Improving the visibility and sharing of the patients data for multi-disciplinary working

1. Improving the visibility and sharing of the patients data for multi-disciplinary working • NATIONAL DOCMAN USERGROUP • 3RD July 2014 • Presenters • Dean Holliday, Project Portfolio Manager, General Practice, proactive and integrated workstream, SLIC • Nigel Brokenshire, IT Lead, SLIC • Sonia Hall - Practice Manager/ Advanced Nurse Practitioner • Concordia Parkside and Melbourne Grove

2. Introduction to Integrated Care • Multi-Disciplinary working • Community Collaborator • Clinical Perspective • Choose: Informal Agenda

3. Southwark and Lambeth covers a population of 600,000 people; we have world-class medical institutions but worse than average health outcomes and deprivation Guy’s Hospital St Thomas’s Hospital King’s College Hospital SLaM Source: Health Profiles 2013

4. Academic partners • Commissioners of care • Leaders and citizens across the care system have come together to improve value : raising quality and experience whilst reducing overall costs • Providers of care • Local CCGs and LAs • LAs, GPs and FTs • AHSC • Southwark and Lambeth Integrated Care

5. Older People’s Programme Aims 1 Early identification and intervention to avoid crisis Too little emphasis was placed on keeping people healthy and avoiding the development of crises Proactive management: the holistic needs of individual over 65s year olds were often not systematically known in general practice, with little/no care plans in place, and without any support structure to help interagency care planning Clinical pathways: there was too little focus on preventing ill health in the general population specifically in areas of Falls, Infection, Nutrition and Dementia a b A&E GP Limited ability to correspond electronically between GPs, hospital, community and social care Multi-disciplinary discussions had no secure way of discussing information about a persons care other than via e-mail L3 CMDT ?? No way to view GP record within an Emergency Department L2 L1 4 Using IT to support integration There were too few options other than the hospital, so people who didn’t need it ended up in acute care Internal and external processes were making it difficult to discharge people in a timely and effective way and inadequate community provision of reablement services was impacting on flows into and out of hospital Improving hospital discharge and reablement services to maximise independent living Providing alternative urgent response 3 2

6. Promote contact and collaborative working between practices and partner organisations • Demonstrate a better use of staff time, to contribute to the CMDT meetings • Increase the continuity of patient care planning and help to reduce duplication of effort • Provide a centralised patient/client case summary that is accessible to relevant parties • Provide a secure environment to share patient/client data • Provide an audit trail of care planning and delivery • Anticipated Benefits

7. One for the techies!

8. Approach / Timeframes

9. As at the end of the pilot Sept 2013 we had: • 2 out of 6 Community MDTs using Collaborator • 23 active users (classroom trained & 1 to 1 sessions) • 42 cases loaded • As at 1stJuly 2014: • All Community MDTs able to use Collaborator • We now have ~70 users • Estimated 150 patients case discussions undertaken • Support Model • 1 to 1 sessions • Sharing learning at CMDT meetings • 3 PDF guides and 17 online videos • Collaborator progress to date

10. Ability to view and contribute

11. Evaluation of Collaborator against SLIC objectives and aspirations • Continue to keep it simple ………. • 3 stages – pre, during and post CMDT • Share information in advance via Collaborator • Allow CMDT members to contribute to case notes • Electronic view during the meeting (IG, paperless, adding value) • Actions added to Collaborator post meeting and assigned to CMDT members • Looking forward and action planning ?

12. Questions? • Thank you • “Using Docman Collaborator has been by and large a very positive experience. With lots more functions still to explore I see it certainly meeting the needs of the CMDT in a safe efficient manner” • Brenda Donnelly • Co-chair South Southwark CMDT • Practice Nurse, Elm Lodge Surgery “I have found using DOCMAN Collaborator to be an overwhelmingly positive experience. It has made working in the CMDT much easier, as now it is possible to share information in a safe, efficient, Caldicott compliant manner. It has dramatically reduced my preparation time and provides a secure means of communication” - Dr Dan Bailey Consultant Physician Department of Clinical Gerontology King's College Hospital NHS Foundation