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Looking forward, pulling together and pressing on Lewis Ritchie.

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Presentation on theme: "Looking forward, pulling together and pressing on Lewis Ritchie."— Presentation transcript:

1 Looking forward, pulling together and pressing on Lewis Ritchie

2 SCIMP 2008 Conference Ballot Invitation to give final talk Please choose and tick only one of the following options:- I am delighted & honoured to accept  I am reluctant & have serious misgivings about this great responsibility  You have sent this invitation to me by mistake 

3 SCIMP 2008 Conference Ballot Invitation to give final talk Please choose and tick only one of the following options:- I am delighted & honoured to accept  I am reluctant & have serious misgivings about this great responsibility  You have sent this invitation to me by mistake 

4 “Small men….. cannot handle great events” General Charles de Gaulle

5 Learning from the mistakes of others…..

6 The task: To summarise key principles and take home messages

7 An excellent Conference - packing it all in…..

8 Not biting off more than we can chew

9 A fair sense of proportion…. (proportionality)

10 Looking forward…. Values, vision and leadership Opportunities and obligations Pulling together and pressing on

11 What of our values….?

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13 A rapidly changing and uncertain world..

14 Remembering why we are all here

15 The importance of the clinician- patient relationship: Essential humanity Intimacy Safety Truthfulness Mutual understanding Workable consent for information sharing

16 Key value: “…Do unto others as you would have done unto yourself…..”

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18 A few guiding principles…..

19 Guiding principles Patient centred care = patient centred records Patient and health professional needs main drivers - not available technology Imperative of strong clinical leadership and professionalism

20 Guiding principles Universal CHI - key for successful record linkage – “journey of care” Cultural change and confidentiality concerns – are the ultimate obstacles - not technological constraints Incremental, measured progress v “big bang”

21 “Prove all things…hold fast to that which is good” The imperative of evaluation – establishing resilient models, sharing success and the avoidance of duplication of effort

22 Our Vision

23 …but beware the Dubya binocular trap!

24 Ageing population Increase in long term conditions Unhealthy lifestyles / obesity epidemic Leading to: Growth in emergency hospital admissions Pressure on services / waiting times & lists Compounded by: Remote and rural dimension Deprivation and inequalities Increasing public expectations Technological advances / cost pressures Scotland’s Health Challenge

25 eHealth to support world class patient care New Evidence & Clinical Trials ScottishCareNetworks Confronting the Health Care Challenge From Cell to Community Translating Excellence In Life Sciences Community Cell

26 Vision Traditional boundaries of care – demarcated by sectors of provision - must give way to integrated care, focused on the patient ‘journey of care’ Primary and secondary care – the language of the past?

27 A patient centred service: the journey of care Patient Home Patient enters hospital* Available as and when required *CH, RGH, DGH Community Care Health information etc Specialists 65 Specialties GPwSI Primary Care Diagnostics Sexual Health Services Mental Health Services Pharmacy Dentistry Optometry GPs GPwSI Practice, District Nursing, Health Visiting, AHPs Emergency Care In the past organisational and perceptual barriers have separated primary and secondary care NHS 24 Source: Carol Black (modified), 2006

28 Our Vision for eHealth “exploiting the power of electronic information to help ensure that patients get the right care, involving the right clinicians, at the right time, to deliver the right outcome” Better eHealth Better Care NHS Scotland eHealth Strategy Heather Strachan

29 eHealth strategy in the round: Continuing an incremental and pragmatic approach to long- term aim of electronic recordsContinuing an incremental and pragmatic approach to long- term aim of electronic records Focus on:Focus on: –eHealth’s contribution to priorities such as 18 weeks and Shifting the Balance of Care –Delivering benefits, not systems –Integration across patient journeys – Safer, more effective and efficient care – Promoting patient engagement and self-care

30 What it looks like:

31 Without vision, we perish…… without values, we decay… without leadership, we lose our way

32 ….and the leadership thing?

33 “essential…in partnership with technical and other health professional and administrative support staff – the team”

34 A defining moment, a new morning, hope for the future

35 Opportunities & Obligations

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37 “eHealth supporting the best clinical care and research environment in the world” AM’s four year “manifesto” – opportunity for change

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39 Better Health Better Care We are committed to the delivery of high quality palliative care to everyone in Scotland who needs it, on the basis of need not diagnosis, and according to established principles of equity and personal dignity. Extend the use of high quality generalist palliative care standards in all care settings

40 Palliative Care Summary (PCS) Macmillan Nurses led initiativeMacmillan Nurses led initiative Palliative Care FormsPalliative Care Forms –Based on Gold Standards Framework Scotland (GSFS) –Paper process already in place in many GP Practices –IT Development to assist with key patient group –Underpinned by new GMS DES Elizabeth Ireland and Libby Morris

41 “ a whole journey waiting time target of 18 weeks from general practitioner referral to treatment …. by December 2011” Cabinet Secretary for Health and Wellbeing, Scottish Parliament – Official Report, 28th June Weeks Referral to Treatment Time Tracey Gillies

42 Current view of many clinicians Quality Speed of access Key Message: Both please! - Imperative of service redesign and cultural change

43 INFORMATION GOVERNANCE Information Governance ensures necessary safeguards for, and appropriate use of, patient and personal information. Key areas are information policy for health and social care, IG standards for National Programme for IT systems and development of guidance for NHS and partner organisations. George Fernie Key message: getting confidentiality right for both patients and professionals

44 A proportionality test A test of proportionality is the application of objective judgement as to whether the benefits outweigh the risks, using what some might call the test of reasonableness or common sense. Proportionality involves making a considered and high-quality decision based on the circumstances of the case, including the consequence of not sharing.A test of proportionality is the application of objective judgement as to whether the benefits outweigh the risks, using what some might call the test of reasonableness or common sense. Proportionality involves making a considered and high-quality decision based on the circumstances of the case, including the consequence of not sharing.

45 HealthSpace Development Patient portal through which they have a secure on line domain for their transactions with health service Aligned with Choices Place to store records – access on line electronic records-and also from which they can send information to their clinician Gillian Braunold

46 Key Messages - HealthSpace: Considerable potential for real patient engagement and supported self care enhancement Enhanced consent model possibilities Patient audit of care and of professional access Universality of eHealth – need to learn from other systems (to avoid the ‘Scots Wha Hae’ syndrome)

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48 Analyse need Source – Find / Capture Evaluate Generate / Synthesise Share Adapt Use Information Literacy Cycle Heather Strachan

49 Key Message Shared understanding and optimal use of health care information key for both patients and health professionals

50 Data Transfer v Data Migration Not synonymous Complex and usually incomplete Classification of Diseases etc continues to evolve “Transfer of electronic patient records from one general practice to another a key milestone in primary care computing” Leo Fogarty

51 Pulling together and pressing on

52 Looking forward…a word of encouragement

53 Success is a journey, not a destination!

54 Choosing but one – ECS a singular success ECS connected to 99% of practicesECS connected to 99% of practices Accessed by A/E, NHS24 and OOHsAccessed by A/E, NHS24 and OOHs Palliative Care Summary next developmentPalliative Care Summary next development Pilots in Grampian for EMIS and INPSPilots in Grampian for EMIS and INPS Next year for GPASS and ASCRIBENext year for GPASS and ASCRIBE

55 ECS Accesses

56 “Much has been achieved… there is much still to do…”

57 “Unless we share information reliably we can’t improve care” 8 th Annual Conference

58 “That will require high quality leadership, professionalism and commitment at all levels… and we’re all in this together

59

60 Scary journey but safe outcome!

61 “We can achieve more provided we are prepared to give others the credit” Ronald Regan

62 Final thoughts:

63 America today has a new face as President, so farewell Dubya!

64 Size does matter…..

65 Thank you for listening Thank you for listening!

66 …and safe home!


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