Childrens Health Digital Strategy Update Alison Golightly May - PowerPoint PPT Presentation

Children’s Health Digital Strategy Update Alison Golightly May 2016 www.england.nhs.uk

What is it? A document which sets out the case for transforming the way information is handled in children’s health services. It suggests that making health information interoperable – translating it into messages which can be exchanged – is the only way of achieving our key objectives: ‘Knowing where every child is and how healthy they are’ ‘Appropriate access to information for all involved in the care of children’ www.england.nhs.uk

Current Challenges in CHIS Fragmentation • Partial records in several different systems – Maternity, GP, Child Health Information Systems, Acute • No single picture of a child’s health interventions No Failsafe for population management • Children unregistered to CHIS systems (National Incident Team Report) • Possible for children’s information to be mislaid/delayed when they move to a new area Limited Access • Very limited access to information for our partners outside the NHS, for example, Social Services or Education • Some providers of public health services for children have no access to IT systems Paper Heavy/Manually Intensive • Information still largely recorded on paper and sent from care-setting to care-setting • Information re-keyed from systems to system creating large administrative burden www.england.nhs.uk

Strategy aims at risk reduction Current live issues Solution Improve how we track children by Lack of effective population • Location management – how can we know • Responsible professionals and agencies with certainty where a child is? • Population Screening (Healthy Child Programme 0-19) ensuring that all are offered the preventative interventions they are entitled to. Improved electronic exchange of information (interoperability) – Lack of up to date, accurate and consolidated records – how can ensuring data can flow between systems AND TO PARENTS AND YOUNG PEOPLE in a timely, automated way. we know how healthy a child is? Presenting information in a core overview dataset reflecting the current Personal Child Health Record requirements Lack of access to information – Addressing authentication, consent and information sharing in a framework for parents, families, carers, children and young people. how can we ensure appropriate Being transparent about what is currently shared and why. access to information for all involved in the care of a child? Providing a digital roadmap for how to develop child health Lack of guidance, collaboration information services and collaborate with colleagues to achieve the and standards. change needed www.england.nhs.uk

Directors of Map of Child Public Public Health Research & Public Health & Health Commissioners Children’s England Policy Health Info Services Maternity CAMHs National Audit CYP Dataset GPES Dataset Dataset Emergency & Mental Health Voluntary Education Delivery of all other Services Services Services Acute Services care services Professional Health Neonatal Community Justice (Some Children) Social Services Services Services Services Midwifery Health Visiting Primary Care School Nursing Delivery of Healthy Child Programme Maternity Screening Primary Care (All Children) Information Information SCR Systems Systems Systems 146 CHIS / CHIS / CHIS / CHIS / CHIS / CHIS / CHRD CHRD CHRD CHRD CHRD CHRD CHRDs School Entry Chk 8/12/16 wk Imms 12/13 mth Imms 4-5yr eyesight 6-8 Week Exam 2/2.5 yr Integ 3yr 4mth Imms 12 mth Review Year 6 Check Year 8 HPV Personal Health Bloodspot New Baby Booster Hearing Review check Review Imms NIPE PCHR 0d 5d 11d 4y 8d 7w 9w 12m 13m 24m 40m 5y www.england.nhs.uk

Complexity/variety of services Healthy Imms & GP Routine All Screening Child Vacs Check Programme Most / Population Coverage All of the GP Illness Local Health School above + Many Visit Hospital Visiting Nursing Chronic or Mental Requires 5y All of the Acute LT Disability Some Health multi- above + Illness (3%) (2-10%) agency care (2-5%) Complex Looked Safe All of the Care Adoption After Few Guarding above + Packages (0.02%) Children (0.6%) (0.5-1%) (0.3%) 5y Complexity of Care www.england.nhs.uk Modified after RMP 2009

A Whole Population Approach: Patient Segments in Child Health • Advice & prevention eg: Breast feeding / Immunisation / Healthy Child Mental well-being / Healthy eating / Exercise / Dental health • eg: Safeguarding issues / Self-harm / Substance misuse Vulnerable child with / Complex family & schooling issues / Looked after social needs children Child with single long- • eg: Depression / Constipation / Type 2 diabetes/ Coeliac Disease / Asthma / Eczema / Nephrotic syndrome term condition • eg : Severe neurodisability / Down’s syndrome / Multiple Child with complex food allergies / Child on long-term ventilation/ Type 1 health needs diabetes Acutely mild-to- • eg: Croup / Otitis media / Tonsillitis / Uncomplicated moderately unwell child pneumonia / Prolonged neonatal jaundice • eg: Trauma / Head injury / Surgical emergency / Acutely severely unwell Meningitis / Sepsis / Drug overdose / Extreme preterm child birth Dr Bob Klaber & Dr Mando Watson Imperial College Healthcare NHS Trust www.england.nhs.uk

Personal Professional Public Health Health Health Contributes to Is source for Info for use by: professionals in Info for use by public health Info for use by: Parents, Health, Social Care and professionals and Children, Young People, Education caring for parents, commissioners providing care Carers children and young people services to populations Info sharing controlled by: the Info sharing controlled by: organisation in which the care Info sharing controlled by: Parents, Children, Young takes place, e.g. GP practice, national and local agreements People, Carers hospital, children’s centre, etc Info type: per child records with Info type: groups of individual, Info type: anonymized data, does not personal identifiers and personal identifiable health records e.g. identify individual children. Often data. Recorded by parents and young caseloads, medical notes. Recorded aggregated or statistical. Analysed people and professionals by professionals rather than recorded. Info grouped by: national, regional, or Info grouped by: families, extended Info grouped by: organisation local populations. Sometimes by family, social groupings providing the care disease or condition Info Systems in use: Maternity and Info Systems in use: CHIS, PAS, Children and Young People’s Info Systems in use: PCHR, Health Maternity, MH Systems, GP Systems, Passports, eRedbook, Baby Buddy, Datasets, Immunisation Cover SCR, CP-IS, A&E, Screening Patient Knows Best and many others reports, Screening Key Performance Systems and many others Indicators and others www.england.nhs.uk

Digital Child Health Hub Information to HUB from Care Information to HUB from Parents, Children and Data Professionals & Services Young People CAMHs Dataset CYPs Dataset Collaborative Health My Health My Health Notes Facts (Personal Communication Preferences Professional Health Narrative) Personal Health Info Sharing Preferences Health Promotion Summary View Public Health Tell Us Once General Practice Extraction Service (Consent) My Healthy My & Child Preferences Programme My Health My Local Maternity Dataset Events Services www.england.nhs.uk

What if all this information is ‘events’? { { { { { “birthWeight”: 6500, “birthWeight”: 6500, “birthWeight”: 6500, “birthWeight”: 6500, “birthWeight”: 6500, “gestationLengthBirth”: “gestationLengthBirth”: “gestationLengthBirth”: “gestationLengthBirth”: “gestationLengthBirth”: 35, 35, 35, 35, 35, My Health “deliveryMethodBaby”: “deliveryMethodBaby”: “deliveryMethodBaby”: “deliveryMethodBaby”: “deliveryMethodBaby”: “ventouse” “ventouse” My Health “ventouse” Notes “ventouse” “ventouse” } } Facts (Personal } } } Narrative) { { { { { “birthWeight”: 6500, “birthWeight”: 6500, “birthWeight”: 6500, “birthWeight”: 6500, “birthWeight”: 6500, “gestationLengthBirth”: “gestationLengthBirth”: “gestationLengthBirth”: “gestationLengthBirth”: “gestationLengthBirth”: My Healthy 35, 35, My 35, 35, 35, Child “deliveryMethodBaby”: “deliveryMethodBaby”: “deliveryMethodBaby”: “deliveryMethodBaby”: “deliveryMethodBaby”: Preferences Programme “ventouse” “ventouse” “ventouse” “ventouse” “ventouse” } } } } } { { { { { “birthWeight”: 6500, “birthWeight”: 6500, My Health My Local “birthWeight”: 6500, “birthWeight”: 6500, “birthWeight”: 6500, “gestationLengthBirth”: “gestationLengthBirth”: “gestationLengthBirth”: Events Services “gestationLengthBirth”: “gestationLengthBirth”: 35, 35, 35, 35, 35, “deliveryMethodBaby”: “deliveryMethodBaby”: “deliveryMethodBaby”: “deliveryMethodBaby”: “deliveryMethodBaby”: “ventouse” “ventouse” “ventouse” “ventouse” “ventouse” } } } } } www.england.nhs.uk