University Hospitals NHS Trust • Consultant Nephrologist (1 clinic/week; 4 weeks on-call per year) • Challenges: – Rather prolonged gestation of our digital vision – Resistance to change – Resistance to the “bigger picture” – Training clinicians when they “don‟t have time for this” – Contracts – The 24 hour day
to change • Cultural barriers to open source • Funding Areas of Interest • Software Design • Specific Software • Data Collection and Analysis • Change Management
Hospital • Previously clinical lead for Respiratory Medicine • Previously clinical lead for Lung Cancer and currently Tuberculosis • Clinical lead for EPR at King‟s since 1999 • Clinical Director for IT at KCH (CCIO) since 2009
• Specific Software • Communication and collaboration software • Hardware Purchasing and Deployment • Data Collection and Analysis • Data for Regulatory bodies • Interoperability between systems - within organisation/ out with organisation • Patient Engagement
systems, slowing down workflow and distracting from high quality care. • Ever-increasing functionality gap between software, systems and devices I use outside of work and those within work. • Clinical information isn't always available at the Point of Care in the right form, yet nationally data can be extracted w/o direct patient consent. • Inadequate hardware capability and infrastructure (such as clinician accessible WiFi)
Director • >15 years of healthcare IT experience – Client Executive, Acute Delivery Manager, Programme Manager – Head of IM&T at NHS Enfield Primary Care Trust – Consultant to the Department of Health • EDS, BASF, 3M
My past: • Consultant Cardiothoracic Surgeon • Management consultancy • Clinical Director for Service transformation @ NHS • Editor @ BMJ • Consultant at European Medicines Agency
most effective strategy to engage and excite patients and the clinical community on the use of technology to transform healthcare, improve patient satisfaction, outcomes, effectiveness and ultimately prevent progression of medical conditions
large organisation with a large EPR deployment 2. Enabling nursing to be an equally recognised leadership role internally & externally (profession) Interests 1. Professional development 2. Communication & collaboration software 3. Social media
of radiology and chief clinical information officer (CCIO) at The Christie, as well as a clinical health informatics lead with NHS Northwest and a national lead with NHS Connecting for Health. Thanks to his visionary approach, Dr Bramley has been fundamental in many projects, which have enhanced the safety, quality, speed and efficiency of information flow across care pathways - all of which are vital to improving patient care. His achievements include leading on the successful national deployment of radiology information systems, digital imaging and voice recognition. He was highly commended in the HSJ clinical leader award for his innovation in developing clinical portals that provide secure web access to clinical records and enhancing clinical safety through electronic result acknowledgment and recording clinical outcomes.
• Software procurement and deployment • Specific software • Communication and collaboration software • Data collection and analysis • Change management • Information governance and security • Interoperability between systems
Bay • April 1996: Consultant Physician / Gastroenterologist • Developing Trust endoscopy services and systems • 2003-2007: Cumbria and Lancashire SHA Endoscopy Lead • Influencing Trusts towards patient centred, high quality, safe services • Learning / experiencing how to “align agendas” • Planning/set up 2 BCSP centres • 2008 – now: Clinical Director of Cumbria and MB BCSC • Delivering a “world class” patient-centred, clinical service • 2011 – 2013: Trust Clinical Lorenzo lead • Transforming an organisation from informatics-led, through clinical engagement phase, into a clinical and business-led informatics agenda for patient-centred services • 2012 – 2013: Interim Clinical Director for Elective Medicine • Re-setting specialties along a clinician-led, business planned agenda • 2013: CCIO (Associate Medical Director) • Chair of Lorenzo National User Group
(poor maternity/acute services) • Financial difficulty • Failed Trust Board (2011) • Lorenzo early adopter • Highly innovative Informatics team (Single Patient Record) • Being transformed with local CCG’s (Bettercaretogether) • Cumbria and Lancashire Footprint : • Disconnected health economy records (defined by patient flows) • Less mature local trusts (Blackpool, Preston, East Lancs) • Forward thinking GP’s • Need to connect e-health economy • National / Regional : • Where are the delivery vehicles for the EPR single record strategy ? • Has the NHS lost its faith ?
lead on record standards Health Informatics Unit, Royal College of Physicians. www.rcplondon.ac.uk/projects/healthcare-record-standards Executive Chair, Professional Record Standards Body for health and social care www.theprsb.org.uk
collaboration software • #Data Collection and Analysis • #Change Management • #Data for Regulatory bodies • #Interoperability between systems - within organisation/ out with organisation • #Patient Engagement
Social Care Information Centre Pressures I face: • Increasing professional engagement and leadership • Ensuring needs of nurses, midwives and HVs included in system design • Avoiding medical dominance in system delivery (we are greatest part of NHS and care workforce)
– 12 professions! • Change management – making sense out of change • Patient engagement (and clinician!) – bringing patients closer to clinicians with data • Collaboration with industry – can we utilise industry to help make the changes?
an IT and communications organisation that predominantly provides clinical portals – both provider and patient portals • Pressure Points: – The complexity of health IT within an already complex health system: it‟s a rapidly evolving landscape – Although improving significantly, health IT projects are still more management/IT led with clinical buy in, rather than clinically-led
University Hospitals Trust – New Hospital Opens 2017 – no medical records department! – Our EPMA is rubbish – Our desktop support is very poor and totally lets down what is otherwise an extremely good and progressive IM&T dept.
enough local leaders……unrealistic expectations….poor financial planning……. • Personal Development • Data Collection and Analysis • Change Management • Patient Engagement
Acting General Manager, Service Improvement • Business Support to the Chief Nurse Main Pressure Point - Career Progression Still challenges for nurses wishing to progress interest in informatics: • Remain in clinical specialty & develop expertise in specific system • Move to informatics/corporate role (where informatics plays key part), but challenge to retain clinical identity and support for clinical practice.
anyone out there?) – Administrative burdens (forms, forms, forms) – Revalidation • Locally – Better communication channels and networks to • create meaningful dialogue amongst clinicians, practices and CCGs whilst at the coal face to better inform decision making . • disseminate important clinical pathway guideline information in a way that has more impact • 111 Post Event Messages
Informatics, City University London • Past: Chairman, Academy of Medical Royal Colleges Information Group Senior Clinical Consultant to the Design Authority, NPfIT Founder member HL7-UK, UK CHIP Chair, Clinical Terms Project
standards) Decision support systems • Now: #Personal Development #Communication and collaboration software #Change Management #Information Governance and Security #Interoperability between systems #Patient Engagement
the network – Consent and IG – Interoperable systems and standards • Areas of Interest – Personal development – Data collection and analysis – Information Governance and Security – Interoperability between systems
for Cambridge University • Clinical Informatician, involved in IT since early ‟80s • Clinical Lead for Informatics, Bedfordshire CCG • Chair iSUG, Member SNUG Committee, member NCRP for C&B • Professional writer and broadcaster – currently columnist for eHI • Member, Advisory Panel for eHI‟s CCIO network
their way, with limited funds for development • Poorly joined up primary and secondary care systems • Nationally, primary care is almost overwhelmed and needs supporting (but clinicians have little time to learn new skills)
bump, bump, bump, on the back of his head, behind Christopher Robin. It is, as far as he knows, the only way of coming downstairs, but sometimes he feels that there really is another way, if only he could stop bumping for a moment and think of it.
for IT NHS Trust Medical Director Clinical Software Comparison Website Owner Newcastle United Supporter Frequently mistaken for a low ranking but knowledgeable official, the bus driver / train guard etc.
of Emergency Medicine England Fellowship in Informatics USA MSc in IT Management England Consultant in Emergency Medicine Leeds Teaching Hospitals Chief Clinical Information Officer Leeds Teaching Hospitals Chief Clinical Information Officer Leeds NHS & Social Care
quality care, ie, safe, good outcomes, good experience. • This is critically dependant on: i) good process, which is fed by good data ii) engaged numerate clinicians, who have responsibility and accountability iii) Engaged management Developing the argument that EPR's are essential for safety And efficient care delivery
promote and participate in Service redesign with the patient at the heart of the process. Service transformation requires the Right Information, in the Right Place, at the Right Time. This can ONLY be done with information technology, and it's use will in turn stimulate further redesign.
• Practising Reproductive Endocrinologist, seeing patients, doing surgery, teaching at U.S. National Institutes of Health • Served 23 yrs on Active Duty, US Navy • Was Associate CIO for Military Health System. Caring for 10 Million patients, 65 Hosp, 450 Clinics worldwide • Was first Deputy National Coordinator for Health IT at US Dept of Health and Human Services (HHS). Set up the ONC (Office of Nat Coord for Health IT) • Elected President-elect of AMA (American Medical Association) Will be President, June 2015
better information for better decisions • I work to create a Grand Healthcare Platform, a virtual pool of information that everyone in healthcare will contribute to and extract from.
London Rotation University of Newcastle upon Tyne Graduate MRCP FRCPath PhD • IT Journey – User (Why things don‟t work) -> EHI Live 2011 – Electronic Prescribing Implementation Committee • National Leadership and Management Fellow Alumni – Bupa Clinical Analytics – Chair of the Junior Doctor Executive forum – Royal Free Hospital
Guidance to Safe Record Keeping • NHS Hackday x 4 – CellCountr – VitalVis • Digital Doctor Conference and Podcasts • CCIO Leaders Network Advisory Panel – Inaugural Chair
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