Update for IM&T Committee – November 2009
1. Introduction
This paper aims to provide the Performance Committee with a summary of the IM&T activities and key issues for the directorate.
2. General
There is still one vacancy which will be filled in the next few months. A temporary project manager has been appointed to help with the implementation of the Cancer Waits module and help with various electronic requesting system projects.
As stated in the IM&T strategy the ICT infrastructure review is under way.
Sickness rates remain high largely due to the same member of staff having multiple bouts of sickness for extended periods. Occupational Health and HR will be consulted again on return from the most recent bout of illness.
Saroj Patel visited Centralised Booking to follow up on the actions identified during the ‘back to the floor’ exercise. Several new facilities have been introduced which will considerably help the work flow and data collection in the team. The success of the exercise has led to requests from other areas. These will be scheduled in the next few months and will also include all IM&T senior managers.
Saroj Patel gave a presentation to the Special Audit Committee meeting to discuss information assurance.
The IM&T Committee approved the IM&T Strategy Implementation Plan and the proposals for the procurement of a new pharmacy system and a fixed asset register system. The Committee also noted the outcome of the internal audit on Information Governance and Information Security.
3. Information Management & Information Governance
The Information Governance Action Plan has still not been completed. The Head of Information has been asked to expedite this. The exercise to update information flows for personal data was launched. Two workshops were held to assist information owners across the Trust to reassess their information flows and their security. The workshops were very poorly attended. The deadline for the completion for the new mapping exercise is the end of October.
There has been continuing work load from 18 weeks which is causing work pressures in the Information Department. To alleviate this external resource was sourced to develop the 18 weeks performance dashboard required by the Department of Health 18 week intensive support team. The work on the dash board has been completed.
As required by all Trusts, an initial pseudonymisation project plan has been submitted to the Department of Health. The delivery of the project will be heavily dependant on further clarification from the centre regarding definition of pseudonymisation, ability of systems suppliers to upgrade their systems and the cost of implementing universal pseudonymisation across all information uses.
All internal and external data submission deadlines have been met. The Information Team has had training on the business intelligence tool Qlikview and on the development tool to application bridges for the Single Sign-on and Context management products. They will now begin to work closely with the RNOH Insight project team to develop the next phase of reporting.
Work has been completed to re-engineer the way cancelled operations data is collected and coded. The codes have been simplified and the same code applied to all areas of the system. Collection of data in multiple systems has been stopped. This should significantly improve the reporting of cancelled operations data.
5. Clinical Coding
In September the RNOH participated in a sense check exercise looking at the proposed national tariff for 2010/11. The Commissioning, Information and Coding departments worked together to report back to the Department of Health Payment by Results (PbR) development team. Work is continuing at RNOH to describe areas where the RNOH is not paid sufficiently and suggest solutions to the PbR team. The feedback from RNOH has included detailed and extensive descriptions of various activity areas and how the PbR mechanism is failing, such as incorrect grouping into HRGs and unfortunate tariffs on some HRGs.
The proposed inpatient tariff is slightly better than this year (09/10), in terms of overall Trust income, but there were significant possible losses due to rule changes around outpatient-based activity, including diagnostic and therapeutic radiology.
The RNOH has developed a good relationship with the PbR development team and we are hopeful of improving the proposed tariff in time for the national Road Test exercise in December 09.
The Audit Commission PbR has been completed and a draft report has been completed. Head of Coding is producing feedback for the auditors. The report will be finalised at the closure meeting in November.
6. Systems Update
6.1 The Patient Administration System (PAS) – iCS
PAS has been stable with no down time. Developments to help Centralised Booking to keep electronic notes of patient contact and to help the infection control nurse to keep clinical notes on high risk patients is being finalised and will be rolled out in the next two weeks.
6.2 Bolsover Street Development
The core network supplier Cisco have informed the Trust that due to global shortage key components to build the new network will not be delivered on time. Urgent meeting has been requested with Cisco senior managers to resolve the issue.
All other Bolsover Street ICT projects are running on schedule.
6.3 London Sarcoma Service System (LSS)
There still has been no progress to recruit the systems administrator nor has there been any progress at UCLH end to connect to the LSS system. The RNOH team are also not using the cancer wait module. In order to progress the latter, a temporary project manager has been employed. Using the Cancer wait module will significantly streamline the collection and production of cancer wait data as well as producing patient tracking lists for management of patient pathways. Successful implementation will be heavily dependant on engagement from the Sarcoma Team.
6.4 PACS
Due to ongoing problems with access to PACS an additional 25 licenses have been purchased.
PACS I200 which enables image sharing between London Trusts has gone live.
PACS 200 which provides image archiving capability has been installed and is currently being tested. There is a concern regarding retrieval times and unless this is satisfactory the Trust will not sign off the project.
Resulting from the Trust’s successful bid for a ‘free’ license for an England wide image sharing an order has been raised with BT to allow us to connect to Electronic Imaging Portal. This will reduce the number of CD’S that the Trust receives saving time and staff resources to load these CD’S onto PACS
The new Direct Radiology x-ray room has been installed at Stanmore and connected to PACS. Staff training has been completed and system is now operational. There has already been significant increase in patient throughput resulting in reduction in imaging related outpatients waiting times.
6.5 Electronic Requesting (ICE)
Work is in progress to extend the use of the ICE system for electronic requesting of Orthotics, Physiotherapy, Occupational Therapy and TCI’s (inpatient admission request). The project manager is working closely with the clinical and clerical staff in each area to ensure that the system will provide them with the information that they require. Once this work has been completed there will be a pilot with a few clinicians. After successful implementation in these areas the system will be expanded to include dietetics, social work, and speech therapy and possibly limb fitting.
As a result of a number of clinical incidents all consultants were reminded of their responsibility to regularly review there ICE mail alerts. A request was made for a written response with details of one additional staff member to be included in their ICE mail alerts and written procedures to ensure that all ICE mail alerts are acted upon. Only a small minority of consultants have provided a response. To progress this, the Imaging Systems Administrator will visit each clinician personally to collect the data. A third letter has been written to all clinicians and they have also been informed that at the request of the SHA an audit of compliance will begin from December 2009.
7. New Major Projects Update
This section provides highlight reports for major projects underway which were not discussed in Section 6 above
S. Patel, November 2009 Page 11 of 11
S. Patel, November 2009 Page 11 of 11
8. ICT
A technical expert has been employed to carry out a detailed network infrastructure review. The objective is to audit the implementation of the very significant network infrastructure upgrade implemented in the last three years and to recommend a development plan for the next 2 years. This will also include implementation of standards, policies and procedure as well as service improvement initiatives.
The help desk activity is shown on the next page.
Help Desk Call 7 September - 9 October 2009Total Work Orders / Pending Work Orders / Over Due Work Orders / Closed Work Orders
iCS / 83 / 3 / 3 / 77
Printer / 85 / 6 / 0 / 79
Microsoft Outlook / 16 / 0 / 0 / 16
Hardware/PC / 49 / 1 / 4 / 44
Email / 95 / 1 / 1 / 93
Reset Password / 25 / 0 / 0 / 25
Software/Application / 61 / 1 / 0 / 60
Access to Calender / 15 / 1 / 0 / 14
Unlock Account / 15 / 0 / 0 / 15
Enable Account / 13 / 0 / 0 / 13
PACS / 13 / 1 / 1 / 11
File/Folder Access / 54 / 2 / 3 / 49
Create User Account/E-mail/iCS ID / 79 / 0 / 3 / 76
Amend Email Address Book / 12 / 0 / 0 / 12
Other / 198 / 13 / 2 / 183
Total Jobs / 813 / 29 / 17 / 767
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