1. Tiani Spirit REALISING AND MANAGING THE SINGLE PATIENT RECORD MIKE MORRIS

2. An event, seen from one point of view gives one impressionSeen from another point of view it gives quite a different impressionBut its only when you see the WHOLE PICTURE that you can fully understand what’s going on

3. The Problem Decisions made in the absence of all available information may result in: ▪ Poor outcomes for patients ▪ Costly and unnecessary interventions ▪ Litigation The better the information, the better the chance of accurate decisions

4. Sharing the information ▪ Primary Care ▪ Acute Trust departments ▪ Pharmaceutical ▪ Mental Health ▪ Social Care ▪ Private Sector ▪ Third Sector ▪ Other agencies (e.g.: police) ▪ Patient ▪ Carer

5. The Issue Sharing patient/citizen information between stakeholders: ▪ Need to know: role based access ▪ Data Protection / Information Governance ▪ Secure connection (PSN/N3) ▪ Hosting location ▪ Access: authentication & presentation ▪ Management ▪ Data Structure

6. Tiani-Spirit OVERCOMING THE ISSUE

7. SUBSCRIBER The integration engine enables one system to publish information to another system that subscribes to all published information PUBLISHER INTEGRATION ENGINE One Integration engine per interconnection One Information Governance agreement per use case per link Traditional Approach

8. SUBSCRIBER As the number of connections grows so does complexity. N systems = 5+4+3+2 = 17 links per use case PUBLISHER INTEGRATION ENGINE One Integration engine per interconnection One Information Governance agreement per use case per link

9. Tiani-Spirit Creates a “lens” through which published elements of a patient record can be seen Presents the consolidated view to the consumer Tiani Approach

10. PUBLISHER CONSUMER The publisher is willing to publish some of his patient record to specific consumers according to agreed information governance rules HEALTHCARE INFORMATION EXCHANGE Tiani Approach

11. PUBLISHER CONSUMER The Tiani HIE temporarily holds the information pertinent to the patient in question within the exchange Tiani Approach

12. PUBLISHER CONSUMER When more than one publisher publishes information to the exchange, a consolidated single patient record view becomes established PUBLISHER Tiani Approach

13. PUBLISHER CONSUMER The consumer then views the consolidated record in the manner required and subject to role and information governance PUBLISHER Tiani Approach

14. PUBLISHER Tiani Approach CONSUMER With Tiani there is only one Information Governance per link to the exchange and only one link per system (N systems = N links) PUBLISHER

15. Scalable system Multiple systems can connect into a single exchange known as an Affinity Domain

16. Scalable system To ensure operating efficiency, additional systems use a second or subsequent Affinity Domain, connected by a Super Exchange Super Exchange

17. Scalable system This is continually scalable Super Exchange Affinity Domain

18. Delivery Delivered by CGI ▪Financial Stability ▪Very Large Resource Pool ▪Health and Government references

19. ▪Clinician sees the latest information ▪Unauthorised users know that further information exists ▪Operates throughout the care pathway ▪Workflow Integration ▪Open Interface Summary

20. ▪Local information control is maintained, no duplication or new repository ▪Information governance is preserved and simplified ▪Patient consent is enforced ▪Building block approach Summary

21. The Benefits ▪Phased approach to aid adoption ▪Drives culture change towards interworking ▪Enhances decision making by all professionals ▪Limited learning curve ▪Improves Efficiency

22. Reference European Project for Smart Open Services www.epsos.eu

23. epSOS European Project for Smart Open Services Enabling European Cross Border Healthcare 25 member states 45 beneficiaries 31 industry partners €36.5 million funding 1 st July 2008 – 31 st July 2014

24. Tiani Spirit Realising the single patient record For more information: www.tiani-spirit.co.uk www.tiani-spirit.com mike.morris@tiani-spirit.com daniel.thomas@tiani-spirit.com