1. Moving Forwards with HealthSpace Gillian Braunold Clinical Director Summary Care Record & HealthSpace

2. 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

3. What is HealthSpace Secure on line domain for patients for their transactions with the Health Service Offered through the Choices Portal Through high level registration authentication and authentication services can be offered to patients across a range of work streams

4. My Health Information

5. View and store clinical information about themselves SCR Renal patient view piloting in Salford Diabetes record piloting in Salford Can choose to have letters about themselves copied to their HealthSpace account rather than through the mail

6. HealthSpace sets the portal and security standard through which other patient records can be enabled for patient viewing The full GP record where the GP wishes to make it available to patients Patients can store URL pointers to abnormal scan/x ray results The coded information in both Summary Care Record and GP records enable context sensitive knowledge support through on line access to approved databases and factsheets

7. Communicator

8. Enables a secure communication channel between patients and clinicians This can enable updates to records both demographic and clinical and many of the features that follow The email addresses of both the clinician and the user remain hidden and communication is managed through webforms in HealthSpace The invitation to a patient to be communicator linked is under the control of the clinician

9. Communicator Challenges Not all clinicians and all patients will want to use communicator Not to be used for urgent clinical communications Will this create a two tier service?

10. Can enable better continuity of care as patients are able to exploit this medium for support if they are unable to see the clinician. –Time zone management if patient abroad –Enables patients who otherwise may feel it is too risky to travel if they cannot keep in touch with their clinical team

11. Ordering repeat prescriptions –From GP –From pharmacist Patient and service experience enhanced as clear communication enabled and securely recorded

12. Self Care

13. Patient sending information to their clinician and records Regular monitoring of physiological measures sent directly to clinical records Ability to send digital photo of their progress say in ulcer management Ability to receive back advice on medication levels following the sending of information

14. Receive information securely If chosen as medium for communication HealthSpace can be used for Screening reminders Opportunity for patients to ask for information of relevance to their conditions to be sent to them –Sending opportunities to help with research –Conferences and self help groups

15. Better Care

16. Enables patients to contribute to management Ability to fill in pre consultation questionnaires Send choices regarding advanced directives Preferences when in hospital setting eg gender of clinician, dietary requirements, pastoral involvement Organ donor consent status

17. Appointments

18. Make appointments directly with the service Choose and book which enables authorised secondary care appointment booking directly by the patient Direct access to appointments in primary care through the HealthSpace portal into GP and other systems

19. Privacy and Security

20. Assures secure access View alerts generated within SCR Check consent status Approve carers to have access Limit carers view of HealthSpace against filters View who has last logged onto HealthSpace and when

21. Potential business reengineering as a consequence Cognitive behavioural therapy on line with results directly back to clinician INR monitoring and results directly back to patient Managing larger case load as work smarter with e consultations in the mix Case conferences chaired by patient with key actions posted by patient into their section of SCR Extended hours offered by e-consultation Impact of communicator on the service provision to Residential care homes and how GPs and other clinicians can communicate directly with the carers there on behalf of patients

22. When will this new functionality start? Salford diabetes record Communicator Patients sending messages to SCR

23. How does patient access to records change our perception of medical records? Fundamentally records move to being a resource Fears of clinicians –Accuracy and workload if challenged –The need to illuminate and explain the records and consequent workload –Protecting patients from the uncertainties we shoulder on their behalf

24. How does patient access to records change our perception of medical records? Change in the relationship Patient access to information leads to control Partnership between patients and clinicians in management of care Resultant change in dynamic of service delivery Protection or paternalism?

25. Legal Issues Data Protection act –Check for 3 rd party information –Check that patient doesn’t come to harm by seeing records How practical is that when records are continuously available to patients

26. Moving Forwards with HealthSpace Gillian Braunold Clinical Director Summary Care Record & HealthSpace