‘The power of information’

1. Patient Online: The Roadmap16th April 2013Healthcare ComputingDr Imran RafiChair RCGP Clinical Innovation and Research Centre(CIRC)http://www.rcgp.org.uk/patientonline

2. “By 2015, all general practices will be expected to make available electronic booking, cancelling of appointments, ordering of repeat prescriptions, communication with the practice..” “All NHS patients will have secure online access, where they wish it, to their personal GP records by 2015” ‘The power of information’ • patient-online-access@rcgp.org.uk

3. Welcome The programme is split into three phases: • Phase 1- Initiation and defining the scope of work (June - September 2012); • Phase 2- Specification development and initial delivery (October – December 2012); • Phase 3- support, training and education 2013-2015 • patient-online-access@rcgp.org.uk

4. Objectives: in the setting of a national policy • Guidance on what is needed to implement Patient Online in general practice • Guidance on the implications of implementing Patient Online in general practice • A plan for next steps (2013 to 2015) • patient-online-access@rcgp.org.uk

5. The working groups (WGs) • Defining the Offer • Communicating the balanced benefits • Information Governance and Safeguarding • Support, Training and Education • Supplier and Market Liaison • Evidence and evaluation • patient-online-access@rcgp.org.uk

6. WG1: Defining the offer (Ash) • Items specified include functionality that is already present in current systems and that many practices are already using or considering implementing as a first step in offering online access. • Resources will need to be identified to enable practices to take on these new work processes, such as password management.

7. Ash Practices Services: Order medication Book and cancel appointments Results (with or without comments) Demographic changes • patient-online-access@rcgp.org.uk

8. Moving on: Incremental progression Coded information e.g. immunisations, allergies, problem titles Letters to and from hospitals and clinics Entire record from today Entire record • patient-online-access@rcgp.org.uk

9. What is the current status? • patient-online-access@rcgp.org.uk

10. WG2 :Communicating the balanced benefits • Technology as an enabler • Change Management • Enthusiasts, early adopters and the mainstream • Clinically and locally owned • Mix-and-match • Supporting partnership and trust, patient centric • patient-online-access@rcgp.org.uk

11. Health inequalities and Vulnerable Groups • Children • Adults with incapacity • Domestic violence • Health literacy • patient-online-access@rcgp.org.uk

12. WG3:Information governance Information governance risk register, identifies the vulnerability and potential mitigating factors • Identity management • Liaison with Caldicott IG review (e.g. Third party data) • Consent management • System and data security • Safe record keeping guidance • patient-online-access@rcgp.org.uk

13. WG4: Support, training, education • Developing learning materials with partners for Practices and Patients based on the final offer and any updated RCGP Guidance • Developing and implementing a Training Needs Analysis process for Practices to assess need and review progress • Promoting and rolling out learning support and materials via the proposed Portal in partnership with key national and local groups • Regular review and evaluation to ensure new lessons are learned and applied and policy/service developments are incorporated • patient-online-access@rcgp.org.uk

14. WG5: Industry perspective • NHS England should encourage innovation, diversity and development (should reduce risks to suppliers) • NHS procurement should incentivise • Mandate Patient Online through GP systems of choice (GPSoc) • Suppliers need to offer guidance to practices • GP system suppliers need to provide functional options to give practices flexibility. (Should include patient – centric system design principles) • patient-online-access@rcgp.org.uk

15. Objectives • Identify and understand the barriers and facilitators to providing online access to records and transactional services in ambulatory care • Assess the benefits and harms of online access to records and transactional services and how they affect the quality and safety of health care • patient-online-access@rcgp.org.uk

16. Evidence • Online access to records potential enabler • Limited evidence of benefit • None of significant harm • Well designed and developed transactional services have greatest potential for benefits for patients and efficiency gains for providers

17. Wider international perspective • Croatia – no national access • Denmark – joined up since 1997, online detailed access 2000, used by 0.4% • England & France: SCR & DMP • Estonia – comprehensive system 3.6% access records • Greece – legislation but not available • Ireland – Hospital slots & waiting times (24 hour patient access not realised) • Russia – private free system available – but patient access not a priority de Lusignan S, et al.,. Submitted for publication MEDINFO 2013

18. International Perspectives

19. Phase 3 • Development of commercial framework to support practices • Completion of systematic review • Caldicott Information Governance review

20. Acknowledgments • Chairs of WGs: Libby Morris, Peter Short, Sandy Gower, Simon de Lusignan • Stakeholder Group Members • Vice Chairs of WGs, WG Members, Support for WGs • RCGP Health Inequalities Group • RCGP: Chris Gush, Arwen Wilcock, Gillian Watson, Hannah Price, Lucy Wood • DHID: Henry Pares, Richard Ives, Richard Haigh, Bruce Elliot, Toto Gronlund, Eileen Phillips • patient-online-access@rcgp.org.uk