THE FORWARD VIEW INTO ACTION: Paper-free at the Point of Care –

Developing Local Digital Roadmaps

 

Five Year Forward View April 2016

Transfers of CareUse technology to seamlessly transfer patient information at discharge, admission or referral

“Having the ability to quickly access an individual’s medical history will enable me as a paramedic attending a call to make informed decisions when responding to an emergency.” Paramedic

Records, Assessments and PlansCapture information electronically for use by me and share it with other professionals through the Integrated Digital Care Record

Medicines Management and OptimisationEnsure people receive the right combination of medicines every time

Decision SupportReceive automatic alerts and notifications to help me make the right decisions

Remote CareUse remote, mobile and assistive technologies to help me provide care

Asset & resource optimisationIncrease efficiency to significantly improve the quality and safety of care

Orders & Results ManagementUse technology to support the ordering of diagnostics and sharing of test results

Baseline and benchmark (NHS providers) progress towards being paper-free at the point of care using a new Digital Maturity Self-Assessment Tool

Create a Digital Roadmap outlining the steps (operational and strategic) to be taken towards becoming paper-free at the point of care

Confirm a Footprint detailing the partners and the governance arrangements to drive the local health and care system to become paper-free at the point of care

1. 2. 3.

85 Footprints

48 single CGG Footprints

37 multiple CCG Footprints – ranging up to 12 CCGs

Region North Midlands & East London South

Total Number 32 23 7 23

Single 22 9 2 15

With partners 10 14 5 8

24

6

7

24 1

Number of LDRs in each STP1

2

3

4

5

6

44 STPs with between 1 and 6 LDRs in each

1

2

3

4

5

6

7

8

9

10

11

12

0 2 4 6 8 10 12

Number of CCGs Per STP

Number of STPsNumber of CCGs per STP

Number of STPs

Num

ber o

f CC

Gs

READINESSAre providers set up effectively to deliver paper-free at the point of care?

CAPABILITIESDo providers have the digital capabilities they need to deliver paper-free at the point of care?

INFRASTRUCTUREAre the underpinning technical enablers in place to deliver paper-free at the point of care?

Red = Infrastructure score <40%

Amber = Infrastructure score 41 – 75%

Green = Infrastructure score 76 – 100%

Blue lines reflect the bandings applied in MyNHS

National Scores for Readiness, Capabilities & Infrastructure themes (all services).

National Scores for Readiness, Capabilities & Infrastructure themes (all services).

Strateg

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Lead

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Resou

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Govern

ance

Inform

ation

Gov

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Record

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& Plan

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Transfe

rs of

Care

Orders

& Res

ults M

anag

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Medici

nes M

anag

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ptimisa

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Decisi

on S

uppo

rt

Remote

& A

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Asset

& Res

ource

Opti

misatio

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Standa

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Enabli

ng In

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102030405060708090

100

Readiness Capabilities Infrastructure

Readiness Sections scored higher than capabilities

Medicines Management, Remote & Assistive Care and Decision Support have lowest

results across the self-assessment

What percentage of respondents stated positively* that…Healthcare professionals rely on digital records for the information they need at the point of care… 32%

Professionals have digital access to the information they need from other healthcare providers… 21%Professionals have access to a consolidated view of their patients health & care records… 14%More than 60% of care summaries are shared digitally with GPs… 64%

More than 60% of lab tests are ordered digitally… 52%

More than 60% of radiology tests are ordered digitally… 49%More than 60% of inpatient medications are prescribed digitally... 19%

Healthcare professionals receive digital alerts to patient preferences... 23%Digital systems alert professionals to patients whose observations or EWS are deteriorating… 28%

Remote/virtual clinical consultations and clinical advice are available to patients… 11%

Staff rostering is managed digitally throughout the organisation… 74%Healthcare professionals have access to Wi-Fi throughout the organisation… 82%

Wi-Fi is available in public areas throughout the organisation… 50%

*Answered ‘Mostly Agree or Completely Agree’ or >60% for quantitative responses

1. Users can view a dedicated page for each section of the assessment as well as an overall summary.

3. A selection of charts allow users to display the raw data in an accessible/informative way.

5. Users can apply different filters to the data more relevant. E.g. average of acute only, data from the South only.

2. A trend line allows users to make a visual comparison of their own scores/answers against the national/regional/ service average.

4. Each page shows the national scores & answer breakdown for the questions in the different sections of the DMA.

In their LDRs, commissioners and providers should describe how, working collaboratively, they will underpin and transform service models and key clinical priorities with the necessary digital technology and capability, and in so doing, help to close the gaps in health and wellbeing, care and quality and finance and efficiency.

In their LDRs, commissioners and providers should plot their route to the delivery of ‘paper-free at the point of care’ within and between care settings, and outline how they will exploit digital technology and data to support transformation and secure sustainability more widely.

THE FORWARD VIEW INTO ACTION: Paper-free at the Point of Care –

Developing Local Digital Roadmaps

 

Five Year Forward View April 2016

A vision for digitally-enabled transformation

Information sharing• Approach• Information sharing agreement• Adoption of NHS number and

standards

Readiness• Leadership, clinical

engagement and governance• Change management

approach• Benefits management and

measurement• Investment approach• Programme structure• Resources for change

Capability deployment• Schedule• Trajectory

System-wide Infrastructure• Mobile working • Unified communications • Shared infrastructure initiatives

Where are we now• Overview of current maturity• Key recent achievements• Key current initiatives• Rate limiting factors

Universal capabilities delivery plan

• Baseline• Ambition• Activities• National services /

infrastructure / standards• Evidencing progress

The Thinking• Every local health and care system will be expected to

make progress against a set of 10 universal capabilities, demonstrating clear momentum between now and end-March 2017 and substantive delivery by end-March 2018.

• In many systems, the capability will already have been deployed to some degree and the main challenge going forward is achieving more comprehensive take-up and optimisation.

• The potential of these capabilities has already been clearly demonstrated in some localities. They represent the minimum evidence that local footprints are making clear progress towards operating paper-free at the point of care.

• The priorities require only marginal financial investment. Many are (or will be) supported by national services, standards or infrastructure. In some systems, alternative local solutions will be available –if used, a rationale should be provided.  

• The list of universal capabilities may evolve in due course.

The List of Universal Capabilities• Professionals across care settings can access GP-held information on

GP-prescribed medications, patient allergies and adverse reactions• Clinicians in urgent and emergency care settings can access key

GP-held information for those patients previously identified by GPs as most likely to present (in U&EC)

• Patients can access their GP record• GPs can refer electronically to secondary care• GPs receive timely electronic discharge summaries from secondary

care • Social care receive timely electronic Assessment, Discharge and

Withdrawal Notices from acute care • Clinicians in unscheduled care settings can access child protection

information with social care professionals notified accordingly• Professionals across care settings made aware of end-of-life preference

information• GPs and community pharmacists can utilise electronic prescriptions• Patients can book appointments and order repeat prescriptions from

their GP practice

Alignment

Governance

Resourcing

The Driving Digital Maturity Programme