eHealth Strategy

Primary and Community Care where next?

Paul Gray

Director of Primary Care & Community

Care

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1. The Government’s policy context

2. Revised eHealth Strategy

3. Prospects for primary and community care IT

To cover

Paul Rhodes, eHealth Programme Director, on the programme itself

Tomorrow

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The future model of health care

Geared towards long-term Embedded in communitiesTeam basedContinuous careIntegrated carePreventive care Patient as partnerSelf care encouragedCarers supported as partnersHigh tech

Geared towards acuteHospital centred

Doctor dependentEpisodic care

Disjointed careReactive care

Patient as passive recipientSelf care infrequent Carers undervalued

Low tech

Evolving model of careCurrent view

Policy context

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Key principles

1.Much has been achieved – don’t rip-and-replace unless necessary

2.Incremental progress – link to what exists

3.Work closely with clinicians and other users

eHealth Strategy

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Where we are now with eHealth –big picture

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Where we’re trying to get to

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Long list of desired investments, for example..

Secondary care: disparate, ageing patient admin systems and few clinical systems

Electronic test requesting

CHI number use and Single sign-on

GP and community systems (IPACC)/ links with partner agencies

National Child Health systems – in silos and paper-heavy

eHealth Strategy: What might be new?

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• whole list can’t all happen – resource and capacity constraints

• prioritisation needed, and levering real benefit from previous investment

eHealth Strategy: What might be new?

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1. Efficient and effective flows of information to support whole patient journey• including links with partners, principally

Local Authorities and the voluntary sector

2. Information to support anticipatory care

3. Information to support patient involvement

eHealth implications for primary and community care

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Examples• SCI Gateway referrals – 60,000 per

month• Emergency Care Summary – proving

useful in A&E, OOH and NHS24

• electronic Single Shared Assessment (eSSA)in one or two Data Sharing Partnerships

Issues• few discharge letters using SCI

Gateway• slow progress with eSSA• confidentiality/ information governance

Examples: 1. Information to support whole patient journey

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Information governance• Benefits barrier in existing eHealth systems

• For example, the storage of clinical letters in SCI-Store from SCI-Gateway.

• Potential barrier to eHealth innovation.

Approach • Study investigating key IG challenges

• Staff Identification, authentication, and access control; Consent; Clinical IF Ownership; Patient engagement; IG Frameworks

• Report due Spring 2008

Examples: 1. Information to support whole patient journey

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Examples• Nairn project – working with Raigmore

to spot patients most likely to be re-admitted

• SPARRA – ISD’s prediction algorithm

Issues• getting sufficient and accurate data• incentives for primary care

Examples: 2. Information to support anticipatory care

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Examples• Townhead Surgery, Irvine - Patient

Online. Secure web site: books appointments, commented test results etc

More opportunities?• further exploit the Internet? (SHOW gets

26 million hits per month from Internet)• individual care plans on patient’s

secure website? With access to trusted guidance?

• trial of voluntary patient access to ECS?

Examples: 3. Information to support patient involvement

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Further consultation and analysis

eHealth Strategy Board – key meeting in December

Draft for comment early 2008, finalised around April

Make your views known!

eHealth Strategy: next steps

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1. Primary and community care is key to the patient care. But whole patient care means information support wherever the baton of care is passed. 

2. Local decisions can mean central spend, but that might be the wrong place for ensuring best value for money from that spend.  Equally, national decisions can have local knock-on, so we want to get better at understanding that.

3. Before considering new things to invest in we must make sure all possible benefit is squeezed out of what exists.

Key messages

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For sponsoring the conference

But more particularly for their useful workaround future for Child Health eHealth

Finally,thanks to …