Electronic Patient Records and the new national agenda: Where do Radiology Management systems and PACS fit in today? Patients in your heart Patients in mind Patientsand families Dr Charles Gutteridge Clinical Informatics

The scale of change Dr Charles Gutteridge Clinical Informatics

Have we reduced the mountain of suffering? Dr Charles Gutteridge Clinical Informatics

Do health costs matter? Dr Charles Gutteridge Clinical Informatics

It is global.... Dr Charles Gutteridge Clinical Informatics

Productivity and growth Dr Charles Gutteridge Clinical Informatics

NPfIT - Spine Service Connections Messaging (TMS & DTS) Demographics SCR Directories Data transfer Test envts Unstructured data Choose & Book GP 2 GP Infrastructure LRS ETP PDS GP Summary PSISQ Discharge Emergency Dept Healthspace Outpatients Sealed Envelopes Alerts Health / Social Care Integration Pathology Common P2P Admissions Out of Hours Ambulance Mental Health NHS Direct Diagnostic Imaging NMS National Monitoring Service Unstructured data Choose & Book GP 2 GP Infrastructure LRS ETP PDS GP Summary PSISQ Discharge Emergency Dept Healthspace Outpatients Sealed Envelopes Alerts Health / Social Care Integration Pathology Common P2P Admissions Out of Hours Ambulance Mental Health NHS Direct Diagnostic Imaging NMS National Monitoring Service Data Infrastructure Messages supported Services provided Summary Care Record, Choose and Book, Electronic Prescription Service, Healthspace,GP2GP, NN4B, QMAS SUS National applications supported Identity mgt GP systems, Pharmacy systems, Hospital systems, Electronic Staff Record Other connected systems MoD, Home Countries, Other government systems Reporting info Prescriptions Demographics Care records Messaging Identity management Test & Training environments Test & Training environments Reporting Dr Charles Gutteridge Clinical Informatics

Health IT use Dr Charles Gutteridge Clinical Informatics

Lesson 1 - Interoperability It is possible to deliver systems nationally but: Time frame is long Leadership challenge is great Innovation gets left behind Dr Charles Gutteridge Clinical Informatics

Lesson 2 – Professional leadership Professional engagement in solutions is critical: Local works better than national Nurse involvement is critical Usability is a key factor Dr Charles Gutteridge Clinical Informatics

Lesson 3 - Innovation IT and software innovation is a key to change but: Innovation outstrips organisational capacity to introduce change Innovation is costly for first in type users Innovation disrupts established processes Dr Charles Gutteridge Clinical Informatics

Lesson 4 - Analytics Analytics must be built in from the start: Clinical data extraction is the key to use by doctors and academics Performance management tools deliver engagement Dr Charles Gutteridge Clinical Informatics

Lesson 5 – User training User training is key to good system performance and: Is always underestimated and under delivered System implementation has a stronger focus than sustainable use Dr Charles Gutteridge Clinical Informatics

Are we clear about what we want to do?

Focus on changing care delivery Dr Charles Gutteridge Clinical Informatics At present it is: Centred on infrastructure Led by professional groups Digital solutions remain disconnected Clinical variation

% of high risk TIAs treated within 24 hours Dr Charles Gutteridge Clinical Informatics

The changed paradigm – local delivery Dr Charles Gutteridge Clinical Informatics Wellness and self care Defined by citizens Innovative use of digital solutions Information and knowledge Comparison and choice Apps and mobile devices

Opp0rtunities for care Dr Charles Gutteridge Clinical Informatics At the bedside Care and treatment discussions Safety Quality Productivity Decision support Video and application support Training routines Comparative information Analytics

Dr Charles Gutteridge Clinical Informatics Digital care delivery So how might we do that….?

Dr Charles Gutteridge Clinical Informatics 5 challenges for a clinical leader 1. Knowledge and content management 2. Measurement and performance 3. Patient experience at the frontline 4. Innovation 5. Education and training

Connecting the data Pharmaceutical data Clinical dataActivity data Imaging data Dr Charles Gutteridge Clinical Informatics

Data quality Dr Charles Gutteridge Clinical Informatics

Comparative OECD 2010 data CountryScanners/millionCT scans/1000 Australia4294 Canada14125 Denmark2784 France11138 UK873 US34228 Dr Charles Gutteridge Clinical Informatics

Patient involvement Dr Charles Gutteridge Clinical Informatics

Teaching and education Link the professions Teach advanced informatics Teach analytics Teach performance management Dr Charles Gutteridge Clinical Informatics