NATIONAL INFORMATION BOARD Interoperability workshop – Taking forward Personalised Health and Care...

NATIONALINFORMATIONBOARD

Interoperability workshop – Taking forward Personalised

Health and Care 2020

Indi Singh 2nd June 2015


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Key themes that rely on effective information sharing


Interoperability Programme - Operating principles

• “Interoperability” wide and expansive term and overly technical

• Breaking down “interoperability” into meaningful parts• Key priorities e.g. use of NHS Number, Transfers of Care• Key blockers e.g. information governance guidance• Future direction – new ways of information sharing

• Scope across health and care

• Co-creation of products to assist local organisations, developed in conjunction with local organisations such as Integration pioneers

• Facilitating communities on information sharing • showing local best practice and direction of travel

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Working directly with local organisations

Leeds (W1)

WELC (W1)NW London (W1)

Greenwich (W1)

Barnsley (W1)

Cornwall & Isles of Scilly (W1) South Devon &

Torbay (W1) Kent (W1)

South Tyneside (W1)

N Staffordshire and Stoke (W1)

Southend-on-Sea (W1)

Cheshire (W1)

Islington (W1)Worcestershire (W1) Camden (W2)

Airdale, Wharfedale & Craven (W2)

Flyde Coast (W2)Greater Manchester (W2)

Nottinghamshire (W2)

Nottingham City (W2)

Sheffield (W2)

West Norfolk (W2)

South Somerset (W2)

Wakefield (W2)Vale of York (W2)

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Complementing by bringing together cohorts on information sharing

Pioneers Wave 1

Pioneers Wave 2

Technology Fund Applicants

“Pioneering organisations”

e.g. Hampshire, Bristol

e.g. Royal Marsden

e.g. Wakefielde.g. Barnsley

Driving priority standards for information sharing

Collective guidance on breaking down “myths”

Understanding common and priority needs

Articulating direction of travel

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Interoperability/Information Sharing

Sub-package 1:Priority Standards

Transfers of Care

Sub-package 2:Interoperability

Maturity (System)


Maturity (Transfers of

care)

Sub-package 4:Priority Use Cases

(Discovery)

Sub-package 5:Toolkit for

commissioners on interoperability


Strategy

Interoperability roadmap

Adoption of NHS Number, eDischarge, End of Life, ITK

Maturity across care settings, across organisations

Maturity for specific information sharing needs

Breaking down “information sharing” into key needs

Commissioning case for change; Sample OBS; Handbook of policies, standards, guidance;

Role of integration offerings - local and national into aligned strategy

Articulate direction of travel - key standards, key priorities, national functionality.

Open-source accelerators

Interoperability programme

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Information Sharing – Near Term Milestones

Key components Output Audience Date

Transfers of Care Clinical Case for Change Commissioning Case for Change Standards developmentSupplier ReadinessImplementation (at scale)Levers/incentives (CCG planning / Standard Contract 16/17)

CCIOCCGsAllVendorsVendorsTrusts

Q2 ’15/16Q2 ’15/16Q1 ’15/16(HSCIC)(HSCIC)Q3/4 ‘15/16 (levers stream)

Interoperability Maturity (System) Dataset definition and engagementScoring methodologyAssessment

Local and Health Economies Q1 ’15/16Q2 ’15/16 Q3 ‘15/16

Interoperability Maturity (Transfers of Care)

Dataset definition and engagementScoring methodologyAssessment and Baseline

Acute, Primary Care Q1 ’15/16Q2 ’15/16Q3 ’15/16

Discovery: Priority use cases Engagement through leading lights CCIOs, CCGs Q1 ‘15/16

Toolkit for commissioners on interoperability

Priority requirements for IDCRInformation governance guidance Sample OBSInteroperability roadmap

CCGs Q2 ’15/16Q1 ’15/16Q2 ’15/16Q2 ’15/16

Interoperability Strategy Engagement with key industry suppliers, CCIOs and CIOs, Role of SCR?

Trusts, National Programmes Q2 15/16

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NATIONALINFORMATIONBOARDWhat the design principles….

1. Still enable local “leading lights” delivering integrated digital care records to continue to progress whilst supporting those less mature localities

2. Keeping information at source and having the ability to retrieve this as needed and so removing unnecessary duplication of information.

4. Providing an approach that enables access and contribution by citizens and professionals in the most convenient and effective ways possible

5. Having an architecture for information sharing that supports/reflects and adapts to the current and emerging care workflow

6. Ensuring the strategy optimises public investment, at national and local level

7. Allows for those most appropriate to take ownership at the right level

3. Holding information nationally where they is a clear justification to do so (e.g. such as national flags).

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NATIONALINFORMATIONBOARDWhere do we want to get to?

The GP record remains the main point of the curation of the health and care record. Record can be accessed into IDCRs through open interfaces.

SCR provides the ability to view key universal flags (e.g. CPIS) and these are stored nationally

Integrated Digital Care Records pervasive and provide access to the detailed care record and speciality information for care co-ordination

Extended SCR to hold information nationally but only for where there is a clear clinical/safety case e.g. discharge medications.

Options Curation of care record(supports workflow)

Co-ordination of care across care settings

Patient access Clinician access Public perception

Market position Completeness of record

GP systems GPs the main custodian of care record

Only works where primary care is the care coordinator (e.g. doesn’t work for end of life)

Widespread(March 2015)

Only primary care (with difficulty to share across primary care)

“family doctor” Duopoly High proportion of care record information needed

Summary Care record

Reliant on content provided by source systems (GP)

Provides limited record information to all settings to enable them to co-ordinate care

Not available National (e.g. CPIS flag)

“Big brother” Provides access of information to any consumer

Limited

Local integrated care records initiatives

Reliant on content provided by source systems

Provides detailed care record access for care co-rdination

Limited but growing

Always problem at boundaries

Locally owned Potential to create oligopoly of integration vendors

Provides full coverage

Ability to link across local Integrated digital care records through Open APIs to avoid creating silos

Clinical access to integrated digital care records and summary care record though their native clinical system

Patient access to summary information (SCR) with ability to drill down into integrated digital care records. Ability to access through NHS Choices/ PHRsAbility for patients to provide and contribute information directly /through 3rd party tools (e.g. wearables/apps). PHRs can combine this information with that sourced from clinical systems

Clinical update to record information to be done through native system which then populates the integrated digital care record

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What’s the underpinning architecture?Creation of local integrated digital care records to support clinical access to detailed care record and speciality information.

Use of national assets for key flags and key documents where national access needed

IDCRIDCRIDCR

Clin

icalAcute Com MH SC

GP Systems

GP systems remain main point of curation of record

Acute Com MH SCAcute Com MH SC

Integration Platform(e.g. Graphnet)

GP Systems

GP Systems

GP Systems

Referrals/Discharges i.e. transfers of care(clinical workflow)

GP record ectract

Flags (e.g. CPIS)

Discharge meds

Summary Care RecordMeds, allergies, adverse reactions

MPI

Demographics

Integration Platform(e.g. Orion)

Integration Platform(e.g. xxxx)

Loca

l Clin

ical

Sy

stem

Patie

nt

Inte

grati

on

Platf

orm

s

Use SCR APIs to bring SCR content into IDCRsExpose access to IDCRs through APIs Specific key documents provided up to SCR for national access

Clinical access and contribution to integrated digital care records and summary care record through their native clinical system.

Index

Index to IDCRs

Patie

nt

Patient access to summary information (SCR) with ability to drill down into integrated digital care records. Access through NHS Choices and PHRs

PHR integration platforms will enable apps/PHRs access to other APIs for – i) transactions e.g. use NHS referrals API to book appointments and 2) use APIs to access information from wearables etc Patients also to be able to contribute to PHRs

Open APIs between IDCRs enable sharing across these

Ope

n So

urce

M

iddl

ewar

e

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• Objective for today’s session– Move off the talk into the concrete– Get local organisations onto this agenda– Understand what is already working well– Link into initiatives and activities designed to help you e.g.

Ripple project– Feed into the Interoperability Board on priorities, and

what’s needed in terms of accelerators/blockers– Be a “test-bed” for testing ideas, strategies etc from the

centre, informing them and prototyping and testing early delivery and learning


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NATIONAL INFORMATION BOARD Interoperability workshop – Taking forward Personalised Health and Care...

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