Smartcare - a Foundation for excellent patient care through a strategic approach to IT www.smartcaredevon.co.uk - PowerPoint PPT Presentation

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Smartcare - a Foundation for excellent patient care through a strategic approach to IT www.smartcaredevon.co.uk

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Meaningful Use of EHR. External Informing. Reshaping. Internal Informing. Optimising. Decision . Making (Information) _____ Ways. Of . Working (Technology) Inside the ... – PowerPoint PPT presentation

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Title: Smartcare - a Foundation for excellent patient care through a strategic approach to IT www.smartcaredevon.co.uk


1
Smartcare - a Foundation for excellent patient
care through a strategic approach to
ITwww.smartcaredevon.co.uk
  • Alison Diamond
  • Chief Executive
  • Northern Devon Healthcare NHS Trust

2
A Trust Experience
  • Who and what we are
  • What we wanted to solve
  • Our approach
  • Successes to date
  • Next steps

3
Bude
From To Time (mins)
Bude Barnstaple 55
Bude Plymouth, Exeter, Truro 80, 75, 80
Ilfracombe Barnstaple 25
Ilfracombe Plymouth, Exeter, Taunton 130, 90, 85
Ilfracombe Axminster 105
4
Trust profile
  • North Devon District Hospital in Barnstaple
  • 17 Community Hospitals
  • Integrated health and social care teams
  • Community nursing and therapy services
  • Specialist community services pan Devon
  • We cover just over half of Devon
  • Serve 484,000 people (740,000 Devon total)
  • Over 1,700 square miles (2,500 sq m Devon total)
  • Acute
  • Serve 165,000 people
  • Over 700 square miles

Turnover 2013/14 223m
5
Our Integrated Business Plan (IBP)
6
Smartcare Why? How? What?
  • Why?
  • Patient need only tell their story once and staff
    will have access to a multi disciplinary records
    in all settings
  • How?
  • An EHR programme that is transformational and
    clinically lead
  • What?
  • EHR across Acute and Community Settings
  • Interoperability with all other local systems

7
Principles for staff
  • Single Sign On including Tap in and Tap out
    mobility
  • Fast, reliable and clinically acceptable local IT
  • Easy access to WiFi and safe, secure mobile
    access
  • Off Line working (Community)

8
Meaningful Use of EHR
Internal Informing
External Informing
  • Managing Clinical Quality
  • Clinical Decision support tools
  • Evidence-base part of care giving process
  • Managing Operational
  • Performance

Decision Making (Information) _______ Ways Of
Working (Technology)
  • Patients accessing their records
  • Informing to differentiate NDHT
  • Demonstrate we know and care for the populations
    we serve
  • Helping Commissioners manage demand better
  • Better contracting outcomes for us (coding,
    revenue per case)

Reshaping
Optimising
  • Electronic Correspondence
  • Virtual Health Record (through Health Information
    Exchange)
  • Clinical Portal

EHR
  • EPMA
  • Order Comms
  • Clinical Noting
  • CPOE / CDS

Inside the Organisation Outside the Organisation
9
EHR Programme
  • Smartcare EHR comprises
  • TrakCare (Intersystems) for Hospital Based care
  • RIO (Servelec) for community / home based care
  • Ensemble / Healthshare (Intersystems) for
    interoperability platform
  • In 2015/16 introduce full Digital Observations,
    Handover, Hospital at Night EWS Escalations
    (products Nervecentre Welch-Allyn)
  • Adopt clinical noting early on in the programme
    in what is a clinical foundation first phase
  • Retain Winscribe (or similar) for digital
    dictation and voice recognition to assist with
    EHR data capture
  • 2-3 year roadmap of transformation

10
Year 1 Architecture Summary
11
Tele-health in Ophthalmology
  • Routine follow up for patients with glaucoma(wet
    AMD to follow)
  • Local access to care for patients
  • Remote retinal pressures and photography
    undertaken by technicians
  • Centrally reported and treatment planned any
    changes in medication to patient and GP within 5
    days

12
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14
Outcomes
  • 20,000 ophthalmology patients, 8000 i.e.40 of
    patients seen in local community
  • 30 increase in productivity for consultants
  • Opportunities to develop the technician role

15
GP order comms
  • Rolled out to all the practices that use the
    pathology services at the acute hospital through
    2014/15.
  • This was clinically led and clinical pathway
    based GP/Microbiology.
  • The pilot for the work was to rationalise the
    requests for urine microscopy and culture to
    those patients that needed it.
  • Work based on order sets
  • The net result now that the implementation is
    complete stemmed the growth from an annual 3-4
    to flat growth
  • This has led to a commissioner QIPP - 300,000
    last year
  • 65,000 new business from North Cornwall

16
Complexity and Community Data/PAS
  • Foundation built from collection of CIDS
  • Mobile devices to over 800 staff
  • CIDS (through COMPAS in-house App)
  • Works offline as well
  • Devices support other new ways of working
  • Developed packages of care approach to data
    collection
  • Refined through pilot in teams with highest
    levels of completion and accuracy
  • Refined further through shadow monitoring and
    independent inter-rater agreement of complexity
    for cohorts vs. actual recording in COMPAS
  • Algorithm derived to ascertain community tariff

17
Outcome
  • Used to demonstrate our increasing demand and
    acuity of casemix and secure an additional 1.25m
    on 14/15 contract vs. 13/14. 1.5m on15/16
    contract vs. 14/15
  • Pushing for adoption and move away from block
    contract
  • High levels of staff adoption demonstrates the
    value to them and the productivity and service
    demands they face

18
Next Steps
  • Refine patient pathways to new lean models -
    for ops team and clinicians to design
  • Sign off that EHR fit for purpose
  • Roll out of EHR to hospital sites
  • Contract for EHR for community to be signed and
    move to implementation phase
  • Review and evaluation to ensure benefits
    realisation

19
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