Information for Health

1. Informationfor Health An Information Strategy for the Modern NHS 1998-2005. A National Strategy for Local Implementation. 1998

2. Top level commitment “The challenge for the NHS is to harness the information revolution and use it to benefit patients”. Rt. Hon. Tony Blair All Our Tomorrows Conference 2 July 1998

3. National health policy • Our Healthier Nation • The new NHS - modern, dependable - 1998 • Social Services White Paper • Comprehensive Spending Review • NHS Charter • Working Together

4. Purpose of the strategy To put in place over the next seven years the people, the resources, the culture and the processes necessary to ensure: • NHS clinicians and managers have the information needed to support the core purpose of the NHS • the public and patients have a range of quality information easily accessible about health and health services

5. Patients want . . . • to know how to access NHS services • to learn about their condition, treatments and outcomes • confidence in the skills of those treating them • the information held on them to be accurate, complete and secure

6. NHS professionals want . . . • accurate, complete and immediately available information about individual patients • access to guidelines and knowledge bases to support clinical decision-making • access to information to evaluate their effectiveness (clinical governance) and to support continuing education

7. NHS managers need • better information to determine what works and what doesn’t • relevant and reliable information to assess the health of the population and meet priorities in healthcare • accurate information to support the most effective targeting and use of resources

8. The public wants . . . • access to trustworthy information on health and lifestyle and to support self care • open information about the performance of the NHS • information to help them influence the shape of policy and services

9. Specific targets • an agreed security model • a robust national standards framework • secondary care EPR • lifelong Electronic Health Records • 24hr access to records and information • a National Electronic Library for Health • public access to on-line information • reliable information for management and planning

10. Electronic records - the case • legible, accurate, safe, available when required, rapidly retrieved and communicated • more readily analysed for audit, research and quality assurance

11. Electronic records - the benefits • convenience and confidence • integration of care • improving outcomes • using evidence • supporting analysis • improving efficiency

12. Defining electronic records • Electronic Patient Record - a record of periodic care provided by one institution, typically an acute hospital • Electronic Health Record - the concept of a longitudinal record of a patient’s health and healthcare to combine information from primary healthcare with periodic care from other institutions

13. Hospital EPR Mental Health EPR Primary Care Electronic Health Record Community Services EPR Social Care Records Creating the Electronic Health Record

14. Supporting 24-hour care Developing Health Improvement Programmes Electronic Health Record Aggregated anonymised subsets Patient accessible Clinical Governance Epidemiological Research Routine patient care Using the Electronic Health Record

15. Developing Electronic Health Records • modernising primary care information systems • modernising hospital systems • ensuring access to clinical records • beacon EHR sites

16. Technology for the EHR • integrating data at source • networking information • hybrid model

17. National IM&T infrastructure • NHS number • NHS-wide networking • NHS-wide Clearing Service • Security and confidentiality • NHS Strategic Tracking Service • National Electronic Library

18. National Information Standards • Procurement • Information Management including record keeping and data quality • Confidentiality Protocols • Record Headings/Structure • Clinical Terms • Clinical Messaging • Application-level Communications • Networking Network and applications • NHS-wide Clearing Service • NHS Strategic Tracing Service • NHS Number • NHSnet National Electronic Library for Health National information infrastructure

19. Current issues and problems • lack of common record structures and terminology • lack of clinical information standards and protocols • concerns over security of information • providing mutual access to patient/client records

20. Clinical Information Management • data quality and clinical record management • clinical terms and headings • data dictionaries and standards • Minimum Data Set development • clinical messaging standards • security and confidentiality of information

21. Security and confidentiality • implementing Caldicott report • Caldicott Guardians • use of NHS number • National Standing Advisory Body

22. National Electronic Library for Health • access at the bedside/desktop/home to information • public access to information on healthy living, conditions and treatments, services and performance

23. 4 • Audio-visual material • Leaflets • CHIQ 3 • Knowledge Management Skills • eg Training Programmes etc. 2 • Knowledge • eg MEDLINE Cochrane 1 • Guidelines • eg NICE, CHI, critically appraised • projects Reception Help Desks, Library Navigator Clinicians The Public Managers Patients

24. Improving health • assessing the health of the population and ways to improve it • developing commissioning priorities for Primary Care Groups • ensuring local services are effective and meet local needs • working with Local Authorities to improve health • developing Health Improvement Programmes

25. Effective management • improving data quality • supporting clinical governance • supporting Health Improvement Programmes • delivering the National Framework for Assessing Performance • supporting National Service Frameworks

26. New services • providing on-line advice and information • eg. through NHS Direct • improving local access to distant services and specialist advice • eg. through telemedicine • offering a faster service for collecting prescriptions through links between GPs and pharmacists • using technology to provide quicker referrals, results and coordinated services

27. Improving public information • Health Information Service • NHS Direct • Centre for Health Information Quality • gateway to health information on the Internet • public access to National Electronic Library for Health

28. Treatment and care Primary care EHR NHS Trust EPR Social care records Knowledge for Analysis Public Patients Healthcare professionals Managers Public health Clinical Governance Health Improvement Programme Performance management

29. Implementation principles • national consensus on the objectives • effective and continuous dialogue • centrally mandated deliverables within specified timescales • policy for key information management and technical standards • integrated local implementation of national strategy • performance management

30. National Strategy Partnership arrangements NHS Executive Information Policy Unit Regional Offices • Local • organisations • NHS Trusts • Primary & Community Care • Health Authorities • Social Care NHS Information Authority • Professional organisations • Health management • Suppliers • Academic institutions

31. Making it happen - nationally • political will • national partnership and stakeholder input • NHS Information Authority • NHS Executive Information Policy Unit • Regional Office performance management • Modernisation Fund • education programme

32. Making it happen - locally • Chief Executive leadership • clinical ownership • Local Implementation Strategies • Health Informatics Services • local education programmes

33. Education, training and culture • national IM&T training and education strategy by March 1999 • implement health informatics as a theme for lifelong learning • develop multi-professional approach to managing information • NHS organisations to consider wider change management agenda

34. Information skills and resources • establish local Health Informatics Services • support development of health informatics capacity with Modernisation Fund • identify nationally the nature of skill required and take steps to meet shortfalls

35. 1998 to 2000 • ensuring the NHS copes with the millenium (Year 2000) problem • developing initial costed Local Implementation Strategies (and agreeing them with Regional Offices) • completion of essential infrastructure • connecting all computerised GP practices to NHSnet

36. continued • offering NHS Direct services to the whole population • completing the national NHS email project • establishing local Health Informatics Services • completion of the cancer information strategy • beacon EHR sites complete plans

37. 2000 to 2002 • 35% of all acute hospitals to have implemented a Level 3 EPR • substantial progress in implementing integrated primary care and community EPRs in 25% of Health Authorities • use of NHSnet for appointment booking, referrals, radiology and laboratory requests/results in all parts of the country • community prescribing with electronic links to GPs and the Prescription Pricing Authority

38. continued • telemedicine and telecare options considered routinely in all Health Improvement Programmes • a National Electronic Library for Health accessible through local intranets in all NHS organisations • information strategies as appropriate to underpin completed National Service Frameworks • beacon EHR sites have an initial first generation EHR in operation

39. In 2002 Delivering 21st Century IT Support for the NHS National Strategic Programme --------- The national strategic programme is concerned with major developments in the deployment and use of Information Technology (IT) in the NHS.

40. By 2005 • full implementation at primary care level of first generation person-based Electronic Health Records • all acute hospitals with Level 3 EPRs • the electronic transfer of patient records between GPs • 24 hour emergency care access to patient records

41. It aims to connect delivery of the NHS Plan using modern information technologies to: • support the patient and the delivery of services designed around the patient, quickly, conveniently and seamlessly; • support staff through effective electronic communications, better learning and knowledge management, cut the time to find essential • information (notes, test results) and make specialised expertise more accessible;

42. continued • improve management and delivery of services by providing good quality data to support NSFs, clinical audit, governance and management information • the programme focusses on the NHS intends to take forward in parallel developments in Social Care IT so the two services are integrated as local communities are ready.

43. Core of strategy • greater central control over the specification, procurement, resource management, performance management and delivery of the information and IT agenda. • improve the leadership and direction given to IT, and combine it with national and local implementation based on ruthless standardisation.

44. continued • A Ministerial Taskforce has been established . • An NHS IT Programme Director has been appointed to ensure delivery of the national components and coordinated local implementation. • Each Strategic Health Authority will appoint a Chief Information Officer (CIO) and have a key role in ensuring PCTs and NHS Trusts implement and use the core IT solutions determined at national level.

45. AND?