and the
mainstream
Clinically and locally owned
Mix-and-match
Supporting partnership and trust, patient
centric
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Health inequalities and
Vulnerable Groups
Children
Adults with incapacity
Domestic violence
Health literacy
•
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WG3:Information governance
Information governance risk register, identifies the
vulnerability and potential mitigating factors
Identity management
Liaison with Caldicott IG
review (e.g. Third party
data)
Consent management
System and data
security
Safe record keeping
guidance
•
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WG4: Support, training,
education
Developing learning materials with partners for Practices and
Patients based on the final offer and any updated RCGP
Guidance
Developing and implementing a Training Needs Analysis
process for Practices to assess need and review progress
Promoting and rolling out learning support and materials via
the proposed Portal in partnership with key national and local
groups
Regular review and evaluation to ensure new lessons are
learned and applied and policy/service developments are
incorporated
•
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WG5: Industry perspective
NHS England should encourage innovation, diversity
and development (should reduce risks to suppliers)
NHS procurement should incentivise
Mandate Patient Online through GP systems of choice
(GPSoc)
Suppliers need to offer guidance to practices
GP system suppliers need to provide functional options
to give practices flexibility. (Should include patient –
centric system design principles)
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Objectives
Identify and understand the barriers and
facilitators to providing online access to
records and transactional services in
ambulatory care
Assess the benefits and harms of online
access to records and transactional
services and how they affect the quality
and safety of health care
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Evidence
Online access to records potential
enabler
Limited evidence of benefit
None of significant harm
Well designed and developed
transactional services have greatest
potential for benefits for patients and
efficiency gains for providers
Wider international perspective
Croatia – no national access
Denmark – joined up since 1997, online detailed
access 2000, used by 0.4%
England & France: SCR & DMP
Estonia – comprehensive system 3.6% access records
Greece – legislation but not available
Ireland – Hospital slots & waiting times (24 hour patient
access not realised)
Russia – private free system available – but patient
access not a priority
de Lusignan S, et al.,. Submitted for publication MEDINFO 2013
International Perspectives
Phase 3
Development of commercial framework to
support practices
Completion of systematic review
Caldicott Information Governance review
Acknowledgments
Chairs of WGs: Libby Morris, Peter Short,
Sandy Gower, Simon de Lusignan
Stakeholder Group Members
Vice Chairs of WGs, WG Members, Support for
WGs
RCGP Health Inequalities Group
RCGP: Chris Gush, Arwen Wilcock, Gillian
Watson, Hannah Price, Lucy Wood
DHID: Henry Pares, Richard Ives, Richard
Haigh, Bruce Elliot, Toto Gronlund, Eileen
Phillips
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