Integrated Care Records Service

1. Integrated Care Records Service Durham and Darlington 22 October 2002

2. National Programme Overview

3. Programme Overview Increase IT funding dramatically - target IT spend National direction and performance management of IT National standards and specification Partnership with IT Industry - deliver compliant systems & clinical applications - National, Regional, Local Electronic prescriptions service • Integrated Care Records Service • Phased portfolio includes • clinical tools and functionality • National services • Local applications Electronic appointment bookings Backbone IT infrastructure - accelerate connecting the NHS with secure Broadband

4. Achievements include: • Published ICRS Standards and Specifications – 180+ replies • Published outline Procurement Strategy – 80+ replies • eBooking is at Full Business Case stage • Ministerial Taskforce meets 22 October • HR strategy for NHS Information Professionals – launch at conference end October • Richard Granger, Director General, started on 7 October

5. Delivery • Over 96% of NHS Consultants have desktop PC access to NHSnet • eMail & Directory Services Contract signed 27 September • eBooking Information Broker Service live 12 September (www.nhs.uk) • Health Records Infrastructure pilot in Walsall from end October • Establishment of CIOs in StHAs

6. Key Priorities…. • Provide central direction, local implementation, eg in PPF guidance • Stakeholder inclusion, time to contribute • Target increased funding • Establishing standards • Pragmatic implementation at high speed, while keeping the vision alive Deliver better patient care.

7. Integrated Care Records Service

8. Phase 0 – Research • ERDIP Demonstrators • Patient Survey • Supplier Relations • International exemplars • Exemplar sites

9. Critical elements of the National Programme • National • Robust national infrastructure, with • National information services • An increasing number of national applications, and • standards supporting local users across health communities • Local • generic functions • user environment • specific functions • clinical conditions

10. National Services e-learning Finance e- commerce Analytical NHS Direct Population e-Staff ETP Services CAS . Record Record 3. Application Services National Services Access Reference E-mail Security nhs.uk Directory NeLH Control Files Network 2. Information Services 1. Infrastructure Services

11. ICRS - Overview • The ICRS is the : • Integrated, operating across the care continuum • Care, covering both health and social care • Records, single record based around the patient • Service, with corresponding service levels

12. What is the purpose of ICRS ? The purpose of ICRS is to support the provision of high quality patient care across the whole health community

13. Across Health Communities Health Community C... Health Community B Health Community A 6. Specific Functions 5. User Environment 7. NSFs Information Diabetes Mental Health Pathology Social Care Acute Care Community Primary / Capture Mental Health Information Reporting 4. Generic Functions Local Older People Clinical Governance Analysis Knowledge Management Services Cancer Digital Imaging Prescribing User Tools CHD Ordering and Reporting Booking and Scheduling Information Etc. Diagnosis and Care Governance Service User Index Standards e-learning Finance e- commerce Analytical NHS Direct Population e-Staff ETP . Finance Record Services CAS Record 3. Application Services National Services Access Reference Nhs.uk NeLH Network Security E-mail Directory Files Control 1. Infrastructure Services 2. Information Services

14. Phase 1 – Consultation • Output Specification for ICRS • Procurement Synopsis • CIO Preparation • Work with exemplar sites • Industry consultation

15. ICRS Consultation Exercise • 186 responses (as at 27 September) • 74 from the NHS • 62 from suppliers • 50 others • Workshops • Structured Walkthrough

16. ICRS Consultation – Main Issues • Vision and description – need more on benefits • Clarification of procurement and implementation plan • Need to phase implementation • Suggestions on functional requirements – eg NSFs • Need for Design and Architecture

17. Phase 2 - Planning • Project Definition • Project Initiation • Project plan • Risk register • Dependencies within the programme • National Business Case

18. Objectives for ICRS Procurement • Procure Integrated Care Records Services in a way that: • provides a coherent national, top-down approach that will be capable of delivering the targets in the National Programme • is sensitive to local requirements, both in terms of business objectives and technical / system legacy.

19. Phasing Issues 1 – access services • Possible examples: • Basic connectivity • Access to knowledge • Access to patient demographics • Results reporting • Patient access • Access to clinical records

20. Phasing Issues 2 - specialist services 1 – access services • Possible examples: • Basic connectivity • Access to knowledge • Access to patient demographics • Results reporting • Patient access • Access to clinical records • Possible examples: • Ordering • Digital imaging • Prescribing / Dispensing • Knowledge Management • Resource management

21. Phasing Issues 3 - communication services • Possible examples: • Referrals • Discharge summaries • Clinical correspondence • Care assessment • Care plans • Shared clinical records • Clinical governance 2 - specialist services 1 – access services • Possible examples: • Basic connectivity • Access to knowledge • Access to patient demographics • Results reporting • Patient access • Access to clinical records • Possible examples: • Ordering • Digital imaging • Prescribing / Dispensing • Knowledge Management • Resource management

22. Phasing Issues 3 - communication services 4 - integrated services • Possible examples: • Referrals • Discharge summaries • Clinical correspondence • Care assessment • Care plans • Shared clinical records • Clinical governance • Possible examples: • Rules-based decision support • Integrated care pathways • Multi-organisational scheduling • Telecare and telemonitoring 2 - specialist services 1 – access services • Possible examples: • Basic connectivity • Access to knowledge • Access to patient demographics • Results reporting • Patient access • Access to clinical records • Possible examples: • Ordering • Digital imaging • Prescribing / Dispensing • Knowledge Management • Resource management

23. Objectives Investment Objectives • To improve the experience of patients • To improve the quality of care • To enable effective access to clinical and administration information • To reduce the fragmentation of care • To improve health policy development and health research

24. Outcomes for Patients 3 - communication services 4 - integrated services Patients are able to understand their care process through use of “patient-friendly care pathway views” Patients are able to look at their records and have the ability to amend or add information (taking into account the legal implications) Patients are able to use a range of technologies – PC’s, phones, digital TV – to interact with care services and at times that are convenient to them 1 – access services 2 - specialist services Patients are offered the opportunity to exercise choice over date, time and place of future encounters with care services Patients are reassured that the information that they provide at any healthcare encounter is kept secureClinicians have access to information about the latest care knowledge and practice Patients have access to evidence of the quality of care provided to them or by local providers Patients can be confident that results and information are provided

25. Outcomes for Clinicians 3 - communication services 4 - integrated services Clinicians have ready access to information about their patients when they want it, from wherever they want it (including peripatetic staff), and structured in a format they want Clinicians are assured that their records and communications with patients and colleagues are secure and conformant with agreed information sharing protocols Clinicians have ready access to the knowledge, clinical tools and related services they need to support their clinical decision making process Clinicians and managers are able to use high quality information in support of the implementation of clinical governance and improvement of public health 1 – access services 2 - specialist services Clinicians have access to clinical information for their patients Clinicians have ready access to knowledge and learning materials Clinicians are able to initiate service requests Clinicians will see support for specialist areas such as digital imaging and prescribing Clinicians are able to participate in lifelong learning through access to education, training and development services

26. Current National Tasks • Contract Structure • Payment and performance mechanism • Definition of implementation planning and approach to benefits realisation • Definition of Design Authority • Definition of architecture for ICRS within overall architecture • Baseline Review in each StHA • Agreement on local business cases • Approval of National Business Case • OJEC

27. Local Activities Local Activities • Baseline review (the “warranted” environment) • Funding • Systems • Plans • Develop local plans for ICRS • Linked to Local Delivery Plans • Migration strategy for ICRS • Local selection process • Business case • Selection criteria

28. Any Questions ? Any Questions ?