1. Using portal technology to improve services 8 October 2014 Andrew Haw Head of Health Informatics Service

2. 2 5 Key Strategy priorities  Electronic Patient Record  Electronic Staff Record  Business Intelligence  Mobile working  Integration

3. 3 Portals – 3 types  Organisation based  Community based  Care based portals for collaboration with patients e.g. renalpatientvew.org

4. Active Users: 3,700 Services: Adult Mental Health Older Peoples Service Forensics (3 hospitals) CAMHS Level 3&4 Drug & Alcohol IDD Psychological Therapies Specialist Services Users: 2,300 Services: Adult Community Allied Health Professional CAMHS Level 1&2 Childrens Services SureStart 80% of GP Practices use SystmOne in Nottinghamshire – but unequally spread across 6 CCGs One trust, two systems

5. 5 Trust based: low level integration  Built an EDMS based on SharePoint for those documents that are not part of the RiO record  Role based access controls are identical in EDMS and RiO  Click through from one app to the other

6. 6 e-ICP – Responsible for mapping the patients care pathway and capturing key events/stages, importing relevant clinical data from various systems including RiO, CESA and eCare Plans. CESA – Responsible for replacing paper versions of the MHA Legal folder and Single Health Care Record into an Electronic storage location. RiO – Responsible for Patient Administration including demographics and appointment status, Progress (Running Record) notes and numerous Forms including Trims, HCR20 and Therapy data EPR – One or more computer applications capturing patient information. In Rampton's case this is RiO, CESA, e-ICP and eCare Plans. eCare Plan - Responsible for capturing in one RiO form MDT care plans for a patient. Forensics EPR solution

7. 7 Trust based – next step  Physical health status recorded in SystmOne & Mental health status recorded in RiO, mostly not a problem except: ○No trust wide Master Patient Index except in BI ○No integration between so some rekeying ○No access to some data out of hours except on paper ○Some services through merger are split across both

8. 8 Our plan  Implementation of Viper360 clinical portal that allows a user to see simultaneous views of patient data in Rio & SystmOne, so that RiO users can access SystmOne, SystmOne users can access RiO and all users can access Summary Care Record, MIG and PC-MIS for IAPT – starting with CAMHS  Confirm the type of electronic collaboration between service users and clinicians that best meet the needs of Children, Young People and Family strategy

9. 9 Why Viper  Use of open source components  Price point designed to support starting small and growing later when requirements become clearer  No data is moved  Credentials

10. 10 Community based portals  Connected Nottinghamshire: 2 acutes, 1 Ambulance, 2 Councils, 2 OOH, 6 CCGs, 2 community providers  All transformation programmes describe clinical information sharing as essential : 3 system wide requirements: Comprehensive Geriatric Assessment, End of life Care and Safeguarding Children and Adults, and a 4 th on the way : urgent/emergency care

11. GPs using EMIS Framework-i County Council Integration Engine Carefirst City Council GPs using SystmOne Ambulance Community and Mental Health Providers Acute Providers Out of Hours Organisations Possible Use of Fortrus as Interim Clinical Portal Emergency Admission to a Geriatric Ward Fortrus Patient Index ? E-Forms and Other Capabilities Comprehensive Geriatric Assessment End of Life Care Adult Safeguarding ? CGA E-Form Started CGA Trigger Request CGA Updated CGA Trigger Request CGA Updated CGA Trigger Request Example: Comprehensive Geriatric Assessment Broadcast Message CGA Phase 1 Complete Next action according to business logic is X to be done by organisation Y by time T

12. 12 Patient based portals  Should: ○save time for both patient and clinician in care delivery / travelling / communicating ○be a choice – standards? ○support interfaces to devices ○be portable - not be tied to an organisation or a group of organisations ○support secure data sharing with providers

13. Proposed E-Health Platform Users Social Media Personal Health Record Specific Tool Self Referral to HCP Search Users choose the access path that works for them Discussion Groups E.g. Microsoft HealthVault E.g.. FLO BUDDY, SilverCloud Avatars (to be agreed) Trust web site and others… User facing services and sites E-Health Portal Information Prescription Dictionary Guided Search Tool NarrativesMood Monitor Directory of Services Portal Layer access to Trust National Services

14. Data Interchange with Other healthcare providers Trust’s App Store / Patient Portal PROMsMy Care Plan Resources Secure Network Patient Held Record e.g. Microsoft HealthVault Rate My Day NHC Electronic Patient Record (RiO ) Research Information System NHC Patient data Other provider data User Generated data E-Health Platform – 2015/6

15. Questions? or e-mail me at andrew.haw@nottshc.nhs.uk