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The Integrated Care Record Service - a Local Trusts Perspective

The Integrated Care Record Service - a Local Trusts Perspective. Peter Knight Head of IM&T Winchester & Eastleigh Healthcare Trust. Session Objectives. What is ICRS? Does ICRS exist at present? How will ICRS effect NHS Trusts? Can the IT industry cope? Questions and Answers. ICRS Context.

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The Integrated Care Record Service - a Local Trusts Perspective

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  1. The Integrated Care Record Service - a Local Trusts Perspective Peter Knight Head of IM&T Winchester & Eastleigh Healthcare Trust

  2. Session Objectives • What is ICRS? • Does ICRS exist at present? • How will ICRS effect NHS Trusts? • Can the IT industry cope? • Questions and Answers

  3. ICRS Context National Direction - Funding, Procurement Partner with Industry to deliver Open systems & Clinical applications Provide Prescriptions Service Provide Bookings Service ICRS National Services for NHS IT Architecture – Consent, Authentication, Confidentiality Secure Broadband National Data Standards & Data Interchange Stds Based on Open Technology

  4. What is ICRS? • In records terms it is Patient focused not organisational! • NHS organisation holds multiple patient records, not a truly shared record? • Common integrated functionality • PAS, Order Communications, Pharmacy, PACS, etc. • Common integrated reference material • SNOWMED CT, ICD 9/10, Formulary, Knowledge bases, etc • Specific functionality for: • Primary Care, Community Care, Secondary Care, Tertiary Care, Mental Health and Social Services, etc

  5. ICRS phases of delivery • Phase 1: (2003 - 2004) • Nationally delivered thin patient record spine with viewing functionality only! (e.g. view only EHR) • Functionality is mainly around infrastructure and nationally available applications and knowledge! • Phase 2: (2004 - 2006) • Depth of patient record spine increased • Rollout of new and enhanced systems in the local health economies (e.g. documentation for multi-disciplinary assessment) • Further support for information management and workflow • Extension of nationally delivered applications

  6. ICRS phases of delivery (cont) • Phase n: (2006 - 2010) • Enhanced patient centric facilities (e.g. patients able to contribute to their own record) • True representation of the patient journey (e.g. ICP linked to structured documentation) • Local data will be delivered using national services • Increased capability to support new functionality (e.g. cancer networks) • Focus on patient based self monitoring, using new technology systems(e.g. remote monitoring etc)

  7. Does ICRS exist? • Manual Systems - Perhaps in Concept Yes • Multi-disciplinary documentation exists within some teams but rarely across care settings • Electronically - No • EPR and EHR systems exist that are a limited subsets of ICRS for specific geographies • Commercial products are not ICRS compliant, as they are based upon organisational concepts (EPRs) • Integration engines are just glue and have high costs of ownership and potentially lead to poor data quality

  8. How will ICRS effect NHS Trusts? • Today? (not so good news) • Information services and clinical application development will falter! (awaiting Local Service Provider contracts) • Trusts strategies will need to be re-aligned! • Trusts will need to focus on infrastructure! • Cessation of local procurements resulting in increased organisational risk. • Tomorrow? (good news) • Establishment of a core patient record • Integrated clinical applications • Agility in service delivery • Improved data quality and information management • Beyond (blue sky) • Patient partnership in care information management

  9. So what about my local Trust? • Healthcare Information System • The replacement of a 14 year old EPR level 4/5 • Local Output Based Specification (OBS) is built upon the ICRS OBS • Outline Business Case (OBC) focuses mainly on strategy and benefits • Other initiatives • Need to pump prime the change management that will be required for ICRS delivery • Managing expectation of Trust staff. Consolidation of outlying information sources

  10. Can the IT industry cope? • Technology - (Yes) • We know that the technology required to deliver ICRS exists, but needs standardising! • Industry does technology well • Implementation (Mixed) • Scale - can they cope with the volume and diversity of the NHS? • Scope - can they pull together products that will deliver ICRS? • Client Management - will industry be able to manage the NHS? • Change management (No) • The NHS is complex set of organisations • Patient are individuals who don’t necessarily fit into defined processes

  11. Questions & Answers

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