Transcript E-health demands of those with Long

Pouring IT On
Gareth Paterson - Regional Manager LTCC
Summary
 How does the aim of SCIMP relate to the Long-term
Conditions Agenda?
 Workstreams and the use of information in LTC care?
 The integration of plug and play.
 Analysing information pathways.
 Audience Participation
http://dilbert.com/strips/comic/2010-05-08/
Introduction
SCIMP’s principal objectives include promoting, assisting
and developing the processes to enable the safe and
effective sharing of clinical information across NHS
Scotland organisations.
LTCC helps local staff to deliver improvements in patient
centred services and change the way care is provided for
people with long term conditions across three
workstreams Complex care, Self Management and Care
Pathways.
Project Focus
 Correct systems in place to capture data
 Agreed minimum dataset and key indicators
 Measurement of impact
 Identify local trajectories
 Use Better Together programme to capture
qualitative indicators
 Identification of critical success factors
 PDSA
 Statistical process control, Digital stories, “Talking
Points”
 Story Boards, Process Outcomes, Change
Outcomes
Complex Care
Implementing care management is a complex and far
reaching development that will involve changes to the way
we deliver care and how we share and manage information
flows.
Identification of
Risk
Information Flow
Case
Management
“a proactive approach focused on high-risk patients with a
combination of medical, nursing, pharmaceutical care and
social care needs”
Kaiser Permanente
Condition Pathways
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Person centred care.
Adopting an enablement approach.
Proactive care that is multidisciplinary.
Integrated working.
An anticipatory approach to assessment, care planning and
review.
Coordination of care.
Clarity about responsibility and accountability.
Communication with patient, carer, care team and all
agencies.
Patient reviews that are carried out systematically on a
multidisciplinary and multi-agency basis.
Collaborative working.
Self Management
Making the Connections – Food For Thought
“Effective self management relies on the provision of
accurate, relevant, timely and accessible information
from a trusted source on a basis which people feel is
sensitive to their situation.”
Services from e-systems
 Person Centred
 Safe
 Effective
To Achieve all these things it is necessary to analyse the flow of
information to understand why we need it and how the information
adds to the quality of the service we provide.
In what ways do ‘Quick Wins’ need
to be supported within the system?
 What process changes are needed to integrate new
systems?
 What ways can the manual be modified?
 Can we use present available hardware in a
different way to augment new systems? Email?
Video conferencing? Phone conferencing?
What are we trying to accomplish?
“A bad system allows a good person to behave badly
while a good system makes a bad person behave
well.”
With the adoption of new systems we may be in
danger of abandoning active data collection for
passive supply systems.
The challenges of successful Information
Flow
Like any flow information can be diverted redirected,
misdirected and dammed.
Passive Flow = “Delayed Care”
Passive planning = “Reactive Care”
Information Identity
Date of Birth
----------------AGE
----------------Under 40/40-65/Over 65
----------------OLD/YOUNG
Information Stream
AGE
O/Y
Over 65
Information Chain Analysis
AGE
Inconvenient
Access
Incorrect
Information
Large
Databases
7 Brakes on
information flow
Waiting
Transmission
Overprocessed
Overproduction
Analysis of Constraints
 Where does information get hung-up?
 What is necessary for the development of ‘Information
Pull’?
Primary Care
Social Care
Community Care
Acute Care
Secondary Care
Third Sector
Pouring IT on
What is the impact of IT on those individuals with
Long-term conditions?
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Proactive information gathering and process development
offers faster integration of new systems in the organisation.
Maintaining a proactive information gathering mentality
reduces brakes on flow and increases responsiveness.
By proactively sourcing information required for medical
processes, procedures and treatments clinicians can have more
confidence in the information.
Establishment of procedures reduces unnecessary variation.
Examples of Enhanced Information Flows?
 EPCS. ECS. EKIS.
 SPARRA
 ACP
 Personal Passport
 Clinical Portal
 Multidisciplinary Forum
 Digital Stories
 Estimated Date of Discharge
Anticipatory Care
 A “thinking ahead” philosophy of care.
 Working with people and those close to them to
set and achieve common goals.
 Anticipatory care planning is applied to support
those living with a long term condition to plan for
an expected change in health or social status.
 To allow this information that already exists needs
to be made available by another individual.
Audience Participation
Work Shop
 Identify one line of information flow that you
know is not as fluid as it could be?
 In the group consider what part of the information
is valuable and why?
 Consider the examples of waste that you know of.
 Write down three ways in which one of these flows
could be changed to reduce the impact of this
waste within the information flow?
Output
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Identify what information is required
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Identify the pathway
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FLOW
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Active vs Passive Flow.
Questions?