1. eHealth Strategy Primary and Community Care where next? Paul Gray Director of Primary Care & Community Care

2. SCIMP conference 2 1.The Government’s policy context 2.Revised eHealth Strategy 3.Prospects for primary and community care IT To cover Paul Rhodes, eHealth Programme Director, on the programme itself Tomorrow

3. SCIMP conference 3 The future model of health care Geared towards long-term Embedded in communities Team based Continuous care Integrated care Preventive care Patient as partner Self care encouraged Carers supported as partners High tech Geared towards acute Hospital centred Doctor dependent Episodic care Disjointed care Reactive care Patient as passive recipient Self care infrequent Carers undervalued Low tech Evolving model of careCurrent view Policy context

4. SCIMP conference 4 Key principles 1.Much has been achieved – don’t rip-and-replace unless necessary 2.Incremental progress – link to what exists 3.Work closely with clinicians and other users eHealth Strategy

5. SCIMP conference 5 Where we are now with eHealth –big picture

6. SCIMP conference 6 Where we’re trying to get to

7. SCIMP conference 7 Long list of desired investments, for example.. S econdary care: disparate, ageing patient admin systems and few clinical systems Electronic test requesting CHI number use and Single sign-on GP and community systems (IPACC)/ links with partner agencies National Child Health systems – in silos and paper-heavy eHealth Strategy: What might be new?

8. SCIMP conference 8 whole list can’t all happen – resource and capacity constraints prioritisation needed, and levering real benefit from previous investment eHealth Strategy: What might be new?

9. SCIMP conference 9 1.Efficient and effective flows of information to support whole patient journey including links with partners, principally Local Authorities and the voluntary sector 2.Information to support anticipatory care 3.Information to support patient involvement eHealth implications for primary and community care

10. SCIMP conference 10 Examples SCI Gateway referrals – 60,000 per month Emergency Care Summary – proving useful in A&E, OOH and NHS24 electronic Single Shared Assessment (eSSA) in one or two Data Sharing Partnerships Issues few discharge letters using SCI Gateway slow progress with eSSA confidentiality/ information governance Examples: 1. Information to support whole patient journey

11. SCIMP conference 11 Information governance Benefits barrier in existing eHealth systems For example, the storage of clinical letters in SCI- Store from SCI-Gateway. Potential barrier to eHealth innovation. Approach Study investigating key IG challenges Staff Identification, authentication, and access control; Consent; Clinical IF Ownership; Patient engagement; IG Frameworks Report due Spring 2008 Examples: 1. Information to support whole patient journey

12. SCIMP conference 12 Examples Nairn project – working with Raigmore to spot patients most likely to be re-admitted SPARRA – ISD’s prediction algorithm Issues getting sufficient and accurate data incentives for primary care Examples: 2. Information to support anticipatory care

13. SCIMP conference 13 Examples Townhead Surgery, Irvine - Patient Online. Secure web site: books appointments, commented test results etc More opportunities? further exploit the Internet? (SHOW gets 26 million hits per month from Internet) individual care plans on patient’s secure website? With access to trusted guidance? trial of voluntary patient access to ECS? Examples: 3. Information to support patient involvement

14. SCIMP conference 14 Further consultation and analysis eHealth Strategy Board – key meeting in December Draft for comment early 2008, finalised around April Make your views known! eHealth Strategy: next steps

15. SCIMP conference 15 1. Primary and community care is key to the patient care. But whole patient care means information support wherever the baton of care is passed. 2. Local decisions can mean central spend, but that might be the wrong place for ensuring best value for money from that spend. Equally, national decisions can have local knock-on, so we want to get better at understanding that. 3. Before considering new things to invest in we must make sure all possible benefit is squeezed out of what exists. Key messages

16. SCIMP conference 16 For sponsoring the conference But more particularly for their useful work around future for Child Health eHealth Finally, thanks to …