1. Integrated Care Records Service Durham and Darlington 22 October 2002

2. National Programme Overview

3. Integrated Care Records Service -Phased portfolio includes clinical tools and functionality -National services -Local applications Electronic appointment bookings Electronic prescriptions service Partnership with IT Industry - deliver compliant systems & clinical applications - National, Regional, Local National direction and performance management of IT National standards and specification Increase IT funding dramatically - target IT spend Backbone IT infrastructure - accelerate connecting the NHS with secure Broadband Programme Overview

4. Achievements include: Published ICRS Standards and Specifications – 180+ replies Published outline Procurement Strategy – 80+ replies eBooking is at Full Business Case stage Ministerial Taskforce meets 22 October HR strategy for NHS Information Professionals – launch at conference end October Richard Granger, Director General, started on 7 October

5. Delivery Over 96% of NHS Consultants have desktop PC access to NHSnet eMail & Directory Services Contract signed 27 September eBooking Information Broker Service live 12 September (www.nhs.uk) Health Records Infrastructure pilot in Walsall from end October Establishment of CIOs in StHAs

6. Key Priorities…. Provide central direction, local implementation, eg in PPF guidance Stakeholder inclusion, time to contribute Target increased funding Establishing standards Pragmatic implementation at high speed, while keeping the vision alive Deliver better patient care.

7. Integrated Care Records Service

8. Phase 0 – Research ERDIP Demonstrators Patient Survey Supplier Relations International exemplars Exemplar sites

9. Critical elements of the National Programme National  Robust national infrastructure, with  National information services  An increasing number of national applications, and  standards supporting local users across health communities Local  generic functions  user environment  specific functions  clinical conditions

10. Analytical Services NHS Direct CAS Population Record ETP nhs.uk. NeLH Reference Files e- commerce National Services 3. Application Services 2. Information Services 1. Infrastructure Services Network Security Access Control Directory E-mail e-Staff Record Finance National Services e- learning

11. ICRS - Overview The ICRS is the : Integrated, operating across the care continuum Care, covering both health and social care Records, single record based around the patient Service, with corresponding service levels

12. What is the purpose of ICRS ? The purpose of ICRS is to support the provision of high quality patient care across the whole health community

13. Local Services National Services Standards Across Health Communities Information Governance Analysis Information Reporting Information Capture 5. User Environment User Tools Health Community A Health Community B Health Community C... Pathology Mental Health Acute Care Social Care Primary / Community 6. Specific Functions Service User Index Diagnosis and Care Booking and Scheduling Ordering and Reporting Prescribing Clinical Governance 4. Generic Functions Digital Imaging Knowledge Management CHD Older People Mental Health Diabetes Cancer 7. NSFs Analytical Services NHS Direct CAS Population Record ETP Nhs.uk. NeLH Reference Files e- commerce 3. Application Services 2. Information Services 1. Infrastructure Services NetworkSecurity Access Control DirectoryE-mail e-Staff Record Finance Etc. e- learning

14. Phase 1 – Consultation Output Specification for ICRS Procurement Synopsis CIO Preparation Work with exemplar sites Industry consultation

15. ICRS Consultation Exercise 186 responses (as at 27 September)  74 from the NHS  62 from suppliers  50 others Workshops Structured Walkthrough

16. ICRS Consultation – Main Issues Vision and description – need more on benefits Clarification of procurement and implementation plan Need to phase implementation Suggestions on functional requirements – eg NSFs Need for Design and Architecture

17. Phase 2 - Planning Project Definition Project Initiation  Project plan  Risk register  Dependencies within the programme National Business Case

18. Procure Integrated Care Records Services in a way that: provides a coherent national, top-down approach that will be capable of delivering the targets in the National Programme is sensitive to local requirements, both in terms of business objectives and technical / system legacy. Objectives for ICRS Procurement

19. Possible examples: Basic connectivity Access to knowledge Access to patient demographics Results reporting Patient access Access to clinical records 1 – access services Phasing Issues

20. 1 – access services 2 - specialist services Possible examples: Basic connectivity Access to knowledge Access to patient demographics Results reporting Patient access Access to clinical records Possible examples: Ordering Digital imaging Prescribing / Dispensing Knowledge Management Resource management Phasing Issues

21. 1 – access services 2 - specialist services 3 - communication services Possible examples: Referrals Discharge summaries Clinical correspondence Care assessment Care plans Shared clinical records Clinical governance Possible examples: Basic connectivity Access to knowledge Access to patient demographics Results reporting Patient access Access to clinical records Possible examples: Ordering Digital imaging Prescribing / Dispensing Knowledge Management Resource management Phasing Issues

22. 1 – access services 2 - specialist services 3 - communication services4 - integrated services Possible examples: Rules-based decision support Integrated care pathways Multi-organisational scheduling Telecare and telemonitoring Possible examples: Referrals Discharge summaries Clinical correspondence Care assessment Care plans Shared clinical records Clinical governance Possible examples: Basic connectivity Access to knowledge Access to patient demographics Results reporting Patient access Access to clinical records Possible examples: Ordering Digital imaging Prescribing / Dispensing Knowledge Management Resource management Phasing Issues

23. Objectives 1.To improve the experience of patients 2.To improve the quality of care 3.To enable effective access to clinical and administration information 4.To reduce the fragmentation of care 5.To improve health policy development and health research Investment Objectives

24. 1 – access services2 - specialist services 3 - communication services4 - integrated services Outcomes for Patients Patients are offered the opportunity to exercise choice over date, time and place of future encounters with care services Patients are reassured that the information that they provide at any healthcare encounter is kept secure Clinicians have access to information about the latest care knowledge and practice Patients have access to evidence of the quality of care provided to them or by local providers Patients can be confident that results and information are provided Patients are able to use a range of technologies – PC’s, phones, digital TV – to interact with care services and at times that are convenient to them Patients are able to understand their care process through use of “patient-friendly care pathway views” Patients are able to look at their records and have the ability to amend or add information (taking into account the legal implications)

25. 1 – access services2 - specialist services 3 - communication services4 - integrated services Outcomes for Clinicians Clinicians have access to clinical information for their patients Clinicians have ready access to knowledge and learning materials Clinicians are able to initiate service requests Clinicians will see support for specialist areas such as digital imaging and prescribing Clinicians are able to participate in lifelong learning through access to education, training and development services Clinicians have ready access to the knowledge, clinical tools and related services they need to support their clinical decision making process Clinicians and managers are able to use high quality information in support of the implementation of clinical governance and improvement of public health Clinicians have ready access to information about their patients when they want it, from wherever they want it (including peripatetic staff), and structured in a format they want Clinicians are assured that their records and communications with patients and colleagues are secure and conformant with agreed information sharing protocols

26. Current National Tasks Contract Structure Payment and performance mechanism Definition of implementation planning and approach to benefits realisation Definition of Design Authority Definition of architecture for ICRS within overall architecture Baseline Review in each StHA Agreement on local business cases Approval of National Business Case OJEC

27. Local Activities Baseline review (the “warranted” environment) Funding Systems Plans Develop local plans for ICRS Linked to Local Delivery Plans Migration strategy for ICRS Local selection process Business case Selection criteria Local Activities

28. Any Questions ?