Integrated OoH Services Progress Under Radar

Lynn WoodsCEO

Adastra Software Ltd, Ashford, Kent

OoH = Out of Hours…

…and Out of Hospital

Introducing the Operational Hub

• Integrated GP out-of-hours was just the start • There are too many other service silos• We need integrated services, interoperable

systems• Information pathways must be made inseparable

from the Patient Journey• The more that is functionally integrated the

less needs communicating across boundaries!

• ….so what is the operational hub and what is its reach?

Operational Hub

NHS24GP Surgery

Ambulance Control

Hospital

Patient referrals

Downgraded emergencies

Care plans and appointment sharing

Diverted A&E traffic, urgent lab results, images

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SCI Store(ECS)

Upgraded emergencies

Contactreports

Priming Information, special notes and final outcomes

Admissions & Referrals

Information Flows to/from the Operational Hub

ECS access and Demographic validation

inside the Operational Hub “Shell”

An Adastra Model of Integrated Urgent and Out-of-Hospital Care in Scotland

The Operational Hub

Mental Health Team

Out of Hours Primary Care

Centre 1

24hr PCC (Handling GP

Surgery Overload)

OoH Primary Care Centre 2

OoH Primary Care Centre 3

12 wider locality Hubs

Avge 425,000 population

Call Centre & Operational Control RoomConvergence of Single Points of AccessPost NHS24 assessment case disposal

Co-ordination and tasking of point-of-care resourcesUrgent casework distributary

Concentration of Quality and Governance focus

Minor Injuries Unit

Social Servs

Palliative Care District

Nursing

Emerg Dentist

Long Term Care

Out of Hours GPs

Real-time event management – in car computers and hand-

helds

A&E primary care filter

Telehealth/ Long Term Conditions

Intermediate Care

Admissions Avoidance Schemes

Polyclinics

Patient Transport

GP Referrals Management

General Practice

Neighbouringhub services

Hospital

Forensic Medicine

...and the interception or re-routing of primary care traffic

presenting to A&E & 999

Integrated Community-facing Services within the hub umbrella

Wellness programme

National Data Management Resources

Real time data for secondary uses

Capacity Management systemsPandemic response planning

Bioterrorism surveillanceInfectious illness screening

Wideroperational

integration...

Conventional urgent and out-of-hours carecaseload...

Inappropriate (Category C) 999 callers

In Hours urgent visiting

...extending to support of in-hours

operations...

Support of Prisons &

Military Units

E-dischargeCo-ordination

...leading on to the delivery of out-of-

hospital workstreams

Two way passage of clinical and

administrative data

ECS Presentation

SAS

NHS24

Bi-directional interoperation with other NHS domains in support of clinical continuity

System Direction?

• We must enable…– Integrated community services– Complex operational flows– Multiple services and disciplines– Cross-boundary information flow– Embedded expert capability (eg CDSS, Map of Medicine)– Local processes of the user’s definition

• What are our USPs?– User definable case flows – Dispersal and segregation– Operational and clinical functionality– Integral and real-time mobile data

System Demo

(the remainder of the SCIMP presentation comprised a live system demo looking at an example of a DVT clinic integrating into the operational hub setting. This content cannot be replicated in these ppt slides but anyone interested in more detail should contact our medical director alex.yeates@adastra.com