1. Integrated Care Partnership Proposed IT Solution Siobhan Hanna AD Informatics Mark Hindle Managing Consultant, immix 2y November 2012

2. The Problem

3. Some immediate issues Duplication Version control Access control Difficult to follow up actions Distribution

4. The Solution Some immediate issues Duplication Version control Access control Difficult to follow up actions Distribution

5. Options Appraisal Access to internally hosted applications will be a problem for the GP community & patients Some possible functionality that can be recycled Existing (internal) Systems Commercially available & free to use packages Not centered around a person – more a document file system Notifications when things change possible + version control Document Sharing / Collaboration None specifically available in the UK, some add ons to other systems Modifications to a package may be available Commercially available packages supporting integrated care Best fit for functional and non functional requirements Augmentation approach – harness existing data sources with specific functionality Bespoke Solution

6. Recommendation – a bespoke solution Initial requirements Online ICP functionality - with access to view and collaborate for any legitimate care professional with an interest as well as the patient Limited interfacing / connectivity to other systems but enough to avoid duplication around patient detail and hospital information Handling of all of the notifications and alerts to all who 'need to know' when a patient is on a care plan Task management of actions arising from care plans with updates when complete etc Publish this system online to remove organisational and technical barriers to access Aim to have this available by March 2013

7. More advanced requirements Link to a Population Based Risk Stratification and Case Finding tool - identify cohorts and tailor care plans around those 'upstream Mobile access to care plans – an 'app' for patients on care plans and an 'app' for care professionals to look up care plans Inbound - Full integration with as many systems as we can source the data out of to populate as much of the care plan as possible using technology ? Integration with Telehealth ? Integration with the Community Information System (CIS) … etc Outbound - Exposing the care plan to other IT systems Develop full referral pathways with links to other systems and a feedback loop as to what happens in those systems coming back into the care plan Recommendation – a bespoke solution

8. Recommendation – a phased approach Phase 1 Online care planning Task & notification management Multi disciplinary collaboration Patient details & hospital data available Care plan review scheduling Phase 2 Patient Access Phase 3 More advanced requirements Mobile & disconnected working etc March / April 2013 July 2013 Oct 2013 (Timescales are indicative and subject to availability, planning and approval)

9. Example screenshots Integrated Care Partnerships (ICP) – a bespoke web application

14. Patient demographics populated automatically Register an interest Care plan content Care plan subscribers: Dr J Smith (GP) Mr V Anders (Pharm) Mrs S Jones (Cons) Dr H Ponson (Assoc Spec) Message All Add/Remove Recent documents: 1.Medicine Use Review 2.Patient Consent Add/Remove

15. Tabbed pages Add / associate a pharmacy Medicines information

16. A Bespoke ICP Solution - Principles A bespoke ICP web app solution using simple, modern technology Host it in the cloud (securely, using the internet) – accessible online Promote a design principle of generic care plan functionality – create multiple templates in the future (beyond care of the elderly) Provide for patient access – allow them to log on and view their care plan and see the next planned actions / updates on previous ones Build phase 1 functionality foundations then enhance to provide more advanced functionality on top Design an architecture that is agnostic in terms of other systems used by the various care professionals Keep a design principle of all data about the patient available to be accessed by all with a legitimate relationship in respect of the care of the patient.

17. Next Steps & Actions Agreement from ICP Steering that this is preferred way forward Business case development and approval to spend Commissioning someone to develop this via TPA to fast track procurement Agreement on pilot and timeframes to pilot (not long I think) Agreement on process Agreement on post project evaluation criteria to measure success and further roll out Project plan

18. Integrated Care Partnership Proposed IT Solution Siobhan Hanna AD Informatics Mark Hindle Managing Consultant, immix 2y November 2012