Informed Health And Care - Welsh Government

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Informed Health and CareA Digital Health and Social CareStrategy for Wales

ContentsMinisterial Foreword3What is this strategy about?5Our vision6Introduction7Information for you11Supporting professionals17Improvement and innovation23A planned future27Next steps29Ofcom: Communications Market Report: Wales (August 2015)30References31Digital ISBN 978 1 4734 2313 Crown copyright 2015WG24851A Digital Health and Social Care Strategyfor Wales2

Ministerial ForewordImproving access to information and introducing new ways of delivering carewith digital technologies must be at the heart of our service plans and our visionfor prudent healthcare.While so many of us use digital technologyat work or for shopping, banking, booking aholiday and keeping in touch with family andfriends; health and care providers should alsooffer more interactive, personalised health andsocial services.At a time of continued austerity, with increasingdemand and unprecedented pressureson services, this strategy recognises theopportunities to support service efficiency, safetyand quality by improving access to informationand introducing new ways of deliveringclinical services and care supported by moderninformation and digital technologies for a betterinformed and digitally-enabled future.It is critical that the benefits of digital toolsand online access to information are availableto health and care professionals and thosedelivering our health and social care services inWales as well as citizens. Patients, carers andhealth and care professionals should be ableto make use of accurate information, safely,wherever and whenever it is needed.People have told us they want to be wellinformed and supported to manage their ownhealth; they want to be protected from harmand protect themselves from known harm;they want to be able to receive the right careas locally as possible and be able to contributeto making that care successful; they want tohave timely access to services based on clinicalneed and be actively involved in decisionsabout their care.We should be able to view our owninformation relating to our health and careto enable us to take care of ourselves andcontinue to live independently for as long aspossible and to play an active role in decisionsabout the services, care and support we need.A Digital Health and Social Care Strategyfor WalesMark Drakeford AMMinister for Health and Social ServicesWe should be using technology to delivereffective treatment and help professionals andpatients work as partners, while ensuring thatconfidential and sensitive information is secure.This strategy builds on the previous InformingHealthcare (IHC) strategy and nationalimplementation programme that has delivereda national infrastructure and a strong technicalplatform.The IHC programme was established by WelshGovernment with the aim of providing a singleintegrated electronic patient record with dataavailable when and where it is required.In Wales, new technology has been adoptedincrementally and with the consent of healthprofessionals, avoiding the pitfalls of the largescale technology change experienced in othercountries. This approach has favoured theadoption of common, standardised servicesusing modern web-based technology.Clinical engagement has been importantfrom the outset, with delivery driven by acommitment to learning from experience.3

Listening to the needs of the service andservice users has ensured new informationservices provide the necessary assurancesaround information governance, consentand patient safety.on the patient, including ordering tests,creating and viewing electronic documents(e.g. referrals and discharge summaries), andenabling pharmacists to maintain more accuratemedications records.As a result, Wales has a national technicalplatform to support the integration neededto transform services with national services,and common solutions making it easier forhealth and care professionals to work acrossboundaries and improve the continuityof care.We have benefited from a ’once for Wales’approach and will continue with this as aprinciple in working with our universitiesand industry partners, both nationally andinternationally, to develop rapid, flexible andinnovative digital solutions.GPs in ‘out of hours’ services can accessthe electronic medical records held by thepatient’s GP. This service will shortly be madeavailable in all unscheduled care settings,including Accident and Emergency, improvingpatient safety and allowing treatment tobegin more quickly.In our hospitals, health professionals canview information from a range of sourcesthrough a dedicated web service calledthe Welsh Clinical Portal. It streamlines theprocesses needed to support care centredA Digital Health and Social Care Strategyfor WalesWhile this document sets the direction for thenext five years, the ever-quickening pace oftechnological change and innovation meansthat it is not intended as a detailed blueprintfor that period. Rather, it sets out our ambitionsand expectations which will deliver real benefitsand improved outcomes for people in Wales.Mark Drakeford AMMinister for Health and Social Services4

What is this strategy about?Digital technologies and online services have become part of the daily lives ofmany people in Wales. We can bank, shop, work, read, enjoy music and films,book holidays and stay in touch with friends and colleagues across the globeonline, using PCs, tablets and mobile devices such as smartphones.This strategy outlines how we will usetechnology and greater access to informationto help improve the health and well-beingof the people of Wales. It describes a Waleswhere citizens have more control of theirhealth and social care, can access theirinformation and interact with services onlineas easily as they do with other public sectors orother aspects of their lives, promoting equitybetween those that provide and those that useour services in line with prudent healthcareand sustainable social services.It describes a Wales where health and socialcare professionals have access to the samedigital tools in the workplace as they enjoy athome or would in other industries, so they areable to focus on delivering safe, high-quality,efficient care and plan for workforce and servicechange based on digitally-enabled approaches.Although the digital world continues to expandthere will be people in Wales who may not wishto access information or engage with services,advice and support in the ways described in thisstrategy. In these circumstances people will besupported and will have alternative options toaccess services and information, enabling themto remain active participants in their healthand well-being. Staff, too, may lack skills orthe confidence currently to use technologyor engage in service redesign and new waysof working using digital tools. Managing thecultural change and workforce developmentrequirements aligned to this strategy will bea key focus for NHS organisations and localauthorities.We want a future where staff, service users,patients and carers are empowered and betterinformed, where organisational boundaries arenot a barrier to effective care, as informationis available electronically and joined-up, andwhere innovation and improvement can flourishbuilt on a solid technical infrastructure and asafe environment for those who work in or areserved by health and care services in Wales.Collaboration, planning and joint working acrosspublic services, with industry and academia, willbe an important feature, ensuring that Walescan react quickly to the pace of digital changeand identify ways in which best practice can beadopted to ensure the benefits are realised forthe people of Wales.A Digital Health and Social Care Strategyfor Wales5

Our visionInformation for youPeople will be able to look after their own well-being and connect with health and socialcare more efficiently and effectively, with online access to information and their own records;undertaking a variety of health transactions directly, using technology, and using digital tools andapps to support self care, health monitoring and maintain independent living.Supporting professionalsHealth and social care professionals will use digital tools and have improved access to informationto do their jobs more effectively with improvements in quality, safety and efficiency. A ‘once forWales’ approach will create a solid platform for common standards and interoperability betweensystems and access to structured, electronic records in all care settings to join up andco-ordinate care for service users, patients and carers.Improvement and innovationThe health and social care system in Wales will make better use of available data and informationto improve decision making, plan service change and drive improvement in quality andperformance. Collaboration across the whole system, and with partners in industry and academia,will ensure digital advances and innovation is harnessed and by opening up the ‘once for Wales’technical platform allow greater flexibility and agility in the development of new services andapplications.A planned futureDigital health and social care will be a key enabler of transformed service in Wales. Joint planning,partnership working and stakeholder engagement at local, regional and national level will ensurethat the opportunities and ambitions outlined in this strategy are prioritised, with planningguidance issued by Welsh Government in 2015.Informationfor youSupportingprofessionalsImprovementand innovationConnect with health& social care.Health & Social CareProfessionals usedigital tools to dotheir jobs gital toolsand apps.‘Once for Wales’Look afteryour ownwell-beingCreates solidplatform betweensystems.A Digital Health and Social Care Strategyfor Wales Improve decisionmaking Better use of data Plan service change Improve qualityand performance.A planned futureJoint planning,partnership working& stakeholderengagement ensureopportunitues areprioritised.6

IntroductionHuge advances have occurred over recent years in our personal use andaccess to information, computing applications and online services. Significantopportunities now exist to improve the everyday experiences of both the publicand our health and social care workforce in Wales.This document sets out our ambition to buildon the progress we have already made andtransform how the people of Wales, ourcitizens and staff, embrace modern informationtechnology and digital tools to deliver safer, moreefficient and joined-up health and social careservices to improve outcomes and experiences ofpatients and service users.Building on the foundation we already havein Wales, such as our single public sectorbroadband networki and a national deliveryorganisationii, this strategy marks the next stepsin our journey to provide the information andmodern digital services which enable: People to manage their own well-being andconnect with health and social care servicesmore efficiently and effectively and have thebest possible experiences when they needadvice, support, treatment and care. Health and social care professionals to dotheir jobs and deliver safe, high – qualityservices. Planners and policy makers to shape servicesto meet the needs of current and futuregenerations.This strategy builds on the previous InformingHealthcare (IHC) strategyiii, launched morethan a decade ago, which has seen NHSorganisations and the NHS Wales InformaticsService (NWIS) working collaboratively to developand deliver all-Wales IT systems and services.The IHC strategy has enabled NHS Wales tomake significant progress in establishing thekey elements of the infrastructure and technicaldesign (the way our systems are intended towork together) so we are well placed from atechnical perspective to build on this to supportfuture care transformation.A Digital Health and Social Care Strategyfor WalesServices developments include: Welsh Clinical Portal, which is the main accesspoint to information for hospital clinicians.It pulls together key information from themany systems used by hospitals, allowingthe clinician to view a patient’s record in oneplace and use a common system to performvarious tasks e.g. requesting tests, reviewingresults or creating a discharge advice letter. Welsh Imaging Archive Service, includingPACS, picture archiving and communicationsservice, a single solution for Wales supportingthe transfer of digital X-rays, scans andimages. Welsh Radiology Information System (orRadis), the all-Wales radiology managementservice used for patient scheduling, clinicalreporting, resource allocation, managementreporting, clinic and waiting timesmanagement. Welsh Results and Reports Service, whichincludes the Welsh Laboratory InformationManagement System, a modern integratedsolution for the whole of Wales, allowing testresults and investigation reports to be viewedwherever the patient receives care. Welsh General Practice Record (or individualhealth record), allowing out-of-hours andemergency services to see an electronic copyof the medical record held by the patient’s GP. Welsh Clinical CommunicationsGateway, used to send electronic clinicalcommunications from primary care tohospitals and other settings across Wales. Canisc, a computer system supporting thecare of patients with cancer.7

National Directory email Exchange (Nadex),allowing staff to log on to systems andservices regardless of where they access acomputer, with a single up-to-date addressbook and an email address “for life” foras long as staff remain within NHS Wales.This also provides a unique identity for NHSstaff which is used to authenticate users tonational systems securely. Welsh Patient Administration System,“Myrddin”, used in six out of sevenhealth boards in Wales to manage patientscheduling. Master Patient Index which enables a patientto be uniquely identified and their identitycross referenced with records held in othersystems.Our

health and care professionals to work across boundaries and improve the continuity of care. GPs in ‘out of hours’ services can access the electronic medical records held by the patient’s GP. This service will shortly be made available in all unscheduled care settings, including Accident and Emergency, improving patient safety and allowing treatment to begin more quickly. In our hospitals .

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