In\nmid-February, the government launched a white paper to reform the English NHS.\nThe \u2018Integration and Innovation\u2019 document will formalise the creation of\nintegrated care systems already being established across regions in England,\nshifting the focus away from commissioning to population health management, bringing\ntogether health and social care and integrating them to better serve the\npopulation.<\/p>\n\n\n\n
The\ncreation of ICSs and the implications for healthcare technology means there is\na need for shared care records to enable health and care teams to work\ntogether, good data to create new care pathways, and good digital services to engage\npatients in their own care and wellbeing. <\/p>\n\n\n\n
Matthew Gould, the chief executive of NHSX, underlined this when he opened an online conference organised by the Health Service Journal to explore digital transformation. \u201cData is not an afterthought referring to the white paper<\/a>,\u201d he said. <\/p>\n\n\n\n \u201cIt says from the outset that you need data to do integrated care and you need digital to put patients at the centre of their care. That is what the future needs to look like.\u201d To support this agenda, NHSX has urged all healthcare economies to have a \u2018basic\u2019 shared care record in place by September this year.<\/p>\n\n\n\n Gould said NHSX is also working on new guidance to define \u201cwhat good looks like\u201d and \u201cwho pays for what\u201d to support progress, and on blueprints or \u201cplaybooks\u201d for patient pathways that will \u201cexplore the potential of remote monitoring in particular.\u201d Working with existing customers and health economies, Orion Health can help meet this deadline, while laying the foundation for a digital future.<\/p>\n\n\n\n When it\ncomes to remote monitoring, there is plenty of good work to build on. For\nexample, Liverpool is recognised as a pioneer. Its community and mental health\nprovider, Mersey Care NHS Foundation Trust, operates a nurse-led hub to help\npeople living with long-term conditions. <\/p>\n\n\n\n Patients\nuse telehealth devices or their own mobile phones to take readings or fill in\nquestionnaires. Data is uploaded to the Docobo system used by the hub, where\nnurses can arrange intervention or support if any problems are indicated. <\/p>\n\n\n\n Mike Fisher, the chief clinical information officer of the Liverpool Heart and Chest Hospital NHS Foundation Trust, told the HSJ conference that although the project has grown to be one of the largest telehealth systems in Europe, it had been \u201cquite disconnected\u201d from acute services until Covid-19 struck. <\/p>\n\n\n\n During the\npandemic, however, the Trust worked with Mersey Care to monitor patients at risk\nof \u201csilent hypoxia\u201d or very low oxygen levels, using pulse oximeters from the\nnational Covid Oximetry@Home programme. <\/p>\n\n\n\n Dr Fisher explained\nthat clinicians used a Trust-built system to refer patients to the scheme, set\nup a daily call on Microsoft Teams to review the results collected by the hub,\nand kept a note of their progress on its Allscripts electronic patient record.\n\u201cIt has been very successful,\u201d he said. <\/p>\n\n\n\n \u201cIt has also taught us a number of lessons. The first is that it is important to know what resources you have got to work with because the resources we needed were spread across three or four different organisations. <\/p>\n\n\n\n \u201cThe second is that without enthusiasm and commitment nothing happens. And the third is that when you have an opportunity like that presented by Covid, you need to keep an eye on the future, and to think about how you can use what you are doing in the long-term.\u201d<\/p>\n\n\n\n All these points resonated with Jane Hayward, director of networks at Hampshire and the Isle of Wight integrated care system; another digital pioneer moving its long-standing shared care record to the Orion Health platform<\/a> already in use by its neighbour, the Dorset Care Record<\/a>.<\/p>\n\n\n\n She said its experience of Covid had been \u201csimilar but different\u201d because it had set up a scheme for a wider group of patients that could be monitored by primary care. \u201cWe are supporting around 90 people per day, people on pulse oximetry and people who can tell us how they are, via a platform for nurse contact,\u201d she said. <\/p>\n\n\n\n \u201cIt has made a huge difference to patients.\u201d Hayward said she would be \u201ckeen\u201d to exchange experiences with Liverpool and suggested that one of the roles of an organisation like NHSX should be to swap approaches and lessons learned. <\/p>\n\n\n\n In the meantime, she said Hampshire and the Isle of Wight had seen two further digital developments during the pandemic. The first is a rapid move to online appointments, with as many as 60-70% of GP consultations being conducted over the telephone or, much less frequently, video link. <\/p>\n\n\n\n The second is \u201creal progress\u201d on supporting patients with long-term conditions, using the My Medical Record platform developed by University Hospitals Southampton NHS Foundation Trust. <\/p>\n\n\n\n My Medical Record enables patients to track test results, receive advice, and communicate with their clinical teams and each other, and Hayward said it has huge potential in a county that not only needs to support patients on the Isle of Wight but as far away as the Falkland Islands. <\/p>\n\n\n\n Build\nplatforms, plan for the future <\/strong><\/p>\n\n\n\n These\nexperiences also resonated with Lisa Hollins, the director of innovation at\nNHSX. She assured Hayward that the agency is not only looking to spread lessons\nlearned, but to draw up some general principles for healthcare economies to\nfollow. <\/p>\n\n\n\n One of these\nprinciples is that areas shouldn\u2019t allow platforms and apps to proliferate; they\nshould, instead, look for a platform that can manage IDs and logins. \u201cWe need\nto start with infrastructure,\u201d she said. \u201cWe do not want to have lots of apps\nasking for different information. We want platforms that everybody can link\nto.\u201d <\/p>\n\n\n\n Hollins\nadded that another principle was platforms should be able to use the\nproliferation of \u201csmall devices\u201d individuals have been buying for themselves\nover the past year \u2013 not just pulse oximeters, but digital thermometers and\nblood pressure monitors. <\/p>\n\n\n\n Orion Health is already a long way down the line when it comes to addressing these issues. At the heart of the company\u2019s approach is the Amadeus health data platform<\/a>, which sits under its shared care record, team working and care co-ordination products, analysis platform and patient portal<\/a>.<\/p>\n\n\n\n Health and\ncare organisations can use the portal to give patients access to information\nabout their care and to access stand-alone products for engagement and remote\nmonitoring. At the same time, Orion Health is developing the Engage Platform to\nmake it easier to authenticate clinicians and patients using external access\nmanagement solutions, including the NHS Identity Service and NHS Login, and to\nlink to third party apps. <\/p>\n\n\n\n At the HSJ conference product director Nicole Allan focused on how a customer, Quebec, is using the Orion Health remote patient management platform. This enables clinicians to draw up a treatment plan with patients and monitor their progress. <\/p>\n\n\n\n \u201cThe information provided to the care team depends on what point on the journey they are on,\u201d she said. \u201cThe system can also be accessed across primary and secondary care, so everyone can see and access the plans and they are not constantly asking patients to repeat information.\u201d <\/p>\n\n\n\n Allan said\nthat during the pandemic Orion Health customers have looked to expand their\nsystems. Some have started by looking, like Liverpool, to add video\nconferencing enabling clinicians to hold virtual meetings with each other and\nwith patients and family, while others are looking to make creative use of new\ndata. <\/p>\n\n\n\n As Allan\nsaid: \u201cTelehealth has been around for a long time.\u201d What is new is that its\npotential has been given prominence by the Covid-19 pandemic and the need to\nsupport older populations living with a greater incidence of long-term\nconditions.<\/p>\n\n\n\n Allan\ndescribed a project to apply AI to epilepsy data, with a view to sending an\nalert to patients on the threshold of an attack, so they can \u201cmove into a safe\nlocation, or make sure they have somebody with them.\u201d <\/p>\n\n\n\n It sounds\nfuturistic, but as the HSJ conference showed, much can be achieved by\nhealthcare economies. It takes digital technology and a secure data platform to\nsupport a shared care system, creating the foundation for the future of\nintegration and innovation.<\/p>","protected":false},"excerpt":{"rendered":" In mid-February, the government launched a white paper to reform the English NHS. The \u2018Integration and Innovation\u2019 document will formalise the creation of integrated care systems already being established across regions in England, shifting the focus away from commissioning to population health management, bringing together health and social care and integrating them to better serve […]<\/p>\n","protected":false},"author":6,"featured_media":5145,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[1],"tags":[],"region":[27],"class_list":["post-5144","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","region-uk"],"yoast_head":"\nExpanding\ntelehealth in Liverpool to support Covid patients <\/strong><\/h4>\n\n\n\n
New impetus for remote consultations and monitoring in Hampshire<\/strong><\/h4>\n\n\n\n
Integration\nand Innovation for the future <\/strong><\/h4>\n\n\n\n