1. Shared records – shared care Richard Pope Airedale NHS Trust Richard.pope@anhst.nhs.uk

2. Background 1998district diabetes system required 1998district diabetes system required 1999“common clinical system” (SystmOne; TPP, Leeds) 1999“common clinical system” (SystmOne; TPP, Leeds) 2000-3in-service development 2000-3in-service development 2004 ondramatic growth 2004 ondramatic growth 5M patient records >400 practices routinely >5000 concurrent users increasing secondary care links

3. “SystmOne” Central data centre Central data centre Fully functional GP system Fully functional GP system Records shared with other units Records shared with other units Sharing procedure – evolved Sharing procedure – evolved

4. “SystmOne” in Airedale and Bradford - links with: Diabetes Diabetes Homeless project Homeless project Palliative care Palliative care Emergency depts (Airedale and Bradford) Emergency depts (Airedale and Bradford) Renal medicine Renal medicine Surgery Surgery Rheumatology Rheumatology Cancer MDTs Cancer MDTs HM Prison service HM Prison service Child Health Child Health ………. ……….

5. Shared records – clinical use Clinic consultation/comms Clinic consultation/comms E-referral E-referral E-consultation E-consultation Clinical alerts/warnings Clinical alerts/warnings Governance Governance Health needs assessment Health needs assessment

6. Clinic consultation /comms In-clinic use In-clinic use All “shared” data available All “shared” data available Interactive Interactive Real time communications Real time communications Targeted messaging /alerts Targeted messaging /alerts

7. E-referral Referrals for clinic review direct booking possible record viewable from time of referral Referrals for clinic review direct booking possible record viewable from time of referral Within team referrals Within team referrals

8. E-consultation Request for opinion without face to face consultation Request for opinion without face to face consultation Access to full record Access to full record Timely Timely Triage possible in ~40% cases Triage possible in ~40% cases Medical/nursing/podiatry contacts Medical/nursing/podiatry contacts

9. Clinical alerts/warnings Set automatically or manually Set automatically or manually Flag the record Flag the record Recalls can be set by third party Recalls can be set by third party Safety flags Safety flags Outstanding test results Outstanding test results

10. Governance Central view of clinical performance Central view of clinical performance Validation/revalidation GPwSI, etc Validation/revalidation GPwSI, etc

11. Health needs assessment Predict future demand microalbuminuria +ve type 1 diabetes risk of renal failure ~10yrs planning renal replacement services Predict future demand microalbuminuria +ve type 1 diabetes risk of renal failure ~10yrs planning renal replacement services

12. Shared records-shared care Highly valued clinical system Highly valued clinical system Allows secondary care to support local service delivery in new ways Allows secondary care to support local service delivery in new ways Very rich data set Very rich data set Critical mass effects Critical mass effects “Operational” training crucial “Operational” training crucial Scale of future deployment? Scale of future deployment?

13. Success due to:- The Phoenix Partnership (Frank Hester/Sat Virk) The Phoenix Partnership (Frank Hester/Sat Virk) Dr John Parry / Dr John Connelly Dr John Parry / Dr John Connelly Tony Megaw / Ian Roberts Tony Megaw / Ian Roberts IT depts Airedale/Bradford Trusts/PCTs IT depts Airedale/Bradford Trusts/PCTs Clinical colleagues Clinical colleagues