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Highlights from Digital Health's Best Practice Webinar on actionable insights

2 December 2020

2Dec webiinarUsing data to produce actionable insights and target transformation effort across health and care systems was the subject of a well-attended Digital Health webinar on 2 December 2020.

The event was presented by Sharon Boundy, associate director for system transformation from Frimley Health and Care ICS and Mark Sellman, CIO for Frimley ICS and programme director for Connected Care, and chaired by Jon Hoeksma, CEO and founder of Digital Health.

Sharon Boundy started the session with an introduction of the Connected Care digital ecosystem, provided by Graphnet, which encompasses the shared care record, person health record, and population health intelligence platform.

The Connected Care ecosystem is used across Frimley Health and Care ICS and Berkshire West ICP and was described as a key enabler of the ICS’s ‘Creating Healthier Communities’ strategy which focuses on two main priorities: increasing healthy years lived and reducing inequality.

The shared care record element of Connected Care holds data on the area’s 1.34 million residents and is accessed 30,000 times per month by authorised health and care professionals across 139 different organisations. Sharon said the shared record was a fundamental building block for the Connected Care infrastructure, where additional information such as national, lifestyle and operational datasets, could be drawn together to generate a “flow of integrated datasets into a population health platform”.

Drilling down from the population level to patient level

Mark Sellman then gave an overview of their intelligence platform, jointly developed by Graphnet and Frimley ICS. The platform comprises of a number of real-time or near real-time ‘dashboards’ that visualise the different data insights and includes tools to “drill down from the population level to patient level”.

To illustrate this point, Mark provided a live demonstration of the Covid dashboard and Enhanced Case Finding tool. He showed how you could identify high risk cohorts within the ICS (e.g. Slough residents that tested positive for Covid and are at high risk of a more severe form of the disease) and share these lists of individuals with care providers, such as GPs, for targeted and proactive care.

Screenshot Sharon, Mark and Jon

Care@Home Virtual Ward
This led to Sharon explaining their Care@Home Virtual Ward which is providing pulse oximeters to vulnerable residents, identified by the population health platform, for them to self-record their oxygen saturation levels. Information is input into the Connected Care Person Health Record (PHR) app which will then be added to the shared record. “It’s a simple front-end for residents, supports self-care and well-being,” said Sharon.

Another example of actionable insight was their use of data intelligence to inform actions relating to mental health. Looking at how the working age population has been affected by Covid 19, you could see how some areas were disproportionally affected by increasing job losses/furloughed staff and that demand on mental health services was disproportionately higher for younger white and deprived adults.

Advice for integrated care systems

The two presenters concluded the webinar with advice on how other areas could deploy population health management to plan and deliver more targeted and proactive care. In particular:

  • How to overcome Information Governance (IG) challenges.
    An IG board was established early on and through clear demonstrations of exactly how the data was being used, trust and confidence was built. Stakeholders were assured that data was being used appropriately and every new use case for the data has to be approved by the IG board. This governance structure enabled 150 Data Sharing Agreements (DSAs) to be signed up in one week and also means there is no need to rely on COPI notices.

  • Answer the “so what” question to get stakeholder buy-in.
    Data insight needs to have meaning for the stakeholders in your community, and demonstrate practical applications for their patients/residents.

  • Data fairies don’t exist, data is not magically gathered overnight.
    Connected Care’s data has evolved over years as trust and relationships with different care organisations has developed. The shared care record provided a rich dataset and the foundation to augment additional datasets gathered from the third parties and national sources such as Test and Trace. “There are no shortcuts and success breeds succeeds” added Mark Sellman.

Watch the webinar here 

Further information

Please contact us for more details on any of the topics covered by the webinar or for a general conversation on how we can support your integrated care objectives.

Screenshot 2020-12-21 122751

Watch the webinar

Webinar feedback:

"OMG how fantastic is this!"

"Truly, truly impressive"

"Most advanced pop health solution I've seen in UK so far congratulations!"


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