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Telehealth: PHMR Development Review. Richard Trusson NHS Technology Office DH Informatics Directorate. Agenda. Why do we need Interoperability? Previous work: Whole System Demonstrator (WSD) and the 9 use cases Recent work: PHMR Specification Development Lessons learned What’s next?
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Telehealth: PHMR Development Review Richard Trusson NHS Technology Office DH Informatics Directorate
Agenda • Why do we need Interoperability? • Previous work: Whole System Demonstrator (WSD) and the 9 use cases • Recent work: PHMR Specification Development • Lessons learned • What’s next? • Draft specifications for others • PHMR early adopters
Why Do We Need Interoperability? Telehealth • Records • NHS • Housing • Social Care • Personal Health Cholesterol Monitor Care Professionals Blood Pressure Cuff Out of Hours Telecare Glucose Meter Service Hub Pedometer Home Automation Sensor Networks Home Hub Tele-carer Elderly Living Independently Lights, Doors, Windows, Motion, etc. Carer response service Friends and Family Emergency services Limited Offerings Increasing Integration Complexity No integration Increased Offerings Integration required
Previous work: WSD and the 9 use cases • DH wanted investigation into the shared information needs for supporting patient care under telehealth Cross and Multi-Service Working Business / Service Requirement Information Requirement Effective Sharing of Information Value of Information Integration High Quality Supporting Information Ease of Access Ease of Consumption and Use
Previous work: WSD and the 9 use cases • Working with clinicians, GPs, Nurses, etc., patients and the industry we investigated what they needed. This lead to 9 use cases.
Previous work: WSD and the 9 use cases Clinician agreement Import effort • We also identified user concerns and issues Clarity of purpose Clarity of addressee Volume of data Action acceptance Medication record Messaging Assurance Prioritisation Right information, right quality Easy to consume & use Data overlap Ownership of patient record Speed of comprehension Professional liability Easily accessed Update frequency Audit trail of changes/ messages Speed of access Clinical autonomy Linked to right patient Linked to relevant clinician Key Red – most important Blue - important
Previous work: WSD and the 9 use cases • From • Understanding the business needs • Defining the use cases • Identifying the user concerns…the PHMR technical demonstrator message specification was prioritised • This sent vital signs information from the telehealth system (Philips Motiva) to the GP system (EMIS Web) and addressed many of the identified user concerns, • right information, known quality, controlled amounts, easily accessed, easy to use.
Recent work: PHMR Specification Development • In early 2012 we ran a workshop at Intellect to revisit and verify the use cases. • We identified an additional case – click through • Set message priorities. Top three were: • Personal Health Monitoring Report • Clinician Response Message • Referral Message • Initiated a program of work to develop the PHMR – as a result of the technical demonstrator this was the most advanced.
Recent work: PHMR The PHMR sends vital signs information from a telehealth service provider to a system with a legitimate interest – i.e. a GP system. The frequency of updates and range of vital signs reported on can be defined by the receiver. • Working with the ITK team a series of WebEx meetings were run to review, verify and update the requirements. • A draft message specification was released for comment. • In August 2012 this was re-released, with updates, as a Release Candidate message ready for early adopters to start developing against. All work for this is posted on the ITK NHS Networks site.http://www.networks.nhs.uk/nhs-networks/interoperability-toolkit-itk
Lessons Learned • The engagement and development model, overall, worked. • Using WebEx • Using NHS Networks website • Gathering feedback • Reaching agreements • Challenges: • Gathering feedback was harder than expected at times • Compressed time lines • Personal emails were better than generic ones • Would we do anything differently next time? • Have longer timelines • Publish dates for all meetings at the start, if possible • Look to ‘public’ events for mid term discussion, if possible • Shared development environment
What’s Next? • PHMR: Continue to work with NHS and Industry early adopters to support implementation of the PHMR (vital signs) message. To date there are seven organisations, 2 GP system providers and the rest telehealth service providers, signed up. • Clinician Response Message and Referral Message: use outputs from the Workshops this afternoon to inform message development and drive towards early adoption in first half of 2013. • Work with the NHS, Industry, 3millionlives, dallas and others to support the adoption of telehealth and the implementation of interoperability standards across the board.
Questions? Richard.Trusson@nhs.net