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LHCRE: Accelerating Integrated Care with Open Platform Approach

Discover why we are adopting LHCRE and how it will change the way care is delivered. Learn about the open platform approach, plug-in requirements, and how data-driven decisions can improve commissioning and research. Join us to deliver digital capabilities faster and cheaper.

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LHCRE: Accelerating Integrated Care with Open Platform Approach

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  1. The Value PropositionDylan Roberts Tech Stream leadRobert Hickingbotham Tech Stream Partner & guests June 2019

  2. Agenda • Why we are doing the LHCRE • What is an open platform approach and why are we adopting it • What does each organisation have to do to plug in • How are we going to help

  3. Why we are doing LHCRE • Change the way we deliver care • Prevention and Earlier Intervention • Self care • Integrated teams working in localities (e.g. PCNs) • Integrated teams working across regions (e.g. cancer) • Data driven decisions for better commissioning • Data driven decisions into early interventions • Data driven research • To help you (if you want it) to deliver digital capabilities faster and cheaper

  4. Why we are doing LHCRE : The bigger Y&H AMBITION Health and Wellbeing Strategies Raising the base line ICS/STP Strategies & Plans Data driven decisions Industrial Strategy Challenges Improving the lives of the poorest the fastest Enabling PCNs – new models of care The Left Shift – Primary Care Home Model

  5. Our target : a vendor neutral future THE NEW WORLD is a componentised model allowing different mixes of solutions for individual citizens or the professionals. The data is to a common open standard which opens it up to a new competitive market place of innovators and data scientists. Yorkshire & Humber Care Record and Data Ark CORE SYSTEMS OF RECORD are traditional and sequential, emphasizing safety, accuracy and are generally composite applications. The move to new world enabled by easier access to data in a standard form whilst maximising the investment of the existing systems

  6. What do we mean by open platform • Open data standards • Open requirements and business cases • Open APIs • Open information governance • Open source components provided by YHCR • Open citizen engagement kits • YHCR will provide capabilities (that will be continually improved) that can be reused by ICS, localities and organisations to enable and accelerate integrated care.

  7. Following National guidelines and design principles

  8. How are we doing it?

  9. Systems of Systems May 2019 Regional FHIR Store Regional FHIR Aggregator Identity and Access Management FHIR Proxy FHIR Proxy FHIR Proxy FHIR Proxy FHIR Proxy Humber Mental Health & Community Rotherham Acute & Community Yorkshire Ambulance Service Doncaster Acute Leeds Acute

  10. DEMO VIDEO

  11. Population Health Management Sep 2019 BI users have a variety of tools to perform analyses Dataset required for a ‘problem space’ is defined via the Query Builder UI Community Based Analytics Platform Data Collector Query Builder BI Tools Analytics Repository Multiple platforms can be easily instantiated for different communities and/or regional use Returned data will be pseudonymised or anonymised before loading into analytics repository Initial data and streaming updates supplied by the System of Systems National De-Id Service (Privitar) System of Systems Only data for patients that have not opted out of data sharing will be released National Data Opt-Out Service

  12. What does each organisation have to do to plug in?

  13. On site FHIR Proxy

  14. On site FHIR Proxy

  15. Install the FHIR Proxy The FHIR Proxy is your on-site link into System of Systems It is open source software which wraps the FHIR APIs and provides features such as validation, caching, queuing, mapping… (see published specification for details) It is licence FREE! There are two ready-to-install versions of the FHIR Proxy now available Both are open-source, fully supported, and will be further enhanced as new features evolve FHIR Proxy based on QewdJS FHIR Proxy based on Intersystems Ensemble Entirely self-contained, open source, and free FHIR Proxy code is open source and free, but assumes licenses purchased for Ensemble. Did we mention… it is Licence FREE!

  16. Prepare your data * You’d have to do this anyway! • Data validation – ensuring data accuracy and completeness • Data structure mapping – mapping data from existing fields to the standard FHIR schemas • Data Coding – providing a mapping to standard coding schemes • NHS Number is key – and is the key An intimate familiarity with the source systems will be necessary, including analysis of real data Important user engagement from now- working closely with Health and Social Care professionals to understand their day-to-day challenges and improve data quality at source Not all data problems have a technical solution! Working closely with users is vital As a data provider you have a vital role in providing high quality data to the wider System of Systems. Others will directly use the data which you provide.

  17. How are we going to help? • Digital Team

  18. Onboarding We are in process of defining a comprehensive onboarding package to support new organisations connecting to System of Systems. This will build on lessons-learned from the pilots so far. Contacts Workshops Training Checklists / FAQ The onboarding process will be initiated once you enter the pipeline of YHCR Pilots

  19. We are procuring partners to help LOT 1: Product Design, Development and Support Services Procurement started, contract award circa September 2019 LOT 2: Discovery and Change Services Internal Operating Model (“Intelligent Client”) BI Platform, Skills Development, Data Ark, Cloud Hosting. Procurement complete and partners appointed

  20. Documentation– available from https://yhcr.org/downloads/ 25 Architecture documents and guides – Architecture Group are reviewing and agreeing

  21. Use Cases It is still early days, but see below for a sample of use cases being demonstrated by the initial pilots. Humber: ED attendances for “frequent flyers” Provide notifications that an ED encounter has started directly from the secondary care service’s system North Yorkshire County Council: Care home discharge summaries (Transfer of care) Provide hospital discharge message to the care home Yorkshire Ambulance Service: Secondary care ED discharge disposition outcomes YAS to receive finished ED encounter directly from the secondary care service’s system Rotherham: Ambulance transfer of care Provide both the transfer of care document and its composite parts directly from the YAS EPR software to the Rotherham Teaching Hospital North Yorkshire County Council: Social care support plan visibility in ED Provide support plan information from local authority social care case management system to hospital EPR system Leeds: Cancer summary care record - cancer referrals Sharing of the cancer IPTs/Summary Care Record amongst the YHCR cancer service providers We have ambition to do much more! What is your use-case?

  22. What was it like for you?

  23. Fin

  24. Appendixes

  25. Appendix A:Yorkshire and Humber Digital Team and Collaboration Partners

  26. First Phase – February – May 2019 Yorkshire Ambulance Services Leeds Teaching Hospital Foundation Trust North Yorkshire County Council Rotherham NHS Foundation Trust (with CCG oversight) Doncaster & Bassetlaw Teaching Hospital NHS Foundation Trust (with CCG oversight) Humber Teaching NHS Foundation Trust (with CCG oversight) Second Phase – June – Sept 2019 Bradford Teaching Hospital NHS Foundation Trust Barnsley Hospital NHS Foundation Trust North Lincolnshire and Goole NHS Foundation Trust Rotherham MDC York NHS Foundation Trust Harrogate NHS Foundation Trust PilotSites

  27. YHCR Architecture Forum Dylan Roberts Dave Maidment (YHCR Tech Commissioner) Martin Waugh (LTHT) Kevin Woodcock (East Riding) Kevin Beatson (York NHS FT) Toby Page (Leeds City Team) Stephen Stewart (Sheffield Teaching Hospital) Martin Matthews (Sheffield Health&Social Care) Ken Anderson (Doncaster & Bassetlaw NHS FT) Jonathan Booker (Wakefield CCG) Robert Hickingbotham (Synanetics) Yunus.Mayat (Mid York NHS FT) Jim Brayshaw (LTHT) Alison Clare (YHCR Programme Manager) John Aldhous (Doncaster & Bassetlaw NHS FT) Tom Amos (THIS) George Hope (NHS DIGITAL)

  28. Appendix B:Architecture Diagrams

  29. A Component Based Architecture

  30. Appendix C:Maturity Model

  31. Maturity Levels Level 1: Basic Facts Level 2: Clinical History

  32. Maturity Levels Level 3: Pseudonymisation Level 4: Cross-Organisational Working

  33. Maturity Levels Level 5: Care Automation Level 6: Population Health Management En-mass

  34. FHIR MATURITY Maturity Index 1 2 3 4 5 No Plans

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