1. Applying technology to the challenge of community healthcare Julia Clarke CEO, Bristol Community Health 10 June 2015 Health Insights

2. Who we are Provider of NHS adult community health services in Bristol and Offender Health in Bristol & S Glos prisons Social Enterprise ‘spin out’ October 2011 Staff owned community interest company £45 million turnover, 1000 staff (wte) 30,000 patient contacts, 7000 referrals per month

3. Challenges of Community Health Rising demand and rising expectations –Ageing population with multiple long term conditions and frailty –Admission avoidance and supported discharge –Pressure on primary care & hospitals performance Legacy issues: under-funding, under-investment, poor infrastructure (IT, estates, systems) Lack of research, metrics and evidence base Financial & commercial framework – block contract, competition, business transfer ‘at cost’ Dispersed workforce, home and community settings Multiple interfaces internally and externally

4. Our technology projects Mobile working (Totalmobile) Electronic patient record (replacement of RIO with EMIS web) Self-Care / telemedicine (collaboration with Phillips Healthcare) Connecting Care (SC and SW CSU) Business intelligence (Inphase & new data warehouse) HR systems (Perform, e-pay) Communications (websites & e-comms) Patient feedback (Meridian) Clinical incidents and risk (Ulysses)

5. Mobile working collaboration with Totalmobile An intuitive app run on android tablets Screens and forms designed around the clinician– patient interaction by clinicians Added value summary views, graphics, annotated photos and loads of potential for more Links (push & pull) to one or to multiple systems via API Rich and granular data capture Works off line Secure and IG compliant

6. Mobile working current status Around 400 users, 700 planned Rollout suspended while we switch EPR Demonstrable benefits –More satisfied staff, reduced frustration –Productivity up to one hour / clinical day –Better data quality – timely and complete –Patient engagement –Added value eg. photos, functionality of tablets –Catalyst for change in working practices, documentation, service design

7. Supported Self-Care collaboration with Phillips Population health activation and self-management system Clinical / technical self-care hub – linked to patients and to clinical teams Health navigators / coaches / coordinators Range of technical platforms for risk stratified population: –Telemedicine with remote monitoring, education materials and comms –Tailored text and voice interactions –Self care apps – lifestyle, activation

8. Supported Self-care current status Detailed development of concept Risk stratification and segmentation of population Small scale demonstration & learning project with one practice Patients recruited from all segments Support from WoE AHSN, potential test-bed Interest from local stakeholders including Bristol Health Partners, Bristol University, Bristol City Council

9. Our balanced scorecard ThemePerspective Making their dayPatient, customer, commissioner, partners, stakeholders Managing our moneyFinancial, commercial, business Time to CareOperational, systems & processes Being the bestOrganisational, workforce

10. Technology a strategic response ThemeContribution of technology Making their dayClinical quality through analytics, patient feedback, data quality & availability, shared patient view, apps & smart functionality – eg photo capability, incidents reporting and analysis Managing our moneyBusiness intelligence for contracting & management, efficiency through mobile working, Time to CareProductivity – mobile working, apps, Being the bestCultural change, consistent performance management, efficient systems

11. Cultural benefits Disruptive technology Performance and quality aware Greater discipline / rigour Fuelled innovation Created internal demand and faster change Prepared for RIO-EMIS switch Opportunity / necessity for documentation review and service redesign Organisational learning

12. What’s next? E-rostering linked to safe staffing Appointment scheduling More quality-analytics Document management The Cloud