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Dr Amir Hannan Full-time General Practitioner (www.htmc.co.uk)
Information Management & Technology clinical lead, NHS Tameside & Glossop
Primary Care IT lead, NHS North-West Member of the HealthSpace Reference Panel, NHS
Connecting for Health Member of the Clinical Leaders Network
amir.hannan@nhs.net Cartoon taken from www.mediclicks.net
Yvonne Bennett Patient of Haughton Thornley Medical
Centres Member of the local Care Record
Development Board Member of the HealthSpace Reference
Panel, NHS CfH
Real-time Digital Medicine from a patient perspective
“…after a recent visit to Thornley house Dr Hannan put me wise to your web site. WOW so much info for an old timer to take in but well worth the effort on my part. I really like the self care section and the lab test on line is great now.. It’s not so much as have a jab and wait two weeks you can see what they are testing for it makes it a lot better when you know up front .well got a lot more surfing to do well done all at thornley house and doctor hannan give yourself a rise ?”
Quote from another patient of mine
% of patients NOT complying with medications by disease area
asthma 80% diabetes 55% hypertension 40% epilepsy 40% arthritis 35%
The system is not working…. There is a need for tools to help to inform as
well as manage care better for patients
So what’s the challenge ?
Drug
Clinician Patient
What’s the problem ? Patient’s condition worsens
Rushed doctor who
needs to meet a target
Pill prescribed with little
explanation
Poor concordance
Poor compliance
It’s not as simple as that! I forgot to take the tablets I didn’t realise that I had run out of tablets Your receptionists told me I had to wait 48 hrs to get my repeats The pharmacist only gave me 21 tablets and the receptionist
wouldn’t give me a repeat because I wasn’t due yet! The chemist orders them for me I didn’t know I had to take them I don’t like taking tablets Do you think I could stop the injections and go back to tablets? What about those who are foreign speaking with mental health
problems?
What is happening? Patient comes
to clinician
Clinician tells patient what to
do
Patient complies (or
chooses not to or forgets)
Patient comes to clinician Clinician / patient
explains what they are trying to do
Clinician provides information to help
patient to understand the condition, treatment,
where else to learn more and what else to do
How does this happen? Shared understanding of the problem
History Examination Differential diagnosis Access to health record
Shared understanding of the solution What clinician will do and what patient will do Access to high quality information (Map of Medicine) Access to health record
The Partnership of Trust
The Paradigm Shift in Healthcare
IT based health care system Internet Increase (generally) in health literacy Access to trusted health informatiom for patients
builds confidence Patient access to Electronic Health Record Patient choice Choice leads to better outcomes & hopefully
improved concordance
The “eMPOWERed Patient”
Reactive vs Proactive Passive Enabled Informed Empowered eMPOWERed
Patient Person Family
Are you eMPOWERed yet ? e Medical Patient and the Public cOmmunication World wide web Electronic Record
What am I doing in the consultation Listen to the patient, gain an
understanding of their health belief and their surroundings
Encourage them to become active partners Create a shared plan with SMART goals Enable patients to choose the plan Encourage patients to get access to their
electronic health records OR ask how they are using it
What am I doing in the consultation Provide tools for the patient to refer to via the
practice website NHS Choices HealthSpace Map of Medicine Framework for understanding how the practice can support the
patient
ALWAYS allow the patient to come back Share stories about other patients and how their
plans have improved their care Link the practice website to their needs and
wants
An eMPOWERed Patient
Yvonne M Bennett
So what makes us different? We take care of our own health We are part of a ‘partnership of trust’ with our doctor We have access to a computer, not necessarily our own We are NOT STUPID, we are aware of security issues We tend to
Shop online Check insurance quotes Book holidays Use internet banking And many more
So WHY NOT maintain our health online!
A consultation with the doctor We discuss with the doctor our health problem We listen to their advice We may question their suggested medication
This isn’t to challenge the doctor but to find what is best for us
We may not accept the medication just then We may want to do our own research We may have personal moral issues with some
medications We DO get back to our doctor
So where do we go? Everybody has their own favourite sites Encouraged to use trusted websites
These could be Our Practice website patient.co.uk NHS Choices BBC
Haughton Thornley Medical Centres www.htmc.co.uk
Haughton Thornley Medical Centres www.htmc.co.uk
Information re Aspirin
Information re aspirin
Information re aspirin
Haughton Thornley Medical Centres www.htmc.co.uk
Once we have decided We go back to see our doctor We then discuss our findings We could have a different medication to the one
suggested Or we just accept the offered medication
So what next? We now take charge We decide to try the new medication We fit this into our regime How?
Patient access to GP record
Patient Access to GP record
Patients or their families
can order repeat
prescriptions on-line
Can easily see what
patients are taking and not taking
Blue i button gives further information directly from the repeat
script explaining what the
medication is for
Up-to-date repeat
prescriptions
Patient Access to GP record – order repeats
Information re aspirin
Ordering repeat prescriptions
Ordering repeat aspirin
Access GP record
Access GP record
GP record - Summary screen
Consultations
Book appointment online
Links to diabetes
Foot care for diabetes
Results
Information re blood tests
Letters
Using HealthSpace
Using HealthSpace
Using HealthSpace
Using HealthSpace
Using HealthSpace
Using HealthSpace
Using HealthSpace
Using Map of Medicine
How do I manage my medication? I know I need to take my medication regularly The best way is to make it part of my routine Always making sure that my repeats are ordered well
in advance at least 1-2 weeks in advance Attending medications reviews Plan for holidays (including public holidays) For the eMPOWERed it couldn’t be simpler Anytime day or night 24x7
Ways we remember to take our medication
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