Digital Health The Future Landscape

www.handihealth.org
www.woodcote-consulting.com/blog
ewan@woodcote-consulting.com
@handihealth @woodcoteewan @nhsopensource
Ewan Davis Director HANDIHealth Community Interest Company, Director
Woodcote Consulting, Consultant to NHS England Open Source Programme,
Member Health and Social Care Council TechUK
Past Chairman PHCSG

First a Historical Detour
1911 National Insurance Act
Socialist Medicine and the Health Centre
Movement
The Peckham Experiment
www.thephf.org
Pine Street Health Centre

1966 GP Charter
1981 PHCSG Formed
1987 Free Schemes
1990 First Public Internet Service Provider in UK
PHCSG pioneers discovery alt.sex.binaries , learn how to use a
mouse with their left hands and set up GP-UK


1991 GP Fundholding
2004 GP Contract
2000 The NPFiT
Era of Digital Health
Apps and the formation of HANDI Health
NHS Hackdays
Open Data, Open Systems, Open Source
The Changing Landscape
An imperative to harness digital technology and Big Data to address
health and care challenges
The Internet revolution
A proliferation of apps and devices
From organisational to patient centred Driven by a consumer
health revolution
Massive challenges for primary care

Challenges for Primary Care
Increasing demand
More complex patients
Extended access
Care planning for LTCs
Integrated care
Virtual Wards, Hospital at Home
GP as care manager, patient advocate and commissioner
Massive workload pressures
Changes in the workforce and GP shortages


Not quite dead but off it legs!
The Dominant model of
General Practice established
in the 1970s based on the GP
partnership and developed
over the past 40 years has
been taken as far as it can go
is now End of Life
What Next?
GP Federations
http://www.kingsfund.org.uk/topics/commissioning/primary-care-toolkit
http://www.rcgp.org.uk/policy/rcgp-policy-areas/inquiry-into-patient-centred-care-in-the-21st-century.aspx

Accountable Care Organisations
Led by GPs
Led by NHS Trusts
http://www.kingsfund.org.uk/publications/accountable-care-organisations-united-states-and-england

Implications for Digital Health
The Changing Landscape
Megasuite
Best of
Breed
Platform
Open
Ecosystem
One system to rule them all
NPfIT
Enterprise/GP Systems
Limited external integrations
Many systems ~ 100
Portals
Integration engines
Bespoke integrations
Own the Platform
Health Vault, Apple, Lorenzo, etc
~1000 apps
Partner interfaces (Woodcote L3)
The Internet of Digital Health
HANDI-HOPD
The Healthcare Services Platform
Consortium
eHealth - City of Moscow
Reproduced with permission
http://bit.ly/1w9wZQy
Challenges for GP IT
Opening up Building of GPSoC-R
Integration with the ecosystem
patient record access integration with PHRs, wearable tech and
social media. Fredbook?
New business models create challenges and opportunities for
existing GP suppliers
New opportunities for new entrants Particularly apps and
subsidiary systems OpenGPSoC?

Not the time to retire
The time to be young again

Digital Health The Future Landscape
www.handihealth.org
www.woodcote-consulting.com/blog
ewan@woodcote-consulting.com
@handihealth @woodcoteewan @nhsopensource
Ewan Davis Director HANDIHealth Community Interest Company, Director
Woodcote Consulting, Consultant to NHS England Open Source Programme,
Member Health and Social Care Council TechUK
Past Chairman PHCSG