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Wai Keong Wong
     MRCP PhD
Chair, Project Board
The Journey
2011                   2012                                    2013




                                          1st Steering
                                          Comm
                                        Power of                        LAUNCH!
                                        Information
                                                                  Print
                                  Selection
                                                                  Ready
                               Deadline
          Project
                                                             Layout
          Manager         Invitation to tender               Approved
   Idea                  BCS-DH Contract
                                                         Copy
                    Funding approved by                  Crystal Marked
                    HM Treasury
Information for
                           Public Consumption
Behavioural
and Social Aspects
                                 Realistic and
                                 Pragmatic

          Domain Expertise
          - Electronic Records
Steering Committee | Project Board

                          Independents




 Patient Representative
Methodology | Scoping


Steering            Stakeholders        Focus Groups
Committee

   • Face to Face       • 25                • Age <50
   • Online               Respondents       • Age >50
                        • Low
                          response
                          rate from
                          suppliers
Myths and Concerns uncovered
• ‘Everyone will have to sign up to get full access
  to NHS services in future’
• ‘Signing up for online access means the
  creation of an electronic health record’
• ‘Signing up for online access makes your
  electronic health record inherently less
  secure’
• Concerns about potential coercion
Scope
• Electronic Records
• England
• Competent Adults
  – Thinking about, Already Accessing
• Primary, Secondary and Social Care
                                                  NOT
                             Benefits of Record Access
                              Secondary Uses of Data
                       Children and Vulnerable Adults
Methodology | User Testing


One to One         Stakeholders      Project Board
Interviews

   • Polished          • Steering        • The Final
     Draft               Committee         Word
   • Information
     Challenges
   • MHRA/ EMA
The Journey
2011                   2012                                    2013




                                          1st Steering
                                          Comm
                                        Power of                        LAUNCH!
                                        Information
                                                                  Print
                                  Selection
                                                                  Ready
                               Deadline
          Project
                                                             Layout
          Manager         Invitation to tender               Approved
   Idea                  BCS-DH Contract
                                                         Copy
                    Funding approved by                  Crystal Marked
                    HM Treasury
http://www.nhs.uk/records
What lies ahead??
• More versions – accessibility
• Form part of larger set of guidance
• Submitted for 2013 BMA Patient Information
  Awards
A Rapidly Changing Landscape
•   Technology
•   RCGP Working Group
•   Health and Social Care Bill
•   Caldicott Review
protected from or not exposed to danger or risk; not likely to be harmed or lost:




   safe
     records                       and            safe
                                                    patient
Wai Keong Wong*        BCS Health (Chair of the Steering Group and Project Board)
Isabel Chevis          CEO, IHRIM
Neil Churchill         CEO, Asthma UK
Ewan Davis*            Health IT Consultant, BCS; Woodcote Consulting
Alan Doyle             Director, National Information Governance Board
Toto Gronlund*         Director Patient and Public Relations, DHID
Sue Hawkswell          Managing Director, CSE Healthcare; Intellect
Mike Haynes            BCS; Independent Consultant
Penny Hill             NIGB; Mortimore Hill Associates (Social Care)
Peter Short            National Clinical Lead, GPs, DHID, RCGP
Keith Simpson          Nephrologist; Renal Patient View
Pauline Smith*         ProgrammeManager, DHID
Ben Toth               Information Manager, National Institute for Social Care and Health Research
Jean Waters            Patient Representative
Justin Whatling*       Senior Director Strategic Consulting in Europe, Cerner;
                           Chair, BCS Health
Marlene Winfield*      Independent Consultant


                    * Project Board Members

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Keeping your online health and social care records safe and secure

  • 1. Wai Keong Wong MRCP PhD Chair, Project Board
  • 2. The Journey 2011 2012 2013 1st Steering Comm Power of LAUNCH! Information Print Selection Ready Deadline Project Layout Manager Invitation to tender Approved Idea BCS-DH Contract Copy Funding approved by Crystal Marked HM Treasury
  • 3. Information for Public Consumption Behavioural and Social Aspects Realistic and Pragmatic Domain Expertise - Electronic Records
  • 4.
  • 5. Steering Committee | Project Board Independents Patient Representative
  • 6. Methodology | Scoping Steering Stakeholders Focus Groups Committee • Face to Face • 25 • Age <50 • Online Respondents • Age >50 • Low response rate from suppliers
  • 7. Myths and Concerns uncovered • ‘Everyone will have to sign up to get full access to NHS services in future’ • ‘Signing up for online access means the creation of an electronic health record’ • ‘Signing up for online access makes your electronic health record inherently less secure’ • Concerns about potential coercion
  • 8. Scope • Electronic Records • England • Competent Adults – Thinking about, Already Accessing • Primary, Secondary and Social Care NOT Benefits of Record Access Secondary Uses of Data Children and Vulnerable Adults
  • 9. Methodology | User Testing One to One Stakeholders Project Board Interviews • Polished • Steering • The Final Draft Committee Word • Information Challenges • MHRA/ EMA
  • 10. The Journey 2011 2012 2013 1st Steering Comm Power of LAUNCH! Information Print Selection Ready Deadline Project Layout Manager Invitation to tender Approved Idea BCS-DH Contract Copy Funding approved by Crystal Marked HM Treasury
  • 12. What lies ahead?? • More versions – accessibility • Form part of larger set of guidance • Submitted for 2013 BMA Patient Information Awards
  • 13. A Rapidly Changing Landscape • Technology • RCGP Working Group • Health and Social Care Bill • Caldicott Review
  • 14. protected from or not exposed to danger or risk; not likely to be harmed or lost: safe records and safe patient
  • 15. Wai Keong Wong* BCS Health (Chair of the Steering Group and Project Board) Isabel Chevis CEO, IHRIM Neil Churchill CEO, Asthma UK Ewan Davis* Health IT Consultant, BCS; Woodcote Consulting Alan Doyle Director, National Information Governance Board Toto Gronlund* Director Patient and Public Relations, DHID Sue Hawkswell Managing Director, CSE Healthcare; Intellect Mike Haynes BCS; Independent Consultant Penny Hill NIGB; Mortimore Hill Associates (Social Care) Peter Short National Clinical Lead, GPs, DHID, RCGP Keith Simpson Nephrologist; Renal Patient View Pauline Smith* ProgrammeManager, DHID Ben Toth Information Manager, National Institute for Social Care and Health Research Jean Waters Patient Representative Justin Whatling* Senior Director Strategic Consulting in Europe, Cerner; Chair, BCS Health Marlene Winfield* Independent Consultant * Project Board Members

Notes de l'éditeur

  1. The journey began 2 years ago with a conversation between Marlene Winfield, then Director of Patients and Public Relations of at the DHID and Justin when there were working on BCS response to the IS consultation. This set in motion the 1st jointly funded project between the DH and the BCS. Several months later, Justin and Ewan Davies found me at the top of the BT Tower at the EHI CCIO Campaign launch event where my involvement in this project began.After a few delays and hiccups in obtaining funding for this project, the BCS and DH jointly committed equal share of resources to fund this project. DH funding was obtained by a grant by exception approved by the Treasury.After you can see in this timeline activity picked up substantially after January 2012 leading to the production of this guidance and today’s event.
  2. In choosing the right partner to deliver this piece of work, we felt that it was really important that we offered it to a team that recognises and understands the more human and social aspects of record access as opposed to the technical aspects. A team with a track record of creating information for public consumption. And a team with domain expertise in the field of record access, a relatively young field. So after an open and transparent tendering process carried out to standards expected of the DH, we offered
  3. After quite a close contest, we offered the contract to MynorsSuppiah, a relatively new SME that we felt was best placed to deliver this. GeraldineMynors, Sarah Smith and Emily Newsom-Davis.Retrospectively, we are confident that we have made the correct decision.In addition to being a pleasure to work with, Geraldine and her team have actually over-delivered, under budget and ahead of time! I do wonder when I will ever repeat those words again in my career.
  4. The success of any project is ultimately made up of the people that is involved in it. We were very keen that most stakeholders are represented in the steering committee.Working together with MynorsSuppiah, this group provided a very important early steer about the scope and content of the guidance. However, it was recognised that a smaller, more agile decision making unit is required to respond to queries and to make decisions as the Geraldine and her team carried out their work.A project board of 6 that I chaired for was formed for this purpose and it worked very well in practice. 3-4 teleconferences were scheduled and interim communications were all conducted by email.
  5. In addition to the steering committee, Stakeholder Consultation - including patient organisations, informatics experts and commercial providers of patient record systems.Twenty-five organisations took part in the survey, out of a total of 51 potential respondents.There was a disappointing lack of response from suppliers – with only one responding openly.Focus groups were held for those aged 50 and under; the other for those over 50 years. Each group included: a fair mix of men and women of all ages and of levels of education; two members were black or of a minority ethnicFinal Project Summary Report – Chronic conditions, ethnic minorities, use internet regularly.
  6. Indeed user testing revealed some interesting myths and concerns that may not be immediately obvious to those of us that work in this area. The guidance does address of these issues.
  7. A polished draft that was appropriately layed out was tested. Instead of a simple asking people what they thought, Geraldine and her team set specific information challenges with users and measured their responses. This is approach is widely used by the MHRA and EMA. In parallel, the original groups of stakeholders, the steering committee was also given an opportunity to comment on this draft.Overall, the response was very positive and no major changes to the content of the guidance was required even though many changes to wording and presentation style was changed in response feedback.As the first draft performed so well in user testing, it was felt that another round of user testing was not required even though this was in the original project plan.
  8. Towards the end of 2012, following crystal making the Board approved the guidance.
  9. And this is what has been approved and available today.A 16 page A5 booklet, an A5 and A4 summary sheet.And of course, there is an online presence at the link shown that is hosted by NHS Choices.
  10. Now and throughout the whole project, we were acutely aware that this project did not exist in a vacuum and efforts were made to engage with various bodies to keep the up-to-date with our progress and early insights that might help steer how further guidance might be produced and factors to consider on how to role out electronic record access nationally. Furthermore we recognise that as technology changes, this guidance will need updating to ensure that the information remains accurate. All attempts have been made to this guidance to emphasise principles rather that specifics of the system used by each record provider.Not forgetting of course the ongoing Caldicott Review in Information Governance.
  11. The title of this talk and indeed the Guidance is about ‘Keeping your online health and social care records safe and secure.’However, I think that it is important to recognise that the bigger picture is *not* about keeping records safe and secure. What it is, is about a safer patient.This is someone who is more engaged with the management of their health and care of which we believe that having access to their records play a critical role.We are hopeful that this guidance will help increase the confidence of those thinking about and wanting to access their records whilst reducing any potential harm that electronic access to digital records creates.I look around this room and I see representation from software system providers, healthcare professionals, patient groups, NHS-CB, DH and members of the press. You are all key to helping us maximize the impact of this guidance that we have all worked very hard to produce.
  12. Thank you…