WELCOME Connected Health Ecosystem event Prof Ben Bridgewater - - PowerPoint PPT Presentation

WELCOME Connected Health Ecosystem event

Prof Ben Bridgewater Chief Executive, Health Innovation Manchester

Guy Lucchi Digital Innovation Director

Healthcare Challenges

Ageing populations Unacceptable variation Empowered customers Escalating costs

Digital is disrupting all business, healthcare is special but no different

Do things differently Commission things differently

What we need to do

Do different things Technology Can Help

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Digital is disrupting all business, healthcare is special but no different

Old fashioned Taxis Taxis with an app Fleet of taxis On shared platform Uber Hotel Hotel with a website Hotel chain with centralised booking Air BnB GP GP with a website GP consortium and OHH service Babylon

OLD WORLD CUSTOMER INTIMATE OFFERING OPERATING MODEL TRANSFORMATION BUSINESS MODEL TRANSFORMATION

Digital Disruption

The customer is already digital and will define the next moves Digital platforms disrupt existing value chains* Platform effects create winners and losers *source leading edge forum

Digital transformation across industries suggests that greater focus on a specific value optimises chances of success.

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https://www.executestrategy.net/blog/value-disciplines/

Product leadership Operational efficiency Customer intimacy Excellence Threshold

Digital transformation: How technology is changing the way in which products and services are provided to keep people well and detect and treat disease.

Re-imagining services

GM digital operating model

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Method Platform Design Studio Engage

Problem driven pathway redesign and data science. Delivered using agile techniques and cross- functional teams. Maximising existing data and platform assets. Targeted investment to enhance. Bringing together talent to develop the approach Patients, professionals, academics, stakeholders and industry A vibrant place for co- creating new pathways

A digital transformation methodology

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The ability of a system to derive benefits from technology is far more dependent on the people, processes and culture than it is

• n the technology

Problem Statement Process People Culture KPI’s Tools and technology

Use case: re-imagining A&E

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PROBLEM STATEMENT We have observed that A&E is supporting patients that other services are better placed to provide and the unscheduled nature of A&E means waiting times can be extensive, this results in a poor experience for patients and sub optimal utilisation

• f clinical expertise and real estate which in turn

is results in poor patient satisfaction, wasted clinical time and increased costs to the health system. SCENARIO A 13 year old boy who falls through a green house and cuts his leg.

Traditional world

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Incident A&E admission Call 111, 999

• r attend

A&E Up to 4hour wait in A&E Drive to A&E and struggle to park

“Re-imagined” Digital first world

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Incident Multi Channel AI Triage

Non- urgent, direct to alternative

Book GP Appointment

Immediate risk of life

• Direction to the nearest A&E and

estimated driving time

• Automatically dispatches

ambulance (if required) Prioritised A&E admission

Non life threatening but requires urgent treatment

Presents several locations based on speciality & wait time Digitally books time slot and waits at home

• Receives a notification

when to leave based on traffic and estimated travel time

• Rewarded with parking

voucher Number recognition automatically opens barrier and informs the ePR patient arrived Mobile app gives step by step instructions to A&E

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We do not need magic to transform our world. We carry all the power we need inside ourselves already. We have the power to imagine better. J.K.Rowling

Transforming care through digital technology

Stephen Dobson, Chief Digital Officer GM Health and Social Care Partnership

People are more digitally connected than ever before, but we recognise that not everyone is.

OFCOM Communications Market Report, 2019

79% of adults use a smartphone 87% of households have an internet connection 1 in 5 households currently use wearable tech Households with superfast broadband increased by 2.2m from 2018 to 2019 58% of households

• wn a tablet

Lower-income families and people aged over-54 are less likely to have smartphones, laptops and tablets

Despite the digital revolution, healthcare and public services have been left behind

• Important patient information is held on hundreds of different

systems which cannot be accessed from one place

• People have to repeat their story to multiple professionals,
• Care is not joined-up between different agencies
• Important information is missed and problems are not identified

early

• In extreme cases this could lead to harm

We need to digitally transform how people engage with health and care services by maximising data-driven technologies.

Tamara’s story

In April 2015, 13 13 year old Tamara ara Mills s had a fa fatal al asthma hma atta tack

• ck. She was seen

n by medical ical profess ssional ionals s 47 times es in different erent parts s of the NHS. Linking ng these se records ds could d have allowed ed her doctor

• rs

s to treat t her differentl erently and perhaps ps prevent nt her death. h.

Understanding Patient Data, August 2017

After her death, the coroner identified a number of failings in Tamara’s

• care. One of these was the lack of a coordinating record of the occasions
• n which she saw medical professionals. Without this overall 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.

Public attitudes to data sharing

The GMCA commissioned an independent research study in 2018 to survey 1,100 GM residents and hold a series of focus groups and in-depth interviews

6 syst stems ms require quire 15 connec ecti tions.

• ns.

Every y syst stem m has 5 separat rate connecti ctions. ns. Systems are integrated with bespoke connections. Every y syst stem m has just st one connecti ction. n. Create a central repository of data that can be re-used. They also need to be interoperable - they can be connected like Lego bricks using standard OPEN API’s.

Free the data

GM Care and Support plans GP Dashboards GM Contingency Plans.

Organisations across all 10 localities

Patient Specific Apps

Future state: apps can build off a single shared data source and transfer data to source systems

GM shared data store

GM wide medication reviews Rules/Automated Alerts/Escalations Professional visualisation of records across GM Health Intelligence Professional visualisation of records across GM PACS/VNA Digital Pathology Incentive schemes GM-wide stratified health checks

All 10 localities of Greater Manchester already have an Integrated Direct Care Record in place

Supports health and care professionals to access patient data at the point of care to inform better care and treatment

Locality shared care record

300 GP practices now actively use the system 8 acute trusts live

Remaining 2 to go live in summer 2019

All 3 mental health trusts live All 10 Councils and 7 community care providers coming on board

Moving beyond the basic ability to share information to transforming care

• Developing common standard technology for public

services across GM

• Empowering people to take control of their health and

wellbeing

• Ability to share information across GM and beyond
• Technology that allows data from multiple sources to be

reused by a variety of systems

• Presents data clearly to support improved clinical

decision making

• Informs routine and emergency care
• Improves standards of care for all
• Proactively identifies gaps in care
• Reduces variation in standards

GMHSCP & GMCA are working together to procure, develop and test a next generation data sharing platform

Dementia Frailty Early years

£14.3m digital transformation programme to develop advanced technologies across public services

The NHS, councils and other public bodies are working together to invest in new technologies to digitally transform public services

Maximising digital technology is fundamental to achieving Greater Manchester’s public reform plans

INTEGRATE EMPOWER INNOVATE

Population ation health th approac ach

• Citizen access to their

information

• Person centred and

personalised

• Citizen apps linked to

record

Creati ting ng a s sustaina stainable e health th and care syst stem

• Joining up records
• Developing common

standards

• Public services

infrastructure

Unlocking king economic mic pot

• tent

ntial

• Digital Innovation Hub
• Partnerships with

academia and industry

• Data science and

analytics

• Precision health

Dementia Use Case

• Dr. Emma Vardy

Consultant Geriatrician Clinical Dementia and Delirium Lead Salford Royal

It’s about people…

As is…

• Siloed
• Provider centred
• Carers involved very little
• Overly complex

Dementia and Frailty Use Cases

Dementia

• Dementia diagnosis and

type – sharing of codes

• Delirium diagnosis and

triggers - sharing of diagnostic codes

• Carers details and

consent to share including lasting power

• f attorney
• “This is me” document

Frailty

• Sharing of EFI and CFS

scores

• Coding of mild,

moderate, severe frailty

• Share CGA across health

economy

Both

• EPACCS Access 24/7
• Scheduling and visibility of care
• OOH access to records
• Sharing diagnostics codes
• Admissions/discharge notifications
• Test results
• Medications

Dementia use case

Around 30,000 people are estimated to live with dementia in Greater Manchester, with around £270m spent on care and treatment each year. Technology platform will support more robust integrated care planning, help people maintain their independence and detect changes in their condition to avoid hospital admission.

• GP’s unable to view the date of a Memory Clinic

appointment and has to chase mental health services for an update and check for patient attendance.

• Other healthcare professionals (acute, community)

are unable to view if Memory Clinic referral has been made and my duplicate referral and or associated tests

• Memory Clinic outcome is sent to GP via the post,

which needs to be manually inputted into the GP

• system. Can lead to delays in the sharing of vital

information

• Acute professionals know if an individual has been

diagnosed with dementia by viewing their GP record, which can be difficult to locate

Salford Trafford

Vision for Dementia

• System working for people with dementia and carers
• Health and social care professionals use the system as it works for

them and saves time

• Risk of delirium identified and prevented
• People cared for in preferred place at all stages of care
• Reduced risk of hospital admission, prolonged LOS or readmission
• Person-centred care
• Accurate data for national collation

Frailty Use Case

• Dr. Saif Ahmed

Clinical Director Frailty - Tameside and Glossop ICFT SRO LHCR Frailty

Frailty use case

12 million over 65s in the UK are living with frailty. Every year more than one in three people over 65 suffer a fall, which can cause serious injury and even death. Technology platform will support the aim

• f reducing the number of severe frail

people who die in hospital. PROB OBLEMS S

• Missing discharge/admission notifications result in

patients spending unnecessary time in hospital

• Frailty score are not shared across care providers
• Duplicate tests are ordered and unnecessary

referrals made because patient data across care settings is not available

• Patients are admitted to hospital against their

wishes because their end of life care plan is not available to healthcare professionals at the point

• f care
• Patients degree of frailty worsens when fall

frequency is not shared and acted upon soon enough

Salford Tameside & Glossop Stockport

Vision for Frailty

• Identification of frailty using the EFI and CFS scores across the system

(primary care, community, trust)

• Standardised approach to care planning using the BGS standards for

CGA (Comprehensive Geriatric Assessment)

• Reduced rates of admission, length of stay or readmission by sharing

advanced care plans across the system for severely frail patients

• Increased in percentage of severely frail dying in preferred place
• LHCRE to help deliver the GM frailty standards set out in the charter

Early Years Use Case

Early years use case

Freeing-up valuable time for health visiting teams, equating to around £10m per year in productivity once rolled out across the city-region Technology platform will transform the paper-based child development checks for 0 to 5s

Salford Tameside & Glossop Bury

• Digitising current paper-based developmental

assessments parents and guardians undertake for under 5s

• Parents will be able to complete the assessment

questionnaires online, instead of having to write

• ut cumbersome paper forms, which then have to

be manually entered into a different system by staff.

• Will allow parents and professionals involved in

their child’s care to track their child’s progress and better coordinate care that supports the whole family.

Q&A panel discussion

Prof

• f Ben

n Bridg idgewater er

Chief Executive, Health Innovation Manchester

Gu Guy Lucchi chi

Digital Innovation Director, Health Innovation Manchester

Stephe ephen n Do Dobso son n

Chief Digital Officer, GM Health and Social Care Partnership

Dr Dr Emma mma Vardy dy

Consultant Geriatrician/Clinical dementia and delirium, Salford Royal NHS FT

Dr Dr Saif if Ah Ahmed med

Clinical Lead for Primary Care, Clinical Director Frailty, Tameside & Glossop Integrated Care FT