Electronic Patient Recordsand the new national

agenda:Where do Radiology

Management systems and PACS fi t in today?

Patients in your heartPatients in mind

Patientsand families

Dr Charles Gutteridge Clinical Informatics

The scale of change

Dr Charles Gutteridge Clinical Informatics

Have we reduced the mountain of suffering?

Dr Charles Gutteridge Clinical Informatics

Do health costs matter?

Dr Charles Gutteridge Clinical Informatics

It is global....

Dr Charles Gutteridge Clinical Informatics

Productivity and growth

Dr Charles Gutteridge Clinical Informatics

NPfIT - Spine Service Connections

Messaging (TMS & DTS)

DemographicsSCR Directories

Data transfer

Testenvts

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Infrastructure

Messagessupported

Servicesprovided

Summary Care Record, Choose and Book, Electronic Prescription Service, Healthspace,GP2GP, NN4B, QMAS

SUS

Nationalapplicationssupported

Identity mgt

GP systems, Pharmacy systems,Hospital systems, Electronic Staff Record

Otherconnectedsystems

MoD, Home Countries,Other government systems

Reporting info

Prescriptions

Demographics

Care records

MessagingIdentity

management

Test &Training

environments

Reporting

Dr Charles Gutteridge Clinical Informatics

Health IT use

Dr Charles Gutteridge Clinical Informatics

Lesson 1 - Interoperability

It is possible to deliver systems nationally but:

Time frame is longLeadership challenge is greatInnovation gets left behind

Dr Charles Gutteridge Clinical Informatics

Lesson 2 – Professional leadership

Professional engagement in solutions is critical:

Local works better than nationalNurse involvement is criticalUsability is a key factor

Dr Charles Gutteridge Clinical Informatics

Lesson 3 - Innovation

IT and software innovation is a key to change but:

Innovation outstrips organisational capacity to introduce change

Innovation is costly for first in type usersInnovation disrupts established processes

Dr Charles Gutteridge Clinical Informatics

Lesson 4 - Analytics

Analytics must be built in from the start:

Clinical data extraction is the key to use by doctors and academics

Performance management tools deliver engagement

Dr Charles Gutteridge Clinical Informatics

Lesson 5 – User training

User training is key to good system performance and:

Is always underestimated and under delivered

System implementation has a stronger focus than sustainable use

Dr Charles Gutteridge Clinical Informatics

Dr Charles Gutteridge Clinical InformaticsDr Charles Gutteridge Clinical Informatics

Are we clear about what we want to do?

Focus on changing care delivery

Dr Charles Gutteridge Clinical Informatics

At present it is:

Centred on infrastructure

Led by professional groups

Digital solutions remain disconnected Clinical variation

% of high risk TIAs treated within 24 hours

Dr Charles Gutteridge Clinical Informatics

The changed paradigm – local delivery

Dr Charles Gutteridge Clinical Informatics

Wellness and self care

Defined by citizens

Innovative use of digital solutions

Information and knowledge

Comparison and choice

Apps and mobile devices

Opp0rtunities for care

Dr Charles Gutteridge Clinical Informatics

• At the bedside

Care and treatment discussions

Safety

Quality

Productivity

Decision support

Video and application support

Training routines

Comparative information

Analytics

Dr Charles Gutteridge Clinical Informatics

Digital care delivery

So how might we do that….?

Dr Charles Gutteridge Clinical Informatics

5 challenges for a clinical leader

1.Knowledge and content management

2.Measurement and performance3.Patient experience at the frontline4.Innovation5.Education and training

Connecting the data

Pharmaceutical data

Dr Charles Gutteridge Clinical Informatics

Dr Charles Gutteridge Clinical Informatics

Data quality

Dr Charles Gutteridge Clinical Informatics

Dr Charles Gutteridge Clinical Informatics

Comparative OECD 2010 data

Country Scanners/million CT scans/1000

Australia 42 94

Canada 14 125

Denmark 27 84

France 11 138

UK 8 73

US 34 228

Dr Charles Gutteridge Clinical Informatics

Patient involvement

Dr Charles Gutteridge Clinical Informatics

Dr Charles Gutteridge Clinical Informatics

Dr Charles Gutteridge Clinical Informatics

Teaching and education

Link the professions

Teach advanced informatics

Teach analytics

Teach performance management

Dr Charles Gutteridge Clinical Informatics