applying technology to the challenge of community healthcare julia clarke ceo, bristol community...
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Applying technology to the challenge of community healthcare
Julia Clarke
CEO, Bristol Community Health
10 June 2015Health Insights
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Who we are
• Provider of NHS adult community health services in Bristol and Offender Health in Bristol & S Glos prisons
• Social Enterprise ‘spin out’ October 2011
• Staff owned community interest company
• £45 million turnover, 1000 staff (wte)
• 30,000 patient contacts, 7000 referrals per month
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Challenges of Community Health
• Rising demand and rising expectations– Ageing population with multiple long term conditions and frailty– Admission avoidance and supported discharge– Pressure on primary care & hospitals performance
• Legacy issues: under-funding, under-investment, poor infrastructure (IT, estates, systems)
• Lack of research, metrics and evidence base• Financial & commercial framework – block contract,
competition, business transfer ‘at cost’• Dispersed workforce, home and community settings• Multiple interfaces internally and externally
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Our technology projects
• Mobile working (Totalmobile)
• Electronic patient record (replacement of RIO with EMIS web)
• Self-Care / telemedicine (collaboration with Phillips Healthcare)
• Connecting Care (SC and SW CSU)
• Business intelligence (Inphase & new data warehouse)
• HR systems (Perform, e-pay)
• Communications (websites & e-comms)
• Patient feedback (Meridian)
• Clinical incidents and risk (Ulysses)
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Mobile workingcollaboration with Totalmobile
• An intuitive app run on android tablets
• Screens and forms designed around the clinician–patient interaction by clinicians
• Added value summary views, graphics, annotated photos and loads of potential for more
• Links (push & pull) to one or to multiple systems via API
• Rich and granular data capture
• Works off line
• Secure and IG compliant
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Mobile workingcurrent status
• Around 400 users, 700 planned• Rollout suspended while we switch EPR• Demonstrable benefits
– More satisfied staff, reduced frustration– Productivity up to one hour / clinical day– Better data quality – timely and complete– Patient engagement– Added value eg. photos, functionality of tablets– Catalyst for change in working practices,
documentation, service design
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Supported Self-Carecollaboration with Phillips
• Population health activation and self-management system
• Clinical / technical self-care hub – linked to patients and to clinical teams
• Health navigators / coaches / coordinators• Range of technical platforms for risk stratified population:
– Telemedicine with remote monitoring, education materials and comms
– Tailored text and voice interactions– Self care apps – lifestyle, activation
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Supported Self-carecurrent status
• Detailed development of concept• Risk stratification and segmentation of population• Small scale demonstration & learning project with one
practice• Patients recruited from all segments• Support from WoE AHSN, potential test-bed• Interest from local stakeholders including Bristol Health
Partners, Bristol University, Bristol City Council
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Our balanced scorecard
Theme Perspective
Making their day Patient, customer, commissioner, partners, stakeholders
Managing our money Financial, commercial, business
Time to Care Operational, systems & processes
Being the best Organisational, workforce
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Technologya strategic response
Theme Contribution of technology
Making their day Clinical quality through analytics, patient feedback, data quality & availability, shared patient view, apps & smart functionality – eg photo capability, incidents reporting and analysis
Managing our money Business intelligence for contracting & management, efficiency through mobile working,
Time to Care Productivity – mobile working, apps,
Being the best Cultural change, consistent performance management, efficient systems
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Cultural benefits
• Disruptive technology• Performance and quality aware• Greater discipline / rigour• Fuelled innovation• Created internal demand and faster change• Prepared for RIO-EMIS switch• Opportunity / necessity for documentation review
and service redesign• Organisational learning
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What’s next?
• E-rostering linked to safe staffing
• Appointment scheduling
• More quality-analytics
• Document management
• The Cloud