Clinical Health Information Network: The Power of Information from Policy to Implementation

1. Clinical Health Information Network: The Power of Information from Policy to Implementation Breakout session feedback 25 June 2013

2. Introduction • This slide deck provides a summary of the outputs from group discussions undertaken at the Clinical Health Information Network (CHIN) meeting on 25 June 2013. • Each table was asked to debate a series of questions relating to the presentations delivered by Professor Jonathan Kay, Dr Richard Pope, Roy McLachlan and Dr Mark Westwood.

3. Lively debate…

4. Q1: How will information and IT support the implementation of the digital revolution in the North East? Discuss drivers e.g. 3million lives/CQUIN/digital first “Patient expectations and choice - can order shopping, books etc online but cant communicate by email to GP etc.” • CQUIN • Variety of media – PCs, mobiles-apps, internet • Efficiency and cost “Security of data/IG issues of non-IT solutions.” • “Social media – huge influence.” • “Ensure share good practice.” • “Plan, rationalise/expand services according to need.” “Plan and understand population health in real time.” • “Development of dashboard, performance indicators.” • “Remote working.” • “Standardisation of data • Increase in clinical safety • Improve processes.”

5. Q1a: What are the benefits? “Meets patients’ changing expectations on how to interact” “Process / pathway design.” “Improved patient experience.” • “Patient experience.” • “Information easily interrogated.” “Accessibility.” “Better decision making.” “Self care / ownership / better control / preventative.” • “Standardisation of data/processes.” “Increased safety and joined up communication.” • “Performance monitoring.” • “Information quality.” • “Access to clinical data.” “Improved diagnostics.”

6. Q1b: What are the constraints? “Initial set up costs / financial flows of cost savings.” “Not always aware of new informatics developments.” “Constant restructuring.” “Clinical engagement.” “Lack of buy-in at executive level.” “Data-coding.” “Time to effect change and realise benefit.” “Trusts not having staff who can develop IT solutions such as apps.” “Infrastructure.” “Front line resistance to change.” “Fragmentation of processes / non-existent processes.”

7. “Resource to prove concept / evidence benefits.” “Data cleansing.” “Perception that ‘home/ telehealth’ monitoring as hospital/GP monitoring.” “Resources / expertise to set up.” “Information governance.” “Slow processes that aren’t digital.” Q1b: What are the constraints? “System inconsistencies.” “No EPR.” “Silo working.” “No clinical representation in the absence of CCIO.” “Clinical engagement.”

8. Q1c: How could you help implement this? “Ensuring clinicians are engaged.” “Releasing time – patient, staff and NHS.” “Engaging with users (NHS staff) and end users (patients).” “Resource and funding to implement.” “Use of alternative media – including smart TVs.” “Advocacy – service champions.” “Promote social media.” “Find work arounds which use IT.” “Technology strategy within senate.” “Focus on patient not the process or system.” “Champion the cause / evidence base / demo added value.” “Tap into ‘key’ resources.” “Keep it simple with quick wins. Use what is already there by sharing.” “Share best practice within networks.” “Support – ongoing.”

9. Q2: How can networks collaborate and should patients / public be involved with them? “Network events programme – including service users.” • “Patient should be involved in collaboration • Learn from their experience • User generated content – cheap/relevant • Widen opportunities • Not same nominated persons • Make quick and simple • Avoid provider bias – allow patient to drive priorities • Focus groups have a place • How to ensure broad spectrum of users by using different approaches “Sharing information and ideas.” “A network of networks.” “Right patient involvement / contribution – patient benefits / perspectives.” “Patient and public involvement.” “Why are networks on area not need.” “YES the better informed they are the more engaged they will be.” “Cross section of patients.”

10. Q2 cont’d: How can networks collaborate and should patients / public be involved with them? • “Shared repository of projects • Twitter – single portal directory • Innovation direct “Patient focus rather than disease focus.” “Resource / funding and time commitment.” “Discussion forums = feedback website.” “Ensure ask the people who do the job.” “Face to face meetings.” “Share best practice / learning.” “Virtual meetings.”

11. Q2a: What are the benefits? “Best practice.” “Experience – models for implementation.” “Discovering links across different networks.” “Use of technology – de-mystify.” “Sharing contacts – use as a resource.” “Champion the cause / share what works but also what hasn’t and why.” “Streamline care.” “Patients should be involved…Patients at the centre.” “Linking to other care professionals.”

12. Q2b: What are the constraints? “Protective culture in Trusts.” “Access to patients.” “Not well understood: Ownership, who’s on what.” “Positive feedback – capture EHI Awards.” “Process around complaints.” “Time.” “Legalities around social media – Twitter / Facebook and cost.” “Process around patient collaboration.” “Competition / not sharing / business-driven model.” “Venue – would need to travel to different venues to meet.”

13. Q2c: How could you help implement this? “Invite patients to network of use local focus groups. Can find these networks via Twitter and Facebook.” “Expand network – encourage membership.” “Use social media to ‘test’ opinion and gain information.” “Attend, engage and promote benefits and networks.” “CAPI teams” “What would we do with patient feedback – good or bad.”