Introduction to the Map of Medicine Welcome to this short presentation about how we’re using the Map of Medicine in Worcestershire. This presentation focuses on our local Pathway for Persistent pain Management, but we hope to be releasing additional pathways over the coming months. Worcestershire Health Libraries

The Problems Inappropriate referrals to the pain clinic Inconsistency in practice in both primary and secondary care Variation in access times Patients receiving procedures which may not be beneficial to them clinically Locums or new employees not sure of correct procedures and local information The map is designed to address some of the problems and inconsistencies that can occur in the patient journey. As well as meaning patients might not experience the best possible care, a lack of clarity over the correct management of a patient’s’ journey can cost additional time and money, because of factors such as inappropriate prescribing and referrals Patients may be sent for consultations, diagnostic tests or other interventions which aren’t appropriate. There can also be a variance in the way two seemingly similar cases are dealt with, which is difficult to explain, and which may not benefit the patient. Patients may not have a clear idea of how their management will progress or what’s going to happen to them next. New staff may not be familiar with how we deal with a particular condition in Worcestershire, or exactly who to refer to.

The Map of Medicine is a database of care Pathways The Map of Medicine is an online clinical knowledge resource, designed and developed by and for health care professionals, to provide specialist-level information to the right person at the right time Based on pathways which are grouped into broad areas of clinical practice The Map of Medicine provides 24/7 access to evidence-based clinical pathways, via an intuitive web-based interface The Map of Medicine is a database of care Pathways The Pathways in our version of the Map may be existing “national Level” Map Pathways, or localised pathways adapted from National pathways. We can also create entirely new local Pathways, based on our own existing paper pathways or created from scratch. The map has an easy to use interface web-based and in familiar flow-chart format

Features The Map of Medicine : Is localised and designed to be useful to the GP community by the Pain Working Group (consisting of many people you know) Provides access to useful websites, local guidelines and documents available every day, all day - 24/7/365 through an easy to use, intuitive website Helps ensure clinical effectiveness, by facilitating local implementation of clinical guidelines and care Pathways Provides current evidence-based knowledge, assured through timely updates Has an emphasis on Self Management / Patient Information options The persistent pain Pathway, in common with other localised pathways, has been developed by a multidisciplinary working group. The group had members representing pharmacists, physiotherapists, GPs, Consultants, and a self-care expert You’ll find there are links to pdfs of local protocols , guidelines and sub-pathways, and to NICE guidelines, as well as useful contact and referral information The pathway emphasises self-management options, and provides easy access to all sorts of patient information, in the form of links to web-sites such as Arthritis Care and to relevant leaflets and other documents. Arthritis care also had input into the pathway. The information in the Pathway is all based on the latest best evidence as identified by healthcare information experts working along with expert clinicians.

Benefits The Map of Medicine also: saves time at point of care and for support staff by reducing re-inventing content, guidance and searching for the latest evidence represents pathways across all aspects of health or social care provides the right information to clinicians, at the right time and provides knowledge support helps deliver referral to treatment targets helps meet clinical governance standards supports professional training and development improves patient experience and understanding of their care To see some case studies illustrating how the Map has helped to improve services visit http://www.mapofmedicine.com/mapinnhs/casestudies Links to Patient information & other useful documents all appear in the relevant stage of the Pathway, giving easy access to information, all in the right place and at the right time. The Map can also help with Training. If you have a new member of staff or locum, and you need to be sure they know what they should do at any stage of the Patient journey, just direct them to the map and they’ll find concise and practical information, and very often a link to more detailed back-ground reading. They can even add notes to the map to confirm that they have looked at a particular page and print them off to show you.

How to access the Map of Medicine

How to access the Map of Medicine All computers on the WHICTS network should have a link to Map of Medicine under the Favourites tab in Internet Explorer otherwise visit https://neem.mom.nme.ncrs.nhs.uk/display/1/index.html You may receive a security warning that it is not recommended to proceed to the site, and that the site’s security certificate cannot be verified, but it is safe to do so You will need a Smartcard to access the Map, and will need Gemsoft authentication software installed on your computer If you prefer, you can access the Map using your Athens account via www.athens.nhs.uk The International view of the Map of Medicine is freely available to anyone (including patients) wishing to view it via the NHS Choices web-site http://healthguides.mapofmedicine.com/maps There are various ways to access the Map of Medicine. If you are unsure which is best for you contact the Project Support managers Richard Brook or Nick Smith, whose contact details appear at the end of the presentation

Demonstration

Map of Medicine This is the map of Medicine homepage, from where you can browse or search for Pathways

Map of Medicine There are different views of the Map of Medicine. A View is a version of the Map aimed at a specific health community Currently, the Map defaults to the Worcestershire View on log-in The International View consists of Pathways and Pages created by teams of professionals commissioned by the Map from a wide range of disciplines The Worcestershire view consists of Pathways inherited from the International View, along with Pathways that we have adapted or created to suit our local needs and practices As well as seeing the International View and our local view, it is also possible to see other region’s views if you want to see how they have localised pathways.

Map of Medicine View pages you’ve looked at recently 1. Search box 2. Browse Pathways by area 3. Search using a clinical presentation Onto Searching & Navigation Firstly, there is a quick link to the pages you’ve viewed most recently. There are 3 ways to find relevant information in pages and pathways We have a simple search box function There is a Browse Pathways by Area function. And you can also search for Clinical presentations  

Map of Medicine Persistent pain management Here you can see how to navigate to the persistent pain pathway using the ‘browse pathways by area function. Persistent pain management

Map of Medicine This is an example of how a pathway will look on your screen. It’s displayed in a Familiar flow-chart format, flowing from from top to bottom illustrating the patient journey. Different branches represent different decision points or scenarios. A branch might just finish at the end of the journey, or it might direct you to another related page via a “Go To” node, indicated by an arrow at the bottom.  

Map of Medicine Information boxes or nodes contain various types of information. Here you can see the background node that gives you information about the pathway you are viewing.   You will also notice the key which tells you about the different types of node you may encounter on the patient journey.

Map of Medicine We are also able to add local information to Nodes, which can contain information such as contact details, clinic times, local patient information leaflets etc. This information is added after the Pathway has been approved and published. If a Node has local information it will display an L icon. We recommend you to open the Local Information Tab if it is displayed As you follow a pathway down, at the point of referral, or where a patient moves from Primary to Secondary care nodes will change Zone   Green nodes indicate Primary Care, Blue Secondary care so you can see straight away which actions should happen in which settings

Map of Medicine We will now have a closer look at the information in the boxes or nodes. In the quick info tab you will notice that there are words which are hyperlinks and have a magnifying glass next to them   Click on these links and you can perform a search on the term that you have selected in the BNF, Google, or NHS Resources, and in many cases you can link through to the full-text of articles. The Option to Search NHS Resources is also available at the bottom of the information box. The terms you will search on are based on the page and node you are in. You can also add search terms to the search box.

Map of Medicine Referrals are dealt with in a variety of ways. You can see here that there is a special kind of node called a Referral Node. These simply open a Referral Form, which can be a standard form provided by the Map of Medicine, or a locally produced form.

Map of Medicine In some referral cases (especially where referrals are made by telephone) we have preferred to use an ordinary Information Node but stated in the text that you should refer and included relevant local contact details

Map of Medicine This slide displays ‘Go To’ nodes. They lead onto another page which in this particular pathway will take you to ‘hyperglycaemic emergencies’, ‘Type 1 diabetes management’ or ‘type 2 diabetes management, part1’

Map of Medicine Notes The Map of Medicine also gives you the opportunity to add notes to particular nodes. You may wish to do this for personal development or to add and submit information or feedback to the Map of Medicine. This could be simply highlighting information we have missed, or informing us of out of date information or broken links.

Thank you Nick Smith Map of Medicine Project Support Manager nicholas.smith@worcsacute.nhs.uk 01905 760601 (direct) Richard Brook Map of Medicine Project Support Manager Richard.Brook@worcsacute.nhs.uk 01527 505771 (direct) Thank You for watching this presentation. If you have any queries regarding the Map of Medicine, or would like to suggest any pathways for localization then please contact Nick Smith or Richard Brook.