eCare Programme Conference 2005

Chief Executive Perspective

Professor Tony WellsChief Executive

NHS Tayside+

Chair IM&T Infrastructure Board

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WHY DO WE NEED A VISION?WHY DO WE NEED A VISION?

Not much happens without a dream. And for something great to happen, there must be a

big dream. Behind every great achievement is a dreamer of great dreams. Much more than a

dreamer is required to bring it to reality; but the dream must be there first.

(Robert K.Greenleaf, The Servant as Leader)

Vision - eCare

“eCare will deliver better care, protection, advice and assistance to the people of Scotland through

the use of computers and communication technology with the individuals consent, eCare

enables secure information sharing between professionals – such as doctors, nurses, social

workers, teachers and the Criminal Justice System – in public and voluntary sector agencies”.

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ASPECTS OF INTELLIGENCEComputersHumans

+ =

Emotion ******* ?Instinct ****** ?Intuition and insight ****** ?Creativity ***** ?Judgement ***** ?Understanding ***** *Abstraction and Generalisation **** *Recognition **** *Learning **** **Organisation *** **Sensing *** **Communication *** ***Analysis *** ***Control ** ***Co-ordination ** ****Logic * ****Memory * *****Calculation * *****

Future NHS Tayside teams

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National Framework for Service Change (“Kerr Review”) – May 2005

Kerr Report - 2005

“In all the work we have done, one issue came up again and again. It was high on the priorities of clinicians, managers and

members of the public. A common information technology system that will

provide the “glue” for an integrated NHS seems to be a universally accepted

requirement”.

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* Approximately 1:7 hospital admissions occur because care providers do not have access to previous medical records.

* 20% of laboratory tests are requested because previous investigations are not accessible.

* 15% of hospitalisations are complicated by drug error.

(U.S. research – UK/Scotland is likely to be higher).

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21st Century Healthcare

“Better, Quicker, Closer, Safer”

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The evolution of man

NHSNHSComputingComputing

NHS TaysideNHS TaysideComputingComputing

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NHS 2005Principle method of communication?

What the Chief Executive is looking for

* Better outcomes for patients

* More effective use of professional time

* More efficient use of resources (diagnosis and treatment)

* Safer and more effective service

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Opportunity ICommunity Health Number

Date of BirthDate of Birth SexSex CheckCheck

07 10 64 02 5 007 10 64 02 5 0

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Clinical information everywhere But not accessible

Purpose Purpose BuiltBuilt

PatientPatient

SafetySafety

Hospital Hospital SMRSMR

PAMSPAMS

Lab Lab DataData

PharmacyPharmacyEye vanEye van

InvestigationsInvestigations

ScreeningScreening

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Linking clinical information Vital for Patient Safety

Patient Patient SafetySafety HospitalHospital

Eye VanEye Van

PharmacyPharmacy

Lab Lab DataData

Purpose Purpose BuiltBuilt

InvestigationsInvestigations ScreeningScreening

PAMSPAMS

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The Clinical Landscape is Changing

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The rise and rise of chronic diseases

• Coronary heart disease and stroke• Cancer• Mental illness• Diabetes mellitus• Degenerative diseases of the

nervous and musculo-skeletal system

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How are we How are we responding responding to this to this

challenge?challenge?

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Mana ge d C

lin ical Netw

o rks

Citizens/Self Help

Locality/Natural Community

National

District/Local

Authority

Regional/Supra

Regional

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22

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Clinical Care requiring eHealth solutions

G-Pass/VAMP /SCI-DC/ ……….

Mental Health Mental Health

CardiovascularCardiovascular

Social CareSocial Care

CancerCancer

Stroke/Hypertension/VascularStroke/Hypertension/Vascular

RheumatologyRheumatology

Parenteral NutritionParenteral Nutrition

RespiratoryRespiratory

and more………………!and more………………!

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Our Current Priorities• Visible Electronic Patient Record

• Amalgamation of GPASS data into Central Vision (80-85% practices)

• Electronic Discharge Documentation• Prescribing linkages

• Within Hospital and Community Pharmacies

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Challenges

• Developing systems that are patient –based: NOT disease based

• Generic Clinical System• Rapid delivery on priorities• Training agenda• Clinical “buy-in” • National e-Health integration

“Better an imperfect tool than no tool at all”

WAYNE BOBBITT