Data Sharing for Better Healthcare Thursday 12 th July 2018 0900 - - - PowerPoint PPT Presentation
Manchester Connected Health Ecosystem Data Sharing for Better Healthcare Thursday 12 th July 2018 0900 - 1300 MSP Citylabs, Nelson Street, Manchester Wifi Username: FREE_MSP_WIFI @Man_Inf @healthinnovmcr @ECHAlliance #McrEcosystem Greater
Thursday 12th July 2018 0900 - 1300 MSP Citylabs, Nelson Street, Manchester Wifi Username: FREE_MSP_WIFI @Man_Inf @healthinnovmcr @ECHAlliance #McrEcosystem
STANDARDISING ACUTE HOSPITAL CARE
TRANSFORMING COMMUNITY BASED CARE & SUPPORT RADICAL UPGRADE IN POPULATION HEALTH PREVENTION STANDARDISING CLINICAL SUPPORT AND BACK OFFICE SERVICES
ENABLING BETTER CARE
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Benefits: Complete IM&T inventory across health and social care organisations Understanding of:
contracts expire
it makes sense
The ability to securely access the applications we need on the device we need, when we need them The ability to share applications across organisations
In April 2015, 13 year old Tamara Mills had a fatal asthma attack. She was seen by medical professionals 47 times in different parts of the
differently and perhaps prevent her death. Over the last four years of her life, Tamara Mills’ health was
professional, this was treated as a unique incident. After her death, the coroner identified a number of failings in Tamara Mills’ care. One of these was the lack of a coordinating record of the
picture, each case was treated as a unique incident. Each medical professional who saw Tamara should have been able to access a comprehensive summary of her previous interactions with the NHS and make an informed decision about the care needed. More comprehensive information and communication could have led to her being treated differently and she may not have died.
(August 2017) Source: Understanding Patient Data
Final 2018_04_12
Outcomes Outputs
Locality Programs Taking Charge Programs In flight Ambition Single sponsor Wider Clinical/Care networks
Use Cases Cost Scale Adoption
Replicating current vs Transformative
– Children at risk, risk of dental decay – risk of developing any LTC – risks of poor behaviors – risk of dementia or serious mental health crisis admission, – risk of transition from mild cognitive impairment to dementia – Risk of Amputation (e.g. People with Diabetes, CVD, and behaviours/conditions such as Smoking and Obesity and similar social circumstances to others with amputations)
– Including DOS/VCSE – Including Wellbeing – Including condition specific educational material
– Ability to follow the care plan. – PROMS – Pre-Questionnaires. – Collection of data by patients that can be used for disease identification (e.g. dementia warning, cancer Q-Risk etc.
to the IDCR and individual organisations as needed.
– Rheumatology – Respiratory – Mental Health – IAPS – MARS
patients across the system via a GM wide integrated digital care record (IDCR)
– Including harmonised problems, medications, diagnostics
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To deliver this we need a GM Interoperability Hub. An open platform based on common information models liberating data and applications by making them portable. It integrates, standardises and harmonises data and makes available (with appropriate governance) for multiple scalable use cases across health, care and wider public services.
Sciences Strategy the concept of Innovation Hubs were created
get data from providers into the platform = birth of Interoperability Hub
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CareCentric
BOLTON CCG: 50 STOCKPORT CCG: 42 MANCHESTER CCG: 93 HEYWOOD, M’TON, ROCHDALE CCG: 36 SALFORD CCG: 46 TRAFFORD CCG: 32 BURY CCG: 30 OLDHAM CCG: 44 TAMESIDE & GLOSSOP CCG: 37 GP PRACTICES
Bolton NHSFT Manchester University NHSFT Pennine Acute Hospitals NHST Salford Royal NHSFT Stockport NHSFT Tameside Hospital NHSFT The Christie NHSFT Wrightington, Wigan and Leigh NHS FT Tameside and Glossop CCG Bolton CCG Bury CCG Manchester CCG Heywood, Middleton Rochdale CCG Oldham CCG Salford CCG Stockport CCG Trafford CCG
DXC (CSC) DXC (CSC) DXC (CSC) DXC (CSC) DXC (CSC) DXC (CSC) SYSTEM C DXC (CSC)
Bolton Metropolitan Borough Council Manchester City Council Bury Metropolitan Borough Council Oldham Metropolitan Borough Council Rochdale Metropolitan Borough Council Salford City Council Stockport Metropolitan Borough Council Tameside Metropolitan Borough Council Trafford Metropolitan Borough Council
LIQUIDLOGIC CORELOGIC SYSTEM C CORELOGIC SYSTEM C OLM OLM/TRIBAL LIQUIDLOGIC LIQUIDLOGIC
Manchester Mental Health and Social Care Trust
BARDOC OOH GO2DOC OOH MASTER-CALL
OOH North West Ambulance Service GM POLICE GM FIRE & RESCUE
ACUTE TRUSTS CCGS LOCAL AUTHORITIES 2,820,000
The Graphnet lntegrated Care Plan brings tangible benefits, particularly in terms of efficiency and cost-effectiveness. They help health and social care teams work together to provide responsive, joined up services
feel independent, in control of their lives and able to plan to prevent further deterioration in their health. They encourage a ‘whole person’ view of the individual, whatever the complexity of their needs
for contact information about the patient, their family and support workers and everyone involved in their care – contact information, detail of involvement, hours available etc
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MDSAS Skin Referrals unique referral QR Code shown within EMIS Web
Using SiD-Secure Image Data mobile app, GPs can securely upload images of the patient’s skin condition using their own smart phone
EMIS Web External View showing MDSAS application
Operationally in use across Greater Manchester for Burns, Plastics, Spinal Cord Injury
3 easy steps to securely upload pictures to referral
Images are never stored on the mobile device Information governance safe
SiD – Secure Image Data
Dermatologist's response is received within five working days PDF containing dermatologists recommended action is saved to patient’s GP record in EMIS Web
Response delivered via Docman Hub workflow
PDF contains all data, as provided at time of referral
NIHR Greater Manchester Patient Safety Translational Research Centre
Proven Blueprints for
plans
bespoke clinical functionality, with information accessible to professionals, citizens and the wider digital system
datacentres
involved in pathway improvement and re-design
= 72 = 1600 = 6 = 4500 = 37 = 4000 = 250 = 3100 = 70 = 3800
Commissioners Organisations Services Population
Health and social care services should support people to be well and independent and to take control of their own care. Health and social care services should be provided at home, in the community or in primary care, unless there is a good reason why this should not be the case. Health and social care services in our Borough should be safe and of a high quality and part of an integrated system led by primary care.
– Robust Information Governance – Medical Interoperability Gateway (MIG)
– New BI Apps to support Acute care – Child Protection Information System – Single View – Risk Stratification – Electronic Document Transfer – Native in Context Displays - MIG, CPIS, SCR, GP to GP development
Bridgewater Leigh Walk in Centre North West Boroughs Partnership Pharmacy GP Extended Access Service Wigan and Leigh Hospice WWL Hospital Palliative Care Team Bridgewater Allied Healthcare Professionals Bridgewater MSK CATS Service North West Boroughs Partnership RAID Team North West Boroughs Partnership Wigan Assessment Team WWL Hospital Mortuary WWL Hospital Clinical Ward Managers WWL Hospital Anaesthetics WWL Hospital Pharmacy WWL Hospital Emergency Care Bridgewater GP Out of Hours Service St Ann’s Hospice Integrated Safeguarding and Public Protection Team Bridgewater District Nursing Local Authority Early Intervention Team Local Authority Hospital Team Local Authority Locality Teams Local Authority Initial Assessment and Out of Hours Teams Safeguarding Teams CCG Continuing Healthcare Team
– GovRoam – Integrated locations (Hindley Town Hall, Lilford Centre, Leigh Sports Village) – Telephony
– Community Services – Adult Social Care – Children’s Social Care and Early Help
– DXS Point of Care
– People Powered Technology – Patient Online + MyAccount – Text Messaging
– Just open and work
– Lan/WiFi/4G – Always connected Intelligent VPN
– PC based in office type experience
– Offered for Follow Ups (where appropriate), also exploring its use for Referral Assessment Services
– Improving Triage, Assessment & Communication between Primary, Community & Acute Care
Smart Devices (IOT)
– assistive living rollout
Intelligence
Paper Free at the point
Digital Health & Care Building self reliance Real time data analytics Whole System Intelligence
The Bolton Care Record (BCR) is a way of bringing together the relevant parts of a patient’s health and social care records. Currently held in separate
systems by different care organisations that are responsible for looking after them. NHS hospitals, community services, out of hours services, social care & 49 GP Practices 300,000 population 1 of 10 localities in Greater Manchester
NHS England has been working with patients and clinicians to try and identify ways
their consultations. To enable this to happen, there is a target that the NHS should be paper free
at the point of care by 2020.
More than 75% of the Bolton population think this already happens!
Joined up care is safer care Faster care in an emergency More time spent on the patient instead of going over the same information Patients don’t need to remember lots of medication or who they have seen, its in their records
Note: only authorised clinicians and healthcare workers from the above organisations
have access to the Bolton Care Record and only where direct care is being provided with consent. Other legal gateways exist including emergency care and where a person doesn’t have the capacity to provide consent.
Information Governance - Governance structures for all aspects of the Bolton Care Record, including information governance, are established and include representatives from all of Bolton’s key partner organisations within the Care4Bolton partnership. NHS Bolton Clinical Commissioning Group retains overall responsibility for ensuring that the governance structures operate effectively. Explicit consent is always be requested from the individual patient before any information held in the Bolton Care Record is accessed. Patient identifiable information can only be accessed for direct care purposes and will always be fully
Data is collected from existing systems. Data is then fed into a single system. Data is joined up and presented in an easy to view format for the clinician.
Organisational Leadership on Board Governance Fully in Place
9 GP Practices Emergency Department
Go-Live
49 Practices (100% population) Migrate to GM wide instance Tertiary Hospital (Cancer) Ambulance Service Other Acute Providers Care Plans
… Future Engagement Starts Information Sharing Protocol & Information Sharing Agreement Sign Up
43 Practices (88% population) Local Acute Trust Community Services Adult Social Care GP Out of Hours Mental Health
Now…
Sep 2016 Feb 2017 Sep 2017 Dec 2018 Oct 2016 Jul 2017 Jun 2018
To inform the public we have developed a communications and engagement plan to support this work. The CCG has conducted extensive engagement with the people of Bolton, staff and other stakeholders to ensure that there is widespread understanding of the Bolton Care Record.
Partner organisations have been nervous about sharing data. Information Governance – holding to our principles GPs see the least immediate benefit
Wealth of information Improved informed decision making Improved patient safety and experience Reduced emergency admissions Reduced calls to GPs missing information Release of staff time to care
Full local rollout Include other tertiary and acute providers Patient portal Maintain trust in the data sharing model Develop GM wide consent and sharing protocol Local Health & Care Record Exemplar
Ben Green
ben.green@manchester.ac.uk 07766 924161
TRE Core Principles
“We make it very difficult to identify an individual from their TRE account credentials” “We avoid sending passphrases to people” “When importing research sensitive data into the TRE, minimise the number of physical storage locations throughout the transfer” “The TRE Service will create and maintain an asset register containing a record for each raw dataset imported into the TRE” “The TRE Service logs all activity related to network traffic, service status and data handling” “The TRE is routinely tested to make sure its security controls continue to operate that the require levels” Where feasible, every file belonging to a TRE user or project will obtain an asset record managed within the scope of the ISMS Sensitivity is not a good measure of personal information Projects operating within the TRE shall experience a negligible risk of reidentification We will only allow data to be imported and made accessible to an individual if there is corresponding IG paperwork that approves this transfer, and names the individuals who have been granted access. “All critical data in the TRE is backed up onto secure offsite storage facilities”
controlled environment full control over access rights no proliferation of datasets no re-identification audit trail
HeRC TRE ISMS
VM VM VM
VPN VPN VPN
ISMS Event and Incident Management ISMS Communication and Stakeholder Management ISMS Document Management ISMS Improvement ISMS Management ISMS Risk Management Staff Induction and Exit Training and Competency TRE Asset Management TRE Data Management TRE Information Governance TRE Infrastructure and Security Management TRE Operations TRE Physical Security TRE Project and User Account Management TRE User Competency and End-Point Security
ISMS Event and Incident Management ISMS Communication and Stakeholder Management ISMS Document Management ISMS Improvement ISMS Management ISMS Risk Management Staff Induction and Exit Training and Competency TRE Asset Management TRE Data Management TRE Information Governance TRE Infrastructure and Security Management TRE Operations TRE Physical Security TRE Project and User Account Management TRE User Competency and End-Point Security
University of Manchester Secure Data Facility
Analytics
Dashboard
Secure and transparent data handling Practice data always stay on N3
CHC BRIT
Challenges & Opportunities of Data Sharing and delivering Data Driven Healthcare?
@Man_Inf @healthinnovmcr @ECHAlliance #McrEcosystem
www.echalliance.com info@echalliance.com @echalliance
Bringing needs and solutions together for the Future of Health
International Projects Manager ECHAlliance
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ECHAlliance Ecosystems: Goals / Objectives
The ecosystem goal is to create ‘permanent’ mutually beneficial partnerships, which improves the delivery of health and social care, at the same time as providing economic benefits. An Ecosystem brings together a community
developing a joint health agenda, aiming to address and find common solutions to challenges facing your region. The main benefit of working together in an Ecosystem is the multiplier effect and of collaborating in an International Network of Ecosystems.
ECHAlliance Ecosystems: Basic Principles
Ecosystem Principles:
Existing Ecosystems
Belgium – Brussels Belgium - Flanders Canada – Ontario Czech Republic Denmark – South England – Manchester England - North West Coast England – London England - Yorkshire & Humber Estonia Finland – Oulu France – Nice PACA Germany - Rheinland Greece - Athens Netherlands - Friesland Northern Ireland Poland Republic of Ireland Scotland Slovenia Spain – Valencia Spain - Galicia Spain – Catalonia USA - New York Wales
Launching soon
Lithuania Portugal Serbia
Progressing Prospects
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Members of the International Network of Ecosystems
100+ quarterly gatherings per year
To support and encourage inter-ecosystem collaboration and greater engagement.
Priority Area / Ecosystem
Brussels (BE) Catalonia Estonia Friesland (NL) Galicia (SP) Ireland Manchester (UK) North West Coast (UK) Northern Ireland Oulu (FI) Scotland Southern Denmark Valencia (SP) Yorkshire & Humber (UK) Slovenia Serbia
Electronic Health Records
P S S P P P S P S P
S Strength Tele Health / mHealth
S P P P P S P
N Need Mental Health
S S P P P P N N
P Priority (strength or need
not defined)
Preventive Care
P S
Active Healthy Ageing (AHA)
N S P S S S N N
Integrated Care
P P S P P
Medicines Optimisation
P P P P N
Patient Data, Analytics, Predictive Analytics
N P S P P P
Home Care
P N P P N
Health Tourism
S S
Interoperability
S N P S P S
Patient engagement
N P P N N P N S
Funding, Financing, Company support
N N N
Others
P P P P P
‘Digital technology is key to transforming health and social care services so that care can become more person-centred.’ “People are frustrated, confused and disappointed and we need to do
enablers, rather than a barrier, to delivering excellent care.” “The issue is not whether digital technology has a role to play in addressing the challenges we face in health and care, and in improving health and wellbeing: the issue is that it must be central, integral and underpin the necessary transformational change in services in order to improve outcomes for citizens.” “This strategy is bold, ambitious and enterprising and presents a once in a life time opportunity to create a digital and interoperable health and social care system, supporting improvement in the safety, effectiveness, efficiency and citizen-centred nature of the services we
http://www.digihealthcare.scot/wp-content/uploads/2018/04/25-April-2018-SCOTLANDS-DIGITAL-HEALTH-AND-CARE-STRATEGY-published.pdf
SCOTLAND
We will build on the philosophy of Prudent Healthcare, and on the close and effective relationships we have in Wales, to make an impact on health and wellbeing throughout life. We will have a greater emphasis on preventing illness, on supporting people to manage their own health and wellbeing, and
new technologies and by integrated health and social care services which are delivered closer to home. https://gov.wales/docs/dhss/publications/180608healthier-wales-mainen.pdf
11 June 18, Signatories: Vaughan Gething, Cabinet Secretary for Health and Social Services Huw Irranca-Davies, Minister for Children, Older People and Social Care Andrew Goodall, Director General for Health and Social Services, Chief Executive of the NHS Wales
WALES
member of the ECHAlliance International Connected Health Ecosystem Network http://www.ehealthireland.ie/Stakeholder-Engagement/eHealth%20Ireland%20EcoSystem/Innovating-for-Slaintecare-Care-Closer-to-Home/ Martin Curley, Chief Information Officer, Health Service Executive Ireland
Innovating for Sláintecare: Care Closer to Home – 22nd June Ecosystem
……….the key sector players, invited to debate on strategic axes defined by the Major of the City and his team, in terms of:
Nice (France) Ecosystem 27 June ‘18:
https://echalliance.com/news/405018/Join-the-Nice-Ecosystem-Gathering-Challenge-for-a-Nice-Life-27-June-Nice---France.htm
Convergence roadmap on interoperability standards and Digital Telehealthcare protocol
Led by Erik GERRITSEN, Secretary General of the Ministry of Health of Netherlands
Citizen-controlled data governance & Data Donors
Led by Angela BRAND, Professor at Maastricht University
Legal framework facilitating the free flow and the 2nd use of health data
Led by Bleddyn REES, Digital health expert and lawyer at Osborne Clarke
Digital transformation & change management in Health & Social Care organisations
Led by Richard CORBRIDGE, Chief Digital & Information Officer, Leeds Teaching Hospitals NHS Trust
Web: www.echalliance.com/digitalhealthsociety Email: estonia-eupresidency2017@echalliance.com
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A multi-stakeholders initiative
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The DHS movement has designed an ambitious research and innovation programme for health and wellbeing in Europe, enabled by key support activities and involving the EU citizens and the whole society.
Its purpose is not to define each project or initiative but to define a moonshot target and to describe the components of the programme to reach this goal. The moonshot aims to develop a series of support activities and research & innovation projects, driving to collect the data (relevant for health purpose) of 100 million European citizens, by 2027, and make them available (under conditions) – read the full description of the moonshot.
Contact us: julien@echalliance.com
ECHAlliance Digital Health Observatory, as a Global Connector section has 4 objectives to: 1. provide relevant, timely and high-quality articles, reports, best practices and research in digital health transformation. 2. increase awareness and commitment of governments and the private sector to invest in, promote, and advance in transforming healthcare delivery. 3. generate knowledge that will significantly contribute to the improvement of health using Digital technologies and processes. 4. disseminate research findings and best practices in events, workshops and through social networks. Contact us: joan@echalliance.com
Digital Health Observatory (DHO) – an invitation to get engaged Opportunity to share: high-quality articles, reports, best practices and research in digital health transformation
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Bringing needs and solutions together for the Future of Health
Andy Bleaden International Projects Manager andy@echalliance.com
Gregor Cuzak Gregor@echalliance.com International Ecosystem Coordinator Damian O’Connor damian@echalliance.com Director Ecosystem Development Brian O’Connor brian@echalliance.com Chair
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will build on the existing assets available across GM
the level of the GM system, not organisationally
and involve industry in its work (eg on thought leadership pieces) so that collectively we develop better, more productive relationships with industry
advantage in brokering new relationships on behalf of GM as a whole
Innovations Board, to which the Hub will be accountable
to the LHCRE
for a regional Digital Innovation Hub
The Digit
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Digital Innovation Hub – a highest level view of what we need to do in GM Understand
population Define the needs of our population Operating model transformation Business model transformation
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Systems of Record Systems of Insights Systems of Engagement Infrastructure
services to the Life Science and Biotech industries
develop enhanced insights from comprehensive data
computer science techniques to healthcare problems
culture, tools and technology to drive better clinical and business outcomes Industry engagement Data science Computer science Digital transformation
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Digital Innovation Hub Pilots: Exemplar Industry Programmes
Phase 1
Design and Dialogue
Phase 2
Delivery and Implementation
Phase 3
May 2018-May 2019 May 2018- December 2019 January 2019- June 2021
HDRUK will launch an exemplar programme later this year. There is £5m to invest in several industry-led projects around the country that can demonstrate enhanced utility from data sharing. No decision on the scope yet.
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Linda.Whalley@healthinnovationmanchester.com 07976 773814
– pioneering discoveries, interdisciplinary collaboration and cross-sector partnerships that are tackling some of the biggest questions facing the planet
– an agency of the Dept. of Health responsible for evaluating new technologies (pharma, medtech and digital) and developing clinical guidelines and standards. – NICE looks at ‘value for money’ and now, affordability, for the NHS.
– an academic health science and innovation system, at the forefront of transforming the health & wellbeing of Greater Manchester’s 2.8 million citizens
– unites local health data and advanced technology to improve health services for patients across the North of England. – operates as four city regions (GM, Connected Yorkshire, NWC, NENC, coordinated by a central hub based in Greater Manchester
“
Real word data has been around for a while, in the form of registries and observational studies, for example. We use RWD in a range of programmes, to develop interventional procedures guidance, for example, and in the Cancer Drugs fund. There’s pressure and opportunity for us to use it more frequently and systematically in, for example, updating existing guidance. We know more about our guidance and how to develop it than anyone else, but we have limited knowledge of and skills in machine learning. Were investing £250,000 this year and potentially more next year in some additional posts and external partnerships to help us understand its potential at NICE.
– Develop evidence for input into guidance creation
– Demonstrate evidence of guidance adoption using routinely collected data – Assess real world outcomes of adoption of NICE guidance from efficacy to effectiveness
– Review current research questions for topics that are suitable for a real world evidence study – Develop computable research questions – Deliver initial analysis of real world evidence for the research question
– Identify scalable methodology evaluating digital health interventions – Provide quality management/metric development tools for evaluation
For GM:
Manchester, that can be leveraged as part of the wider economic development
diseases, natural history, co-morbidities and information on current practice.
world settings.
data can be collected in ways that reduce uncertainty and help demonstrate effectiveness of interventions and technology assessments.
guidance by using current and near-future machine learning technologies.
GM Adult Mental Health Service User Network Launch (Oldham) Mon 16th July 09:00 – 15:30 https://tinyurl.com/yd9sm7kg GM SME and Commissioner Digital Event (Friends Mtg House) Monday 23rd July 09:00 – 14:30 https://tinyurl.com/yd2py2dr NHS Innovation Expo (Manchester Central) Weds 5th & Thurs 6th Sept https://www.england.nhs.uk/expo/ GM Research & Innovation Assets (Alderley Park) Weds 19th Sept 13:00 – 16:30 https://tinyurl.com/yazck2ab GM / Joint Northern Ecosystem (GM TBC) Weds 26th Sept