Gayna Hart Presentation - Personalised Healthcare Revolution

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Bath & Bristol Enterprise Network

BEN Event - 8th October - Personalised Healthcare Revolution

Technology Health & Medicine Business

The IT Challenges of Healthcare
Personalisation

Gayna Hart, Quicksilva

© Copyright Quicksilva 2009

Speaking of IT in Health…
1999
OCT • Quicksilva incorporated

• National Programme for IT initiated by the DoH
2002
DEC

2003
• Consultancy to NHS CFH NPfIT
JAN

2004 • NHS HL7 Toolkit created, NHS Naked Prescriber
MAY delivered, NHS Choose & Book Unplugged developed
2005
JUN • Spinal Tap® launched
2006
• Spine-in-a-Box® launched
NOV

2007
• Compliance-in-a-Box® service launched
NOV

2008 • National Institute for Health Research
AUG SharePoint site
2008
SEP • Managed Support service launched
2008
OCT • Gloucestershire Hospitals diabetic retinopathy
screening programme SharePoint site
2

© Copyright Quicksilva 2009
IT Challenges

Possible IT Challenges
• moving and storing data
» between sites
» on the move
• alerts and triggers
• sharing knowledge
• informatics, predictive
modelling
• procuring IT, contracting
for IT, buying IT

3

© Copyright Quicksilva 2009
IT Challenges

Challenges? – it’s all about…

• DATA – the challenge to IT is to deliver it

• Capacity
• Security
• Information
• Knowledge
• Ownership

5

© Copyright Quicksilva 2009
IT Challenges

What data are we talking about here?

• We call it “patient data”
» but is it the patient’s?
» or is it the NHS’s?
• Who uses it?
» frontline staff
» secondary uses
• Where is it stored?
» across the NHS domain
» private sector

6

© Copyright Quicksilva 2009
IT Challenges

The Spine Debate
• National Care Records debate
» single centralised source
» agreement sought since 2003
» consultation…or lack of it
» privacy issues
» cost over-runs
» still raging…
• 10 Aug 2009 – Tory plans
» “dismantle central architecture”
» contract buy-out
» alternatives…Google Health?

7

© Copyright Quicksilva 2009
IT Challenges

NHS Spine

• National Care Record System
» Summary Care Record
• Spine Services
» Personal Demographics
» Choose and Book
» Electronic Prescriptions
» Laboratory
» Common Assessment

So…do we kill off the Spine?
8

© Copyright Quicksilva 2009
IT Challenges

Data – Capacity

• Can the Spine cope?
» traffic capacity
» Service Level
Agreements
• Local networks
» Images – been around
for a while
• Beyond?
» Europe
» cross-sector
9

© Copyright Quicksilva 2009
IT Challenges

Data - Security

• Legitimate Relationship
» is this my patient?

• Role Based Access Control
» what you have and what you know
» Smartcard plus PIN

• Sealed Envelope
» whole or partial file
» emergency access
» implications of breaking seal

10

© Copyright Quicksilva 2009
IT Challenges

Data – Information

• Needed at the point of delivery
» GP
» A&E
» Out-of-Hours
» Mobile
• Information Technology is there
to deliver…
» …information
» at what price?
» evolution/reuse

11

© Copyright Quicksilva 2009
IT Challenges

Data - Knowledge

• Data sharing across domains
» Health
» Social Care
» Justice
• Predictive modelling
» e Prescribing
» drug development
» epidemiology
» patients at risk
» “cross-selling”

12

© Copyright Quicksilva 2009
IT Challenges

What data are we talking about here…again?

• We call it “patient data”
» but is it the patient’s?
» or is it the NHS’s?
• Who uses it?
» frontline staff
» secondary uses
• Where is it stored?
» across the NHS domain
» private sector

13

© Copyright Quicksilva 2009
IT Challenges

Data - Ownership

• Who owns the data?
» Patient?
» NHS?
» Pharmacists?
» Suppliers?
» Service providers?
» Collection agencies?

data pseudonymised for secondary uses
14

© Copyright Quicksilva 2009
IT Challenges

Joined-Up…thinking?

• Sharing information to build
knowledge
» within the NHS
» cross-sector
» from private sector
» with private sector
• Can we be open enough while
still protecting the individual?
• …and can we afford it?

15

© Copyright Quicksilva 2009
IT Challenges

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Gayna Hart Presentation - Personalised Healthcare Revolution

2. Speaking of IT in Health… 1999 OCT • Quicksilva incorporated • National Programme for IT initiated by the DoH 2002 DEC 2003 • Consultancy to NHS CFH NPfIT JAN 2004 • NHS HL7 Toolkit created, NHS Naked Prescriber MAY delivered, NHS Choose & Book Unplugged developed 2005 JUN • Spinal Tap® launched 2006 • Spine-in-a-Box® launched NOV 2007 • Compliance-in-a-Box® service launched NOV 2008 • National Institute for Health Research AUG SharePoint site 2008 SEP • Managed Support service launched 2008 OCT • Gloucestershire Hospitals diabetic retinopathy screening programme SharePoint site 2 © Copyright Quicksilva 2009 IT Challenges

3. Possible IT Challenges • moving and storing data » between sites » on the move • alerts and triggers • sharing knowledge • informatics, predictive modelling • procuring IT, contracting for IT, buying IT 3 © Copyright Quicksilva 2009 IT Challenges

4. Possible IT Challenges • moving and storing data » between sites » on the move • alerts and triggers • sharing knowledge • informatics, predictive modelling • procuring IT, contracting for IT, buying IT 4 © Copyright Quicksilva 2009 IT Challenges

6. What data are we talking about here? • We call it “patient data” » but is it the patient’s? » or is it the NHS’s? • Who uses it? » frontline staff » secondary uses • Where is it stored? » across the NHS domain » private sector 6 © Copyright Quicksilva 2009 IT Challenges

7. The Spine Debate • National Care Records debate » single centralised source » agreement sought since 2003 » consultation…or lack of it » privacy issues » cost over-runs » still raging… • 10 Aug 2009 – Tory plans » “dismantle central architecture” » contract buy-out » alternatives…Google Health? 7 © Copyright Quicksilva 2009 IT Challenges

8. NHS Spine • National Care Record System » Summary Care Record • Spine Services » Personal Demographics » Choose and Book » Electronic Prescriptions » Laboratory » Common Assessment So…do we kill off the Spine? 8 © Copyright Quicksilva 2009 IT Challenges

9. Data – Capacity • Can the Spine cope? » traffic capacity » Service Level Agreements • Local networks » Images – been around for a while • Beyond? » Europe » cross-sector 9 © Copyright Quicksilva 2009 IT Challenges

10. Data - Security • Legitimate Relationship » is this my patient? • Role Based Access Control » what you have and what you know » Smartcard plus PIN • Sealed Envelope » whole or partial file » emergency access » implications of breaking seal 10 © Copyright Quicksilva 2009 IT Challenges

11. Data – Information • Needed at the point of delivery » GP » A&E » Out-of-Hours » Mobile • Information Technology is there to deliver… » …information » at what price? » evolution/reuse 11 © Copyright Quicksilva 2009 IT Challenges

12. Data - Knowledge • Data sharing across domains » Health » Social Care » Justice • Predictive modelling » e Prescribing » drug development » epidemiology » patients at risk » “cross-selling” 12 © Copyright Quicksilva 2009 IT Challenges

13. What data are we talking about here…again? • We call it “patient data” » but is it the patient’s? » or is it the NHS’s? • Who uses it? » frontline staff » secondary uses • Where is it stored? » across the NHS domain » private sector 13 © Copyright Quicksilva 2009 IT Challenges

14. Data - Ownership • Who owns the data? » Patient? » NHS? » Pharmacists? » Suppliers? » Service providers? » Collection agencies? data pseudonymised for secondary uses 14 © Copyright Quicksilva 2009 IT Challenges

15. Joined-Up…thinking? • Sharing information to build knowledge » within the NHS » cross-sector » from private sector » with private sector • Can we be open enough while still protecting the individual? • …and can we afford it? 15 © Copyright Quicksilva 2009 IT Challenges

Gayna Hart Presentation - Personalised Healthcare Revolution

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