1. Dr Lloyd Humphreys

2. Third sector providers Apps and software Health and social care Consumer tech Mental health Hospices Substance Misuse Charities Advocacy groups Electronic medical records (EMRs) Condition-specific applications Health and wellbeing apps Primary care Community providers Hospitals Mental health Trusts Social Care Prison and probation THE LANDSCAPE

3. Pharmacy Pharmacies Secondary care/Hospital Community teams Employers Relatives GP Charities & Patient Advocacy Groups Government & Commissioning bodies Researchers Mobile device and app developers Patient Primary care services Specialist services THE PROBLEM

4. Hospital services GP The patient doesn’t own the data Often read-only Multiple sites, multiple logins They cannot be shared with others They are not portable TRADITIONAL PATIENT PORTALS – THE SOLUTION? Third sector providers

5. Pharmaceuticals Pharmacies Secondary care/hospitals Primary care health services Employers Relatives GP Charities & Patient Advocacy Groups Government & Commissioning bodies Researchers Mobile device and app developers Community teams Specialist services Social services HEALTH AND WELLBEING: UNDER THE PATIENT’S CONTROL

6. HOW DO WE ACHIEVE CITIZEN LED- HEALTHCARE IN LANCASHIRE?

7. internet firewall NHS network 1.DEVELOP A SUSTAINABLE ARCHITECTURE: LANCASHIRE PATIENT RECORD EXCHANGE SERVICE (LPRES)

8. 2. CREATE OPEN ARCHITECTURE THAT INSPIRES INNOVATION Open REST APIs Apps built on top of the core layer Connected vendors and providers Use standards provided by NHS England (ITK toolkit and Blue Button) Open source wherever possible, but keep a consistency at the core

9. 3. ENSURE INFORMATION GOVERNANCE AND SECURITY NHS N3 hosted Compliant with HIPAA and European data protection ISO27001 Unique public/private key encryption Have patients own the data

10. 4. MAKE IT ACCESSIBLE Translated into 11 languages and can be changed between versions instantly Access information offline Dedicated smartphone app Compatible with all browsers, including IE6 Mobile browser optimised

11. 5. CREATE A VIBRANT MARKETPLACE Work with everyone and anyone in a spirit of collaboration Foster “coopetition”

12. 5. START SMALL AND SUCCEED From 1 site in Great Ormond Street Hospital to 43 sites across the UK Hospitals CCGs Local Authorities (social services) Charities Specialist centres Device manufacturers Pharmaceuticals Software providers

13. WHAT CAN BE ACHIEVED WITH A PATIENT-LED APPROACH? BEYOND THEORY AND INTO PRACTICE

14. WHY IS TECHNOLOGY IMPORTANT IN END-OF-LIFE CARE? 1.COORDINATED CARE

15. SECURE SINGLE INTEGRATED DIGITAL RECORD Held and controlled by the patient, all medical and care planning information is consolidated in one record and available to everyone in the person’s health network, including hospices, GPs, social services, acute hospitals, specialist centres and charities. Available on any device connected to the internet with no software installation.

16. WHAT CAN BE ACHIVED WITH A PATIENT-CONTROLLED RECORD? 2. COMMUNICATION

17. Message people in your network to get the right help, quickly Conduct online video consultations and have all the information to hand Mobile working and remote on-calls become a reality COMMUNICATION

18. WHY IS TECHNOLOGY IMPORTANT IN END-OF-LIFE CARE? 2. MANAGING CARE

19. SYMPTOM TRACKERS, MEASUREMENTS AND RESULTS Lab results and information direct to the patient Monitor symptoms at home, take measurements and share Track medication compliance through Automatic Medication Management

20. DEVICE CONNECTIVITY 100+ integrations, including fitbit, withings, jawbone, Nike+ etc.

21. 3. CARE PLANNING

22. TREATMENT PLANNING Update treatment plans remotely, e.g. change medication regimes

23. All aspects of end-of-life planning completed individually or collaboratively and shared with the people the patient chooses. Independently witnessed, it is legally verified. END-OF-LIFE PLANNING UNDER THE PATIENT’S CONTROL

24. Using a bracelet or card, with a patient ID and pin number, allows emergency medical workers to access essential medical information immediately Any care directives can be legally implemented as they have been witnessed and verified EMERGENCY INFORMATION

25. SUMMARY 1.Putting patients in control benefits everyone and overcomes information sharing problem 2.Turns healthcare from on/off to always available 3.Makes remote working possible 4.Empowers patients and others to manage care proactively 5.Creates a vibrant local economy

26. QUESTIONS?