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Creating leadership resilience in emergency care
Technological solutions.. Achieving quality and performance. What leaders need to know?
1400-1430 Nov 11th 2015
Tony ShannonM.B. B.Ch. B.A.O. UCD, IrelandFellow of College of Emergency Medicine England
Fellowship in Informatics USAMSc in IT Management England
(Clinical Lead, NHS Connecting for Health – National Programme for IT)
(Chair, Clinical Review Board, openEHR Foundation)
Consultant in Emergency Medicine, Leeds Teaching HospitalsChief Clinical Information Officer, Leeds TH/Leeds NHS & Social Care
Director, Frectal Ltd
Objectives
• Key people, process + technology issues in EM• Explore complexity of EM improvement with IT
• EDIS improvement/procurement options• Update on latest market forces in Healthcare IT
• Connect EM leaders with interest in Informatics
Medical Leadership
NHS Connecting for Health
• Biggest civil IT programme in world• 10 year; £12 billion; based in Leeds• Began in 2003
• Primary, Community, Acute, Mental Health
• Aimed at a single strategic solution
Complex Systems
1908
Cynefin Framework
Snowden, D., Boone, M. (2007). "A Leader's Framework for Decision Making". Harvard Business Review: November 2007, pp 69–76.
Complex Probe
10000 1000
Inate 10
Complicated Analyze
Chaos Act Simple Categorize
Value = Quality ↑ Risk↓ Cost↓ Time↓
Change = People + Process + Tech
NHS EDs – after 4 hour std
NHS National Programme for IT
Thinking in silos Process versus IT Closed solutions
Open Platforms
1987
Healthcare Change: State of the EcosystemStandards: Vendors: Innovators: Disconnect
International Standards
Local Innovators
eHealth Bodies
& Vendors
Referral in
Assessment
Plan CareDeliver Care
Referral Out
Operational (1 patient)
Strategic (++ patients)
Tactical ( > 1 patient) Resource management
Performance management
Key Patterns in Health Care
ED: Process related IT needs
Patient Tracking
Registration
Assessment- Nursing
Assessment-Medical
Investigations
Diagnoses
Treatments
Referrals
Patient Tracking
Process A Process B Process C Process D
Patient 1
Patient 2
Patient 3
Patient 4
Leeds TH 200+
Enterprise Wide
System x
Common Web UI
Integration EngineESB
A B C
1
2
3
4
5
Core Process
Core Process
Core Process
Core Process
Core Process
Modular
SOA
Enterprise wide
System Y
Access/SQL
Current State of the HIT Market
The Future
#1 UI & Usability
Leeds TH 200+
Enterprise Wide
System x
Common Web UI
Integration EngineESB
A B C
1
2
3
4
5
Core Process
Core Process
Core Process
Core Process
Core Process
Modular
SOA
Enterprise wide
System Y
Access/SQL
# 2 Integration
#3 Clinical Kernel
• Clinically oriented• Reusable list of clinical
statements
• Maximal dataset• Can be coded with
terminologies
e.g. Pulse, BPLeeds Care Record datasetEnd of LifeKey contactsetc
• Computable
#4: Code & Community
# 5 Governance & Leadership
NHS England 2011
The beginning...
3 Key Levels
Single Patient Multiple PatientsClinical Intelligence View
Single Patient View
Multi-Patient View
Aggregated Data View
Single Patient View
Single Patient View
Virtual Ward View
Collaborate : Innovate : Open Towards an open health & care platform
@RippleOSI www.RippleOSI.org
21st Century Healthcare
International Standards
Local Frontline Innovators
National eHealth Bodies
& Vendors
Regional
Objectives
• Key people, process + technology issues in EM• Explore complexity of EM improvement with IT
• EDIS improvement/procurement options• Update on latest market forces in Healthcare IT
• Connect EM leaders with interest in Informatics
