1. How to Achieve the Impossible with Interoperability….

2. Purpose ….bring to life an example of an IM&T enabled transformation of a care pathway through the use of a patient journey ….give an overview of how Informatics Merseyside has supported service transformation through innovation and interoperability of technology

3. IM&T enabled Award Winning COPD Pathway North West Respiratory Best Practice Award - Integrated Care Category Name: Jimmy Smith Age: 54 Diagnosis: COPD Medical History: Generally in poor health, heavy drinker, smoker, Liverpool Fan

4. Jimmy’s wife has noticed a decline in his general health and books an appointment for Jimmy to see his GP via a web enabled booking service

5. Jimmy attends his GP Practice and ‘arrives’ himself via touch screen in reception

6. Jimmy has a consultation with his GP, who views the North Mersey COPD Pathway via the Map of Medicine. A spirometry test is carried out along with a thorough assessment of Jimmy’s health. GP updates his clinical system using digital dictation / voice recognition technology

7. Later that evening Jimmy presents at the local AED who are able to view the GP Summary record through interoperability with System C (Acute Clinical System). This includes details of his earlier consultation and his spirometry test results. Jimmy is admitted to hospital.

8. Jimmy is prescribed a course of antibiotics and steroids using the Trusts EPMA system. His extensive medical history is reviewed by the care team, accessing all 6 volumes of case notes electronically through the EDMS system. A range of devices are used at Jimmy’s bedside.

9. The electronic white board is able to flag Jimmy as medically fit for discharge after a 7 day stay in hospital, and shows his referral to the Community Respiratory Team and TTO order is incomplete. On leaving, Jimmy completes his patient satisfaction survey using a tablet device / APP

10. CRT Team visit Jimmy the following morning and are able to view the GP Summary and Jimmy’s e-discharge via their agile working equipment and I’m Mobile solution

11. Informatics Merseyside / I’M Mobile Apps Smart phones / Tablets / PC’s Scales down the EPR Allows viewing and updating of record Disconnected working Integration into any underlying system Interoperability of multiple systems on the go I’M Mobile

12. The GP OOH Service is triggered by CRT later that month, the OOH Team are able to view Jimmy’s patient record in Adastra and advise appropriately. Jimmy remains at home with increased care from CRT & Community Matrons. Jimmy is later enrolled onto the local telehealth programme.

13. Telehealth equipment allows Jimmy to record a series of self care values on an easy to use system, making this information available to Jimmy’s care team. Should these values become alarming or drop outside of a preset range then the care team can intervene at the earliest opportunity, avoiding hospital admission and increasing Jimmy’s quality of life.

14. Jimmy Smith, COPD Patient “….this service has changed my life….” (Service. In Partnership)

15. Merseyside Local Health Economy Several Local Authorities Health and Wellbeing Boards Shared Informatics Service for local NHS partners Acute Trusts Specialist Trusts Community Providers Mental Health Providers GP Out of hours Primary Care Contractors CCG’s Merseyside Local Area Team Merseyside Commissioning Support Unit Emerging Commissioning Organisations Provider Organisations Social Care Informatics Merseyside

16. Clinical Pathways Community Services Out of Hospitals Acute & Specialist Providers Primary Care

17. IM&T Transformation Programme Electronic Patient Record Innovations Pathways Informatics Developments Electronic Patient Record Service Redesign EMIS Web MIG Record Sharing Sharing Diagnostics E-Discharge

18. IM&T Transformation Programme Electronic Patient Record Innovations Informatics Developments Pathways Innovations Life Enhancing Technologies I’M Mobile App Programme Video Conferencing Digital Dictation

19. IM&T Transformation Programme Electronic Patient Record Innovations Informatics Developments Pathways QIPP IM&T Programme Decision Support Protocols and Concepts Patient Empowerment

20. Electronic Patient Record Innovations Informatics Developments Pathways Informatics Developments Data Quality Advancing IM&T Standards in General Practice Practice Migrations Paperlight IM&T Transformation Programme

21. Outcomes… Shared information for integrated joined up care Better information for clinical decisions Enhanced information for management and governance Greater patient access to information about their care Improvements to staff working lives Improved resource utilisation and cost savings Faster communication and turn-round times across the health community

22. So… What Difference has all this actually made? “….in the last twelve months the shared care record has been accessed over 75,000 times across North Mersey ….” “….community services seen a 70% reduction in time spent searching for patient information….” “….AMU Department seen increased productivity, enabling a further two patients to be seen in a two hour clinical window….” “….less administration within General Practice, faxing and printing patient summaries to various services….”

23. Clinical Need and Leadership Clear goal and benefits Supplier Relationships Start Small, Give it a Try Learn along the way Sharing Agreements Programme Governance Share success stories Be Pragmatic Use available levers

24. (Service. In Partnership) What's Next….....ensuring the LHE are aware of emerging technologies which in the medium to long-term future will impact its ability to be a effective and efficient provider of health and social care…. ….ensuring the spread of best practice and innovation… …interoperability +++++

25. (Service. In Partnership) Derek Campbell, Chief Executive of NHS Merseyside “….Our experiences show how technology can be used to enhance and improve healthcare systems. The IM&T Transformation programme will build on that success, offering more opportunities for greater efficiency and, most importantly, resulting in improved care for patients….”