Roz Foad PHCSG Chair opened the conference with the biggest audience for some years.
We will try and keep you informed of interesting material as it emerges.
You can see my minute to minute thoughts on Twitter WoodcoteEwan
This has been a fascinating discussion – but mostly, unfortunately, conducted on other lists and blogs – so as the Conference is very close, here is a brief summary of where we’re at – in my personal view – at the moment.
There is general agreement that the problem is real, but no agreement about the exact implications – let alone the best approach. This is hardly surprising: the problem involves not only IT but also clinical management: who is actually in charge of making sure Fred gets the best medical and social care, isn’t harmed inadvertently and remains empowered.
I think there is agreement that there is a role for a “Care Coordinator” who is unlikely to be the GP, but needs to be highly trained and able to deal with both medical and social aspects, such as a Community Matron: this role might be just supportive of Fred – especially if the Fred involved didn’t have quite so many problems…
There are various models for this approach including Virtual Wards, Guided Care and Healthy Circles – but I’m not sure how any of them would be suitable for the total management of Fred (you haven’t forgotten the dog, have you?)
Still, here are a batch of URLs which may be of interest: see you at the conference!
Patients Know Best (a UK company)
http://www.patientsknowbest.com/
IBM Smarter Solutions for Healthcare
CSAM
http://www.csamhealth.com/csam-plexus.aspx
Guided Care
http://www.guidedcare.org/index.asp
Healthy Circles
CareFX
Virtual Wards
http://www.croydon.nhs.uk/services/Pages/virtualwards.aspx
PCEHR
http://yourhealth.gov.au/internet/yourhealth/publishing.nsf/content/home
NHS Examples
http://www.natpact.info/cms/328.php
Excelicare
Mary Hawking’s ’What about Fred (and his dog)?’ rang many bells. I recall a patient’s ‘emergency’ admission for heart failure being delayed for two days while our nursing team desperately tried to find a temporary home for his prize cockatoo.
The challenge of Fred also reminded me of our attempt in 2001 to set up a communications-driven portal for our local Elderly care multi-disciplinary team which eventually failed because of the lack of technical infrastructure and even simple secure communications ability, though one success was the development of a set of shared care components in the Scottish SCI-XML standards, including ‘Pets’!
I first heard Mary discuss ‘Fred’ at the recent BCS HC conference followed by interesting exchanges on Linked-in which pointed to existing approaches such as ‘Virtual Wards’ , though ITC support seems limited to the use of email. Encouraged to explore ‘social media’ in preparation for a PHCSG workshop it seemed intriguing that Facebook, with its streamed Wall/News Feed conversation, built upon structured information, was exactly the sort of paradigm we had envisaged for our elderly care team project.
By coincidence, Vince Kuraitis, a respected US health informatician, posted a blog article entitled ’Can Facebook be your platform for Care Coordination’. The unsurprising conclusion was that Facebook itself was not appropriate but that the paradigm might well have application in complex care coordination, for both the care team and the patient. There are indeed some commercial examples starting to use this approach such as ‘Healthy Circles’ and ‘Patients Know Best’ .
The PHCSG has been looking to make contacts within the mHealth and Patient Health Record communities and the idea arose of creating a ‘Fredbook’ project to experiment with these some of these ideas. I lashed up a quick dummy UI to get help the discussion:
It is surprising how many of the core Facebook elements might have equivalents in a care coordination ‘Fredbook’ application :
Fredbook |
|
Team communications feed with comments / annotations |
News feed / wall |
Care team contacts |
Friends |
‘Patients like me’ contacts |
Friends |
Patient diary – ALL scheduled appointments and reminders |
Events |
Clinical correspondence e.g. hospital letters |
Messages |
Lab results |
Messages |
Patient measurements/device feeds |
Messages |
Targeted local resource directory |
Ads |
The PHCSG plans to take ‘Fredbook’ discussions forwards at the Primary Health Info Conference in May 2011 and to set up a ‘Hackathon’ shortly afterwards, to see just how much can be brought together from ‘mashups’ of existing open source/ open standard projects e.g. the Aliss Project which seems a natural fit to deliver targeted local community resource ‘ads’.
‘Fredbook’ should be a great vehicle to bring together the emerging enthusiastic patient apps/ mHealth community together with experienced, (some might say hard-bitten and cynical) primary care informaticians. Regardless of whether a real ‘Fredbook’ application actually emerges we will learn a great deal, should have a lot of fun in the process.
Oh … and Fred’s dog will definitely be looked after ..
There is an emphasis in modern healthcare on keeping patients, especially those with long-term conditions (LTCs) out of hospital, and providing them with services closer to home and supplied by multiple providers.
This would seem to need a new approach to organisation of care and the information – including but not exclusively medical records – to make sure that care is indeed seamless and joined up.
Meet Fred, a 70 year old widower living alone with his dog. Fred has insulin-dependant diabetes, arthritis (can’t give his own insulin), COPD, a fairly recent left leg amputation – and is understandably depressed.
Fortunately, he also has friends who often take him to the pub on Saturday nights – with the consequence that he is a frequent visitor to A&E on Sunday morning. (you haven’t forgotten the dog, have you?)
The challenge is to devise the information set-up to allow the safe management of Fred’s numerous medical and social problems, prevent medical untoward events (what if rheumatology want him on NSAIs but he is already on an ACE inhibitor to protect his kidneys? who decides which is the most important?) – and make sure the dog is looked after when Fred isn’t there!
Oh, by the way, Fred wants to be involved as well..
I’m hoping that anyone interested in the problem will be at the conference and ready to continue the discussion: will anyone be there on Monday afternoon/evening? I’m there Monday evening and both days of the conference..
With just under 4 weeks to go the Programme is pretty much finalised and it looks like we are heading for the biggest even that PHCSG has run for 5 years with final delegate numbers expected to top 200.
We have also announced some additional tutorials on the day before the conference (Monday 9th)
The exhibition is nearly full with new exhibitors confirmed in the last couple of days, but there are still a couple of spaces left.
We have capacity for 300 delegates and still have some of the half prices NHS places left.
The event is shaping up to be the seminal event on IT and Information for GP Consortia in 2011. If you are going to be working in a GP Consortia or want to work with GP Consortia you need to be at this event.
For details about all of the above see the main conference web site www.primaryhealthinfo.org
