eHealth Update for NMAHP eHealth Leads Network

9th March 2010

Introduction

This eHealth update provides an overview of eHealth objectives and progress towards these objectives. A list of events is also provided. All this information can be found on the NMAHP eHealth Managed Knowledge Network and should be shared as wide as possible with NMAHP colleagues.

eHealth objectives

Current eHealth objectives include:

Clinical Portal - To enable all Boards to implement a clinical portal incrementally, improving the access to information in support of safer, more efficient and effective care.

Primary and Community Care - To establish a Primary and Community care development fund that will enable NHS Boards to use it to invest in information support for shifting the balance of care.

Patient Journey - To improve the management of patient journeys: encouraging integration of clinical and management systems to provide more effective, efficient and safer care.

Governance - To improve the governance of investment and particularly the governance of benefits, to ensure decisions are affordable, implementable, usable and acceptable.

Information Assurance - To ensure we have an assurance strategy and information governance policies, which support the efficient and effective use of existing and planned systems

Efficiency - To ensure we have strategies for managing and reducing IT cost and for developing IT investment programmes, which reduce the cost of providing healthcare.

Clinical Portal Project

The “Discovery” project has recently identified the current capabilities, products and services that are already available to NHS Scotland in relation to the clinical portal requirements; to inform the development of a catalogue of components and services. It is anticipated that the catalogue will be available end of 2010 and will facilitate health boards to create their own clinical portal. Health Boards also recognise the value of working together in regional groups to develop a Clinical Portal. The west region will look at the impact and alignment of PMS with the clinical portal, while the north will explore alignment with GPIT. The southern region is interested in exploring the portal presentation layer.

A national survey of clinicians asked them to consider their information needs and priorities. As a result four main types of information will be delivered in the early stages of the portal programme. These are: patient health summary, clinical letters, diagnostic test results and knowledge support, such as access to clinical guidelines. The method by which Boards actually provide this information may vary, depending on: their approach to portal implementation, the identification of where these information sets are currently held and what work needs to be undertaken to ensure that these information sets are deliverable.

Primary and Community Care

A demonstrator project that supports Community Nursing Teams, Mental Health Teams and Allied Health Professionals is currently being taken forward by NHS Tayside, NHS Lanarkshire and NHS Dumfries and Galloway. The Multidisciplinary Information System (MiDIS) project provided an opportunity for each area to review existing Community Nurse, Mental Health, Allied Health Professional and Single Shared Assessment services and consider information sharing requirements with acute practitioners. The concept behind MiDIS was to develop a set of core, shared modules with integration to existing key eHealth services supported by a feature rich form builder service. The modules include messaging and a shared record home page, with a user directory and patient search functions. The form builder service allows users to create data capture forms to support care plans, assessments etc., without the need for any technical development resource. The main benefit of such an approach is to make the IT system more responsive to services demands and changes. A single forms library is now established, which can be shared across the various service groups enforcing common data standards and improving data quality. A number of other Boards have expressed an interest in implementing the product. There are also plans in Tayside to link MiDIS to the GP record.

To support GPIT in all Boards, a framework contract for GPIT was put in place in February 2010 and Boards can now move over to EMIS and VISION. The last GPASS practice is expected to migrate by spring 2012. These systems have community modules that can be purchased by Boards.

A number of projects are in development to support Patient eHealth. They include; NHS Inform, which is being led by NHS 24. NHS Inform will provide:

· a single shared health information online resource via nhs24.com which will bring together quality assured national and local information from across the NHS and other sectors.

· a national health information helpline;

· a coordinated, network approach to the delivery of information via direct access information points, embedded within NHS Scotland and local communities.

For further information contact Arlene Campbell, Health Information Co-ordinator at

NES have also been developing educational support approaches for the knowledge worker role. A demonstrator of a patient portal for patients with long term conditions is currently underway in NHS Ayrshire and Arran. The project aims to develop a patient engagement model, provide a secure access model, and identify benefits and share lessons learnt in relation to functional requirements that have been identified by patients to support them to manage their health. Discussions with patients and NHS professionals have identified the main capabilities, which include a broad range: encompassing access to information both from NHS healthcare provider records; and trusted sources on health, diseases and their treatment options; as well as the ability to access services and utilise electronic communication channels. The priority is for people to be able to personalise their own portal.

The patient portal project will include a pilot of eCorrespondence in order to support improved communication with patients. There is clear evidence that web technology is increasingly used by the public to share personal information between individuals and organisations. National correspondence sent by the NHS to patients (estimated at 20M per year) could benefit from an e-solution, if a sufficient number of patients elected to receive their correspondence using e-technology. Potential benefits include: reduced cost of paper correspondence, paper usage and process lead times; as well as single source for all patient health correspondence, which patients; their delegated representatives and authorised clinicians may reliably and quickly access.

Supporting the Patients’ Journey

The preferred bidder InterSystems and NHS National Services Scotland have signed a national framework contract for a replacement Patient Management System for NHSScotland. The new system is InterSystems TrakCare™, a connected healthcare system that will help to speed up and improve the effectiveness of patient care. Patient information will only need to be entered once to make it immediately accessible by authorised staff in other hospital departments. TrakCare’s functions include general hospital patient administration with complex scheduling, clinical support tools, order communications functionality and results reporting. The contract is a national framework in line with the eHealth Strategy that will enable any Health Board access to the system and associated modules over the next four years. Initially, the five Consortium NHS Boards involved (Ayrshire & Arran, Borders, Grampian, Greater Glasgow and Clyde, and Lanarkshire) will place contracts.

NHS Fife, Grampian, Lothian and Tayside have been commissioned by the Scottish Government to run pilot projects with the aim of improving their existing bed management and infection control capabilities. The projects are expected to be up and running shortly and will be independently evaluated by Deloitte.

The Emergency Care Summary (ECS), which is an extract of the patients’ GP record containing; patient demographics, allergies and adverse reactions to medications, and medication history; is available Scotland wide to NHS 24, Out of Hours Services, A&E departments, some acute receiving units and pharmacists. It is currently being piloted with the Scottish Ambulance Service. Its dataset has been expanded to include a Palliative Care Summary, which will support the Gold Standards Framework Scotland. The palliative care dataset contains: a palliative care register flag consent, carer and key professionals details, diagnosis and current treatment, preferred place of care, current care arrangements, patient and carers awareness of their condition and advice for Out of Hours services. Further developments to ECS are currently being explored including extending access to ECS for other authorised clinicians and extending the dataset to include special notes for people with long term conditions. This could include: patient and carer information, patient preference, existing care plan indicators, power of attorney and guardianship details. Governance issues and capacity also require to be considered with these potential expansions. Further information:

ECS http://www.scimp.scot.nhs.uk/clinical_ecs.html

ePCS http://www.scotland.gov.uk/Topics/Health/NHS-Scotland/LivingandDyingWell/ePCS

Telehealth - Project teams establish in all Boards (except GG&C) to support Telestroke project

· National Sexual Health – 8 Boards have gone live todate.

· National Theatre Project – NHS Fife and A&A will start implementation along with other phase 1 Boards

· PACS and RIS – The national PACS programme is live in 36 sites

· Renal Clinical System – Some delays have been noted however phase 3 will deliver end of February 2010

Governance

The eHealth Programme has established 4 Portfolio Management Groups (PMGs) to oversee and help implement key eHealth systems and products through their operational shelf-lives. Groups have been established in 4 categories – Clinical, Public, Health, Business Systems, and Infrastructure. Portfolio Management Groups exercise a strategic co-ordination function. They act as a forum for detailed consideration of how changes to the products and systems, within each portfolio, will support the delivery of the eHealth Strategy.

Information Assurance

Information governance is essential to enable appropriate sharing of patient information to support person centred care The Information Governance Team in ISD has been commissioned to facility the review of the NHS Scotland Code of Practice on Protecting Patient Confidentiality, which was last published in 2003. The final document will be published and distributed from May 2010 onwards.

Events

eHealth in Action - RCN Scotland and the Scottish Government are holding a free one-day eHealth event called eHealth in Action on 25 March 2010 at Victoria Quay, Edinburgh. The event is intended for a wide audience of clinicians, managers and educationalists and will provide an opportunity to:

· see various kinds of technology and other uses of eHealth in action.

· try out a range of interactive resources.

· try new initiatives in a safe and friendly environment.

· find out about the RCN eHealth contribution to eHealth.

· find out what RCN resources are available to you.

· hear about the Scottish Government’s commitment to using eHealth to support high quality healthcare in the NHS.

· find out how you can contribute to eHealth.

Go to the RCN’s website here for more details or contact Kathryn Clark at RCN Events on 020 7647 3585 or email


Clinical Document Indexing Standards were last revised in 2007. With the increasing move towards electronic patient records there is a need to review both the document type and specialty listing to ensure that these are consistent with current practice and enable universal access to patient documentation. A review group chaired by Dr Cathy Kelly eHealth Clinical Lead will meet on 19 May to review these and make recommendations for changes. It is likely that the group will meet twice with preparatory reading prior to 19 May 2010. If you are interested in participating within the review group, you should contact:

The Scottish Centre for Telehealth is supporting the establishment of a Telehealth Champions Network. The first meeting will be held on 22 April 2010 13.00 – 16.30. For further information contact Nessa Barrie or Sandra Auld

Other Information

The first annual health practitioners and professionals (HPP) engagement event was held last September to help raise awareness and engage the HPP community in developing clinical functionality within the National Programme for IT. Representatives from the four UK countries were also involved. The report can be found at: http://www.connectingforhealth.nhs.uk/engagement/clinical/ncls/ahp

Further information about The National eHealth Programme, and contacts, can be found on http://www.ehealth.scot.nhs.uk/

Heather Strachan

Clinical eHealth Lead (NMAHPs)

eHealth Directorate, Scottish Government

March 2010