15 th November 2005 Royal College of Radiologists
15 th November 2005 Royal College of Radiologists PACS & Teleradiology Group Creative Tensions in Healthcare Provision Dr Lester Russell Chief Medical Officer, Fujitsu © Fujitsu Services 2005
“I need someone expert in the art of extreme torture – do you know Power. Point? ” 2 © Fujitsu Services 2005
15 th November 2005 Royal College of Radiologists PACS & Teleradiology Group Standardisation Interconnection Personalisation © Fujitsu Services 2005
15 th November 2005 Royal College of Radiologists PACS & Teleradiology Group What’s happening in England? © Fujitsu Services 2005
What’s happening in England? “No, the computers are up. We’re down. ” 5 © Fujitsu Services 2005
The Five Clusters • The programme has divided the country into five geographical areas, or "Clusters". • A Local Service Provider (LSP) has been appointed to implement IT systems for the NHS in each Cluster Key 6 Cluster LSP Main Health Systems Supplier Southern Fujitsu Cerner London CCA IDX North East Accenture i. Soft Eastern Accenture i. Soft North West & West Midlands CSC i. Soft © Fujitsu Services 2005
Southern Cluster There are 7 Strategic Health Authorities in the Southern Cluster: 1. Kent & Medway 2. Surrey & Sussex 3. Thames Valley 4. Hampshire & Isle Of Wight 5. Avon, Gloucestershire & Wiltshire 3 5 6. Dorset & Somerset 7. South West Peninsula 6 7 7 © Fujitsu Services 2005 4 2 1
Basic Demographics 8 The Southern Cluster includes: Organisation Type Acute Teaching Trusts 5 • 81 primary care trusts • 63 hospital trusts • 35 social services Large Acute Trusts 12 Medium Acute Trusts 17 Small Acute Trusts 7 Acute Specialist Trusts 3 Mental Health & Community 19 Primary Care Trusts 81 Ambulance Trusts 12 Total 156 © Fujitsu Services 2005 Cluster Total
PACS Deployment – Overall Status – 4 th November • 40 Initial Engagement Meetings completed • Live Services: • West Dorset – PACS • Salisbury – PACS + locally-hosted RIS • Maidstone & Tunbridge Wells – CR / Master. Page / Printers • Dartford & Gravesham – CR / Master. Page + Data Centre-hosted RIS • Poole – CR • Milton Keynes – PACS • James Paget (EEM Cluster) – PACS • PACS Cluster Data Store – fully operational (6, 089, 130 images at 4 th November) • RIS Data Centre Applications and Databases – operational (4 SHA domains in use) • James Paget – data centre connection 2 nd November • Royal Surrey – RIS commenced service on 4 th November • Poole – RIS 7 th November • Gloucester – RIS 7 th November • Dartford & Gravesham – PACS 8 th November © Fujitsu Services 2005
PACS Deployment – Overall Status – 4 th November • Equipment delivered and implementation proceeding at: • East Kent, Ashford & St Peter’s, Gloucestershire, Plymouth Academy, Royal Surrey, Royal Cornwall • Equipment on order for: • NOC, North Hampshire, Maidstone & Tunbridge Wells, Plymouth, Brighton & Sussex (frozen), East Somerset, UHCW (NWWM Cluster), Medway © Fujitsu Services 2005
Service Status 11 © Fujitsu Services 2005
Mission The role of Fujitsu as a Local Service Provider (LSP) is to enable healthcare organisations to improve and maintain health. 12 © Fujitsu Services 2005
Health productivity – the critical quotient max 13 © Fujitsu Services 2005 $
Health productivity – the critical quotient max 14 © Fujitsu Services 2005 €
Health productivity – the critical quotient max 15 © Fujitsu Services 2005 ¥
Health productivity – the critical quotient max 16 © Fujitsu Services 2005 £
Healthcare productivity The people of the UK should not be asking, “How many events for the pound? ” but rather, “How much health for the pound? ” Donald Berwick - President, Institute for Healthcare Improvement, Cambridge MA Measuring NHS productivity - BMJ Vol. 330 30 th April 2005 17 © Fujitsu Services 2005
Healthcare productivity “In five years’ time, you will be your data. ” Prof. Martin Severs – Chairman, Information Standards Board 18 © Fujitsu Services 2005
Enabling change - achieving health benefits Smart deployment of IT systems Service redesign Realisation of health benefits 19 © Fujitsu Services 2005
Enabling change - achieving health benefits Modernisation Smart deployment of IT systems Service redesign Realisation of health benefits 20 © Fujitsu Services 2005
15 th November 2005 Royal College of Radiologists PACS & Teleradiology Group Standardisation Interconnection Personalisation © Fujitsu Services 2005
Future trends Standardisation vs. Localisation 22 © Fujitsu Services 2005
Future trends Localisation “Our National Health Service is also a very local health service – and therein lies one of its key strengths. …what works in one place may not necessarily work in another. The local challenge is to shape services to match the characteristics, needs and priorities of the communities they support…. ” John Reid, Secretary of State for Health Our NHS – Where Next? South West Peninsula Strategic Health Authority 2004 23 © Fujitsu Services 2005
Future trends Standardisation • Patient confidence • Medical risk • Medico-legal risk • Transfer of data • Care across different settings and by different providers 24 © Fujitsu Services 2005
15 th November 2005 Royal College of Radiologists PACS & Teleradiology Group Standardisation Interconnection Personalisation © Fujitsu Services 2005
Future trends Interconnection vs. Fragmentation 26 © Fujitsu Services 2005
Future trends Fragmentation of providers • Purchaser/provider split • Paid-for (but not necessarily providedby) the NHS • NHS as a commissioner • Increased competition 27 © Fujitsu Services 2005
“If you don’t like change, you’re going to like irrelevance even less. ” General Eric Shinseki, Chief of Staff, US Army 28 © Fujitsu Services 2005
Future trends Interconnection • Home-care, primary, secondary and tertiary care • Scheduled and unscheduled • Urgent care and planned care • Healthcare, social care and education 29 © Fujitsu Services 2005
15 th November 2005 Royal College of Radiologists PACS & Teleradiology Group Standardisation Interconnection Personalisation © Fujitsu Services 2005
Future trends Personalisation vs. Commoditisation 31 © Fujitsu Services 2005
Future trends Comparative clinical outcomes analysis • Away from block contracts • Towards Payment by Results (PBR) really payment by activity • Through Practice Based Commissioning (PBC) • To payment by outcome 32 © Fujitsu Services 2005
Future trends Commoditisation • Robust measures of quality • Quality comparisons • Value-for-money approach to commissioning • Personal health choices driven by quality 33 © Fujitsu Services 2005
Future trends Personalised care • Away from secondary care organisations’ menu-driven approach • Towards primary care organisations, as a proxy for patient-driven care • To patient making choices – including out-of-hospital care 34 © Fujitsu Services 2005
National and regional healthcare The enduring functional unit of the NHS is the referral network which surrounds the patient. 35 © Fujitsu Services 2005
Key point summary 1. Standardisation – Consistency of service, transferability of data. 2. Localisation – Services which are responsive to local needs. 3. Interconnection – Care is deliverable in different settings. 4. Fragmentation – Competition amongst providers. 5. Personalisation – Care packages tailored to the individual. 6. Commoditisation – High quality, low cost, high modularity. 36 © Fujitsu Services 2005
Advances in technology Ray Kurzweil New. Scientist. com 24 September 2005 37 © Fujitsu Services 2005
Advances in technology “We won’t experience 100 years of technological advance in the 21 st century; we will witness in the order of 20, 000 years of progress when measured by the rate of progress in 2000, or about 1, 000 times that achieved in the 20 th century” Ray Kurzweil, Inventor and writer 38 © Fujitsu Services 2005
“. . and that’s why we need a computer. ” 39 © Fujitsu Services 2005
40 © Fujitsu Services 2005
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