Transcript Mike Cooke

Yet another darn talk about portals !
13 November 2014
Andrew Haw
Head of Health Informatics Service
5 Key Strategy priorities
Electronic Patient Record
Electronic Staff Record
Business Intelligence
Mobile working
Integration
2
Our definition
Information system that can integrate data from
disparate systems together & present the data in a
way that supports users needs & other tools:
Integration engine (Ensemble)
Master Patient Index management
Role Based Access Control and Single Sign-On
Workflow engine (messaging, alerts, actions)
Audit and Logging
3
Portals – 3 types
Organisation based
Community based
Care based portals for collaboration with patients
e.g. renalpatientvew.org
4
Active Users: 3,700
Users: 2,300
Services:
Services:
• Adult Mental Health
• Older Peoples Service
• Forensics (3 hospitals)
• CAMHS Level 3&4
• Drug & Alcohol
• IDD
• Adult Community
One
trust,
two
systems
• Allied Health
Professional
• CAMHS Level 1&2
• Childrens Services
• SureStart
• Psychological Therapies
• Specialist Services
80% of GP Practices use SystmOne in Nottinghamshire – but
unequally spread across 6 CCGs
Trust based: low level integration
Built an EDMS based on SharePoint for those
documents that are not part of the RiO record
Role based access controls are identical in
EDMS and RiO
Click through from one app to the other
6
Forensics EPR solution
RiO – Responsible for Patient
Administration including
demographics and appointment
status, Progress (Running Record)
notes and numerous Forms
including Trims, HCR20 and
Therapy data
EPR – One or more computer
applications capturing patient
information. In Rampton's case this
is RiO, CESA, e-ICP and eCare
Plans.
eCare Plan - Responsible for
capturing in one RiO form
MDT care plans for a patient.
CESA – Responsible for replacing
paper versions of the MHA Legal
folder and Single Health Care
Record into an Electronic storage
location.
e-ICP – Responsible for mapping the patients
care pathway and capturing key events/stages,
importing relevant clinical data from various
systems including RiO, CESA and eCare Plans.
7
Our driver
Physical health status recorded in SystmOne &
Mental health status recorded in RiO, mostly not
a problem except:
○
○
○
○
No trust wide Master Patient Index except in BI
No integration between so some rekeying
No access to some data out of hours except on paper
Some services through merger are split across both
8
Our plan
 Implementation of Viper360 clinical portal that allows a user
to see simultaneous views of patient data in Rio & SystmOne,
so that RiO users can access SystmOne, SystmOne users
can access RiO and all users can access Summary Care
Record, MIG and PC-MIS for IAPT – starting with CAMHS
 Confirm the type of electronic collaboration between service
users and clinicians that best meet the needs of Children,
Young People and Family strategy
9
What data could be available?
From GP (via MIG):
a patient summary
problems
diagnoses
medication (current, past and issues)
risk and warnings
procedures
investigations
blood pressure measurements
encounters, admissions and referrals
From SCR:
current meds
allergies
adverse reactions
From Document Management System
Mental Health Act docs not in RiO
From Community Health Services (Systm1):
Main Address and contact details
Key flags (e.g. CGA, End of Life, top 2%
at risk of unplanned admission)
Assessments
Care Plans
Therapists involved
Emergency Next of Kin details
Does the Subject Have a Carer?
Is the Subject a Carer?
From Mental Health Services (RiO):
Recent & future contacts and admissions
Care Programme Approach docs
From Psychological Therapies(PC-MIS):
Recent and future contacts
LC
Live data from the GP clinical system
Patient details
Examinations
Events
Summary
Investigations
Problems
Procedures
Risks & warnings
Technical bit
Viper360 runs on Wintel platform & is built on 3 parts:
The ViperUI, written in JavaScript on Sencha's EXTJS (MCV) framework;
The Broker written in Java , using Jetty, an Open
source Web-server running alongside Mongo DB for
data storage;
a Proxy component which is added to the Trust’s
own Integration Engine, Ensemble
12
Why Viper
Use of open source components
Price point designed to support starting small
and growing later when requirements become
clearer
No data is moved
Credentials
13
Community based portals
Connected Nottinghamshire: 2 acutes, 1
Ambulance, 2 Councils, 2 OOH, 6 CCGs, 2
community providers
All transformation programmes describe clinical
information sharing as essential : 3 system wide
requirements: Comprehensive Geriatric
Assessment, End of life Care and Safeguarding
Children and Adults, and a 4th on the way :
urgent/emergency care
14
Possible Use of a County wide Clinical Portal
Example: Comprehensive Geriatric Assessment
Framework-i
Carefirst
GPs using EMIS
GPs using SystmOne
City Council
County Council
Integration Engine
CGA
Trigger
Request
CGA
Trigger
Request
CGA
Updated
CGA
Updated
Portal X
Patient Index ?
E-Forms and Other Capabilities
Comprehensive Geriatric Assessment
Out of Hours
Organisations
Ambulance
End of Life Care
Adult Safeguarding ?
CGA
E-Form
Started;
Consent
form
shared
Acute
Providers
Broadcast Message
CGA Phase 1 Complete
Next action according to
business logic is X to be
done by organisation Y
by time T
Emergency Admission
to Geriatric Ward;
consent to share
obtained
CGA
Updated
CGA
Trigger
Request
Community and
Mental Health
Providers
Patient based portals
Should:
○ save time for both patient and clinician in care
delivery / travelling / communicating
○ be a choice – standards?
○ support interfaces to devices
○ be portable - not be tied to an organisation or a group
of organisations
○ support secure data sharing with providers
16
Proposed E-Health Platform
Social Media
Users
Discussion
Groups
Users choose the
access path that
works for them
Personal
Health
Record
Specific Tool
E.g.
Microsoft
HealthVault
Self Referral
to HCP
E.g.. FLO
BUDDY,
SilverCloud
Avatars
(to be
agreed)
Search
Trust web
site and
others…
E-Health Portal
Information
Prescription
Dictionary
Guided
Search Tool
Narratives
Mood
Monitor
National Services
User facing
services
and sites
Directory
of Services
Portal
Layer
access
to
Trust
NHC Patient data
Other provider data
User Generated data
E-Health Platform – 2015/6
Trust’s App Store / Patient Portal
PROMs
My Care Plan
Rate My Day
Resources
Patient Held
Record e.g.
Microsoft
HealthVault
Secure Network
Data Interchange with
Other healthcare providers
NHC Electronic
Patient Record
(RiO )
Research
Information
System
Issues
How to get TPP to understand / co-operate – any
ideas anyone?
Community wide portals - learning from best
practice – any suggestions?
19
Questions?
or e-mail me at
[email protected]