1. Sharing Systems and Resources ICRS: Where to start?

2. What is EHR? Not just another application. Not a substitute for things we have already. Can not be extracted out of existing data and applications. EHR is a consequence of a new way of creating and deploying our infrastructure.

3. Commercial experience: Banks 10 years ago banks thought they were their transactions and accounts. Transactions and accounts existed in computers, so…. Banks needed to own and manage them for themselves. Now banks understand that they are totally dependent on their IT but can not afford to procure and operate it themselves.

4. ICRS is not just an incremental change. We need an architecture

5. National Programme for IT

6. 1 – access services 2 - specialist services 3 - communication services4 - integrated services Possible examples: Rules-based decision support Integrated care pathways Multi-organisational scheduling Telecare and telemonitoring Possible examples: Referrals Discharge summaries Clinical correspondence Care assessment Care plans Shared clinical records Clinical governance 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 Functionality Scope and coverage

7. What do we do next ?

8. Functional Reference Models Brokered Information service. Structured Messaging. Distributed workflow. Ethics Governance Ownership Participation Reference Configurations Classes of host systems & networks Oraganisational Models User relationships and supplier value chains and governance frameworks. Technology Model Constraints and opportunities. Story boards Mock ups Prototypes Pilots New applications & Services Output Based Specs. User & patient experience. Political aspirations & targets Budgets. ICRS Architectural Process for ICRS

9. The Challenge Has our work provided a basis for us to create a community based infrastructure? Are we in a position to engage users, managers and suppliers? Can we show the way to a solution which is: –Scalable and configurable to local needs? –Replicable and federable to show the way to a national solution? –Engage with the centre on the definition of the centralised components ? –Able to engage all stakeholders in participation and ownership of the process?