Next generation shared data: the Longitudinal Care Record
Next generation shared data: the Longitudinal Care Record Digital Primary Care Congress Presented by Laura Sato Structure Longitudinal Care Records (LCRs) Context Local Health & Care Records (LHCR) initiatives Vision Progress and plans Digital First Primary Care Vision 2 This Photo by Unknown Author is licensed under CC BY-SA-NC 1. Longitudinal Care Records Context Vision Progress / Plans 3 Longitudinal Care Record Context Local Health & Care Record organisations (LHCRs) are regional coalitions of health and care organisations, working together with their local communities to
deliver a new set of data services, for both care delivery and for local research and service analysis intended to enable seamless and real-time data sharing across care providers for care delivery citizen access and ability to contribute to their shared care data the availability of rich care data for local population management and research first established (Wave 1) in 2018 each to receive 7.5m (capital) as a central investment to start-up, with matched local investment in the start-up period (first 2 years) 4 LHCRs Wave 1 5 Wave 1 Exemplars Exemplars engage with Greater Manchester The Greater Manchester devolution Pop. 2.8m Yorkshire & Humber West Yorkshire, South Yorkshire & Bassetlaw, Humberside and North Yorkshire
Pop. 5.4m One London All of London Pop. 8.5m Thames Valley & Surrey Buckinghamshire, Berkshire, Oxfordshire and Surrey Pop. 3.2m Wessex Hampshire, Isle of Wight and Dorset Pop. 2.6m 5 5 LHCR Future Waves Wave 1 Greater Manchester One London Thames Valley & Surrey Wessex Yorkshire & Humber Cumulative Announced
in 2018 Wave 1 22.5m. 41.6% Wave 2 11.06m 63.0% Wave 3 20.0m 100% Wave 2 Great North Care Record Share 2 Care (NW) One South West Wave 3* Eastern West Midlands Remaining Areas that did not bid Mobilising Wave 3 delivery approach to be informed by Waves 1
and 2 Subject Subject to to business business case case 6 Thames Valley & Surrey (TVS) Geography = six care systems A coalition of health and care organisations, working together with their local communities. We serve a total population of 3.8m and include: 5 Integrated Care Systems 6 Global Digital Exemplars 3 Sustainability and Transformation Partnerships Surrey Heartlands and East Surrey Frimley Buckinghamshire Oxfordshire Berkshire West Milton Keynes 7 The Longitudinal Care Record (LCR) is
A collection of information relating to a persons health, care and relevant circumstances including pointers to detailed records A single care record about an individual from multiple source systems enabling all people involved in care to view and contribute information across care settings Longitudinal in terms of integrating care records data From all settings and providers Over time (potentially from conception to death) 8
Bi-directional data flows in / out of the Longitudinal Care Record Data Providers / Data Consumers of care information Emergency GP Practices Independent Results Social Care GP OOH Community/ MH Acute trusts Patient Other LHCREs Local System Consult and import data from the LCR
Contribute to the LCR Bi-directional capability Type 1 structured Data Type 3 current documents Type 2 Record Locator pointers Longitudinal Care Record 9 Longitudinal Care Record Structured Data per the PRSB national Core Information Standard V1 About Me Demographics & Contacts Pregnancy Status Safeguarding & Risks Investigations, Examinations & Assessments
Problems, Diagnoses, Conditions & Procedures Participation in Research Legal Information Social Context Family History Medications & Allergies Care Plans Encounters, Referrals & Future Appointments Formulation Plan & Requested
Actions Vaccinations Alerts Documents (inc. Correspondence & Images) 11 From the Thames Valley & Surrey LHCR: Primary care data is core, forming the basis of the longitudinal care record when integrated with acute, community, mental health, ambulance and social care data. The new Longitudinal Care Records platform will support the role of Primary Care Networks and population health analytics e.g. excellent work has been undertaken in Frimley providing local and place based analytics linking data (predominantly in primary care) with well known data sources on mortality, admissions and other data sources that enable practices, PCNs and other grouping to measure their performance and provide data to enable gaps in care or poor performance against the norm to be identified and then action taken to improve. Typically this will be used to better manage long term disease cohorts or ensure that targeted performance measures based on data can be introduced.
The other theme relevant for Primary Care is the generation of the key safeguarding data needed for Childrens social care teams, either by direct access to a report, or an automated report generated in the practice and then shared. Primary Care will also benefit from access to ambulance and CHIS data, not currently included in most local shared records. The population health management work of PCNs will be supported and benefit from use of the platform, accessed via each PCNs local shared record. 12 2. Digital First Primary Care Vision Slides from NHS England & NHS Improvement team 13 Digital first primary care the vision What can patients expect? The NHS Long Term Plan commits that every patient will have the right to be offered digital-first primary care by 2023/24. The use of digital channels will be at the choice of
the individual patient, with those who cant or dont wish to use digital tools still able to access services over the phone or in person. Patients should be able to easily access advice, support and treatment from primary care using digital and online tools. These tools should be integrated to provide a streamlined experience for patients, and direct them to the right digital or in-person service for their needs. 14 | Digital first primary care the vision In practical terms, patients should be able to use online tools to access all primary care services, such as receiving advice, booking appointments, having a consultation with a healthcare professional, receiving a referral, obtaining a prescription etc. Access to appropriate services should be as easy to request and receive online as by phone or in person. Digital first primary care should also include providing clinicians with the information they need at the point of care to effectively support patients, relevant digital tools to allow services to be provided to patients (such as a consultation, prescription, referral etc.), and tools to support clinical and shared decision-making.
15 | The digital first patient journey Patients are able to easily access and flow through primary care pathways using digital tools. SIGNPOSTING E n t r y p o i n t s A&E UTC Hub Get advice, check my symptoms Go online NHS App NHS.uk
111.nhs.uk Practice website Local Apps Get the right medical help (triage) View records online Finding the most appropriate care pathway Book appointments online Order meds online 16 | Secondary care referral Outpatients Self Care Self referral Pharmacy
GP practice Online messages Video consults Online consultations simplified patient journey Check Check symptoms symptoms e.g. e.g. at NHS.uk at NHS.uk SIGNPOSTING Self care Pharmacy Online Online consultation consultation Directed to the appropriate
person in the Primary Care Team A&E/UCC/111 Messaging Response 17 | Online Online appointment appointment booking booking select select time time and and date date Prescription Referral Test Advice APPOINTMENT TYPE
Go online using your smartphone, tablet or computer Triage (automated or manual) Face to face Telephone Video consultation Connect with us @nhsdigital company/nhs-digital www.digital.nhs.uk
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