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Integrated Care Records Service
Durham and Darlington
22 October 2002
National Programme Overview
Integrated Care Records Service -Phased portfolio includes clinical tools and functionality-National services -Local applications
Electronicappointmentbookings
Electronicprescriptions service
Partnership with IT Industry - deliver compliant systems & clinical applications - National, Regional, Local
National direction and performance management of ITNational standards and specification
Increase IT funding dramatically - target IT spend
Backbone IT infrastructure -accelerate connecting the NHS with
secure Broadband
Programme Overview
Achievements include:
• Published ICRS Standards and Specifications – 180+ replies
• Published outline Procurement Strategy – 80+ replies
• eBooking is at Full Business Case stage
• Ministerial Taskforce meets 22 October
• HR strategy for NHS Information Professionals – launch at conference end October
• Richard Granger, Director General, started on 7 October
Delivery
• Over 96% of NHS Consultants have desktop PC access to NHSnet
• eMail & Directory Services Contract signed 27 September
• eBooking Information Broker Service live 12 September (www.nhs.uk)
• Health Records Infrastructure pilot in Walsall from end October
• Establishment of CIOs in StHAs
Key Priorities….
• Provide central direction, local implementation, eg in PPF guidance
• Stakeholder inclusion, time to contribute
• Target increased funding
• Establishing standards
• Pragmatic implementation at high speed, while keeping the vision alive
Deliver better patient care.
Integrated Care Records Service
Phase 0 – Research
• ERDIP Demonstrators
• Patient Survey
• Supplier Relations
• International exemplars
• Exemplar sites
Critical elements of the National Programme
• NationalRobust national infrastructure, withNational information servicesAn increasing number of national applications, andstandards supporting local users across health
communities
• Localgeneric functionsuser environmentspecific functionsclinical conditions
AnalyticalServices
NHS DirectCAS
PopulationRecord
ETP
nhs.uk
.
NeLH ReferenceFiles
e-commerce
NationalServices
3. Application Services
2. Information Services1. Infrastructure ServicesNetwork
Security AccessControl
DirectoryE-mail
e-StaffRecord
Finance
National Services
e-learning
ICRS - Overview
The ICRS is the :
• Integrated, operating across the care continuum
• Care, covering both health and social care
• Records, single record based around the patient
• Service, with corresponding service levels
What is the purpose of ICRS ?
The purpose of ICRS is to support the provision of high quality patient care across the whole health community
LocalServices
NationalServices
Standards
Across Health Communities
InformationGovernance
Analysis
InformationReporting
InformationCapture
5. UserEnvironment
User Tools
Health Community AHealth Community B Health Community C...
Pat
holo
gy
Men
tal H
ealth
Acu
te C
are
Soc
ial C
are
Prim
ary
/ C
omm
unity
6. Specific Functions
Service User IndexDiagnosis and Care
Booking and SchedulingOrdering and Reporting
Prescribing
Clinical Governance4. Generic Functions
Digital ImagingKnowledge Management
CHD
Older People
Mental Health
Diabetes
Cancer
7. NSFs
AnalyticalServices
NHS DirectCAS
PopulationRecord
ETP
Nhs.uk
.
NeLH ReferenceFiles
e-commerce
3. Application Services
2. Information Services1. Infrastructure Services
Network SecurityAccessControl
DirectoryE-mail
e-StaffRecord
FinanceFinance
Etc.
e-learning
Phase 1 – Consultation
• Output Specification for ICRS
• Procurement Synopsis
• CIO Preparation
• Work with exemplar sites
• Industry consultation
ICRS Consultation Exercise
• 186 responses (as at 27 September)
74 from the NHS
62 from suppliers
50 others
• Workshops
• Structured Walkthrough
ICRS Consultation – Main Issues
• Vision and description – need more on benefits
• Clarification of procurement and implementation plan
•Need to phase implementation
• Suggestions on functional requirements – eg NSFs
• Need for Design and Architecture
Phase 2 - Planning
• Project Definition
• Project Initiation
Project plan
Risk register
Dependencies within the programme
• National Business Case
• Procure Integrated Care Records Services in a way that:
• provides a coherent national, top-down approach that will be capable of delivering the targets in the National Programme
• is sensitive to local requirements, both in terms of business objectives and technical / system legacy.
Objectives for ICRS Procurement
Possible examples:•Basic connectivity•Access to knowledge•Access to patient demographics•Results reporting•Patient access•Access to clinical records
1 – access services
Phasing Issues
1 – access services 2 - specialist services
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
Phasing Issues
1 – access services 2 - specialist services
3 - communication services
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
Phasing Issues
1 – access services 2 - specialist services
3 - communication services 4 - 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
Phasing Issues
Objectives
1. To improve the experience of patients
2. To improve the quality of care
3. To enable effective access to clinical and administration information
4. To reduce the fragmentation of care
5. To improve health policy development and health research
Investment Objectives
1 – access services 2 - specialist services
3 - communication services 4 - integrated services
Outcomes for Patients
Patients are offered the opportunity to exercise choice over date, time and place of future encounters with care servicesPatients are reassured that the information that they provide at any healthcare encounter is kept secure Clinicians have access to information about the latest care knowledge and practice
Patients have access to evidence of the quality of care provided to them or by local providersPatients can be confident that results and information are provided
Patients are able to use a range of technologies – PC’s, phones, digital TV – to interact with care services and at times that are convenient to them
Patients are able to understand their care process through use of “patient-friendly care pathway views”Patients are able to look at their records and have the ability to amend or add information (taking into account the legal implications)
1 – access services 2 - specialist services
3 - communication services 4 - integrated services
Outcomes for Clinicians
Clinicians have access to clinical information for their patientsClinicians have ready access to knowledge and learning materials
Clinicians are able to initiate service requestsClinicians will see support for specialist areas such as digital imaging and prescribingClinicians are able to participate in lifelong learning through access to education, training and development services
Clinicians have ready access to the knowledge, clinical tools and related services they need to support their clinical decision making processClinicians and managers are able to use high quality information in support of the implementation of clinical governance and improvement of public health
Clinicians have ready access to information about their patients when they want it, from wherever they want it (including peripatetic staff), and structured in a format they wantClinicians are assured that their records and communications with patients and colleagues are secure and conformant with agreed information sharing protocols
Current National Tasks
• Contract Structure
• Payment and performance mechanism
• Definition of implementation planning and approach to benefits realisation
• Definition of Design Authority
• Definition of architecture for ICRS within overall architecture
• Baseline Review in each StHA
• Agreement on local business cases
• Approval of National Business Case
• OJEC
Local Activities
• Baseline review (the “warranted” environment)
• Funding
• Systems
• Plans
• Develop local plans for ICRS
• Linked to Local Delivery Plans
• Migration strategy for ICRS
• Local selection process
• Business case
• Selection criteria
Local Activities
Any Questions ?Any Questions ?