© Fujitsu Services 2005 Royal College of Radiologists PACS & Teleradiology Group 15 th November...

Royal College of Radiologists PACS & Teleradiology Group

15th November 2005

© Fujitsu Services 2005

Creative Tensions in Healthcare ProvisionDr Lester RussellChief Medical Officer, Fujitsu

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“I need someone expert in the art of extreme torture – do you know PowerPoint?”

Royal College of Radiologists PACS & Teleradiology Group

15th November 2005

© Fujitsu Services 2005

Standardisation

Interconnection

Personalisation

Royal College of Radiologists PACS & Teleradiology Group

15th November 2005

© Fujitsu Services 2005

What’s happening

in England?

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What’s happening in England?

“No, the computers are up. We’re down.”

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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

Cluster LSPMain Health Systems

Supplier

Southern Fujitsu Cerner

London CCA IDX

North East Accenture iSoft

Eastern Accenture iSoftNorth West & West

Midlands CSC iSoft

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Southern Cluster

12

3

4

5

67

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

6. Dorset & Somerset

7. South West Peninsula

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Basic Demographics

The Southern Cluster includes:• 81 primary care trusts • 63 hospital trusts • 35 social services

Organisation Type Cluster Total

Acute Teaching Trusts 5

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

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PACS Deployment – Overall Status – 4th November

• 40 Initial Engagement Meetings completed

• Live Services:• West Dorset – PACS

• Salisbury – PACS + locally-hosted RIS

• Maidstone & Tunbridge Wells – CR / MasterPage / Printers

• Dartford & Gravesham – CR / MasterPage + 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 2nd November

• Royal Surrey – RIS commenced service on 4th November

• Poole – RIS 7th November

• Gloucester – RIS 7th November

• Dartford & Gravesham – PACS 8th November

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• 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

PACS Deployment – Overall Status – 4th November

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Service Status

Cumulative Images

0

1,000,000

2,000,000

3,000,000

4,000,000

5,000,000

6,000,000

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Mission

The role of Fujitsu as a Local Service Provider (LSP) is to

enable healthcare organisations to improve and maintain health.

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Health productivity – the critical quotient

$max

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Health productivity – the critical quotient

€max

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Health productivity – the critical quotient

¥max

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Health productivity – the critical quotient

£max

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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 30th April 2005

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Healthcare productivity

“In five years’ time, you will be your data.”

Prof. Martin Severs – Chairman, Information Standards Board

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Enabling change - achieving health benefits

Smart deployment of IT systems

Service redesign

Realisation of health benefits

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Enabling change - achieving health benefits

Smart deployment of IT systems

Service redesign

Realisation of health benefits

Modernisation

Royal College of Radiologists PACS & Teleradiology Group

15th November 2005

© Fujitsu Services 2005

Standardisation

Interconnection

Personalisation

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Future trends

Standardisation vs.

Localisation

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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

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Future trends

Standardisation

•Patient confidence•Medical risk•Medico-legal risk•Transfer of data •Care across different settings and by different providers

Royal College of Radiologists PACS & Teleradiology Group

15th November 2005

© Fujitsu Services 2005

Standardisation

Interconnection

Personalisation

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Future trends

Interconnection vs.

Fragmentation

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Future trends

Fragmentation of providers•Purchaser/provider split•Paid-for (but not necessarily provided-by) the NHS•NHS as a commissioner•Increased competition

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“If you don’t like change, you’re going to like irrelevance even less.”

General Eric Shinseki, Chief of Staff, US Army

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Future trends

Interconnection •Home-care, primary, secondary and tertiary care•Scheduled and unscheduled•Urgent care and planned care•Healthcare, social care and education

Royal College of Radiologists PACS & Teleradiology Group

15th November 2005

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Standardisation

Interconnection

Personalisation

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Future trends

Personalisation vs.

Commoditisation

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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

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Future trends

Commoditisation•Robust measures of quality •Quality comparisons•Value-for-money approach to commissioning •Personal health choices driven by quality

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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

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National and regional healthcare

The enduring functional unit of the NHS is the referral network

which surrounds the patient.

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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.

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Advances in technology Ray Kurzweil NewScientist.com 24 September 2005

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Advances in technology

“We won’t experience 100 years of technological advance in the 21st 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 20th century”

Ray Kurzweil, Inventor and writer

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“..and that’s why we need a computer.”

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