Welsh Results Reporting Service (WRRS) Proposed PTHB Implementation

Transcription

1 Welsh Results Reporting Service (WRRS) Proposed PTHB Implementation Purpose of Document WRRS is a key component of national infrastructure and has clear benefits to PTHB. This paper describes those benefits and the resources required for a WRRS implementation. It also covers some of the wider implications of WRRS as a key stepping stone towards having full electronic patient records. The Executive Team is asked to approve the implementation. Description WRRS contains all Pathology Test Results and all Radiology reports for Wales in a single database. It will also (later this year) contain Pathology test results from both Hereford and Shrewsbury hospitals. PTHB has already started to implement WCP with the MTeD project. WRRS is the next component. Current Position PTHB relies on a complex network of pathology and radiology services in neighbouring Health Boards with a number of different IT systems in place to view results. (See Appendix A). This has several disadvantages: 1. Results of tests requested in Primary Care are sent direct to the requesting Practice (via GP Links) and cannot be viewed in Powys hospitals. 2. Results of tests requested in Powys Hospitals cannot be viewed in GP Practices 3. Results of tests carried out for Powys patients in neighbouring health boards (whether as an Inpatient or as an outpatient) cannot generally be viewed in Powys. 4. The above situation leads to tests been repeated because clinicians cannot access all the relevant results. 5. Some of the IT systems used to provide pathology results currently are unreliable, for example the ICE system (used predominantly for viewing results from England) and the Indigo system used in ABMU. Staff at Llandrindod Wells hospital and Ystradgynlais hospital (as examples) need to phone labs on a daily basis to obtain test results that are either missing altogether from their system or for other reasons cannot be viewed. Benefits of WRRS 1. The WRRS removes the complexity around results reporting because it provides all test results in a single system accessibly via the Welsh Clinical Portal (See Appendix B). 2. Helps prevent diagnostic tests having to be repeated as all test results regardless of which lab carried out the test and regardless of whether the tests were requested in Primary Care or in Secondary Care, can now be viewed in one place. 3. Following WRRS implementation the use of the ICE and Indigo systems can be phased out in Powys removing the associated risks. Details of those risks are recorded on DATIX. 4. Decommissioning of the ICE system releases financial savings of 6k per annum. 5. Simplifying results reporting in this way greatly reduces the effort required by IT staff in supporting the range of current systems. Ian Ruse 1 March 2017

2 Resources Required for the Implementation 1. A WCP System Manager Permanent post, 0.5 WTE: to do the things listed in Appendix C. This will be an ongoing requirement but the post-holder would be able to manage other systems as well, for example those listed in Appendix D. 2. A WCP Trainer Permanent post, 0.5 WTE: WRRS training material will have to be developed and training delivered to approx. 300 staff. After MTeD and WRRS PTHB will probably want to implement other WCP components (See Appendix D) so further training effort will be required for those. Once WCP is fully implemented the training requirement will be limited to major new software releases and new members of staff. 3. Project Management 0.5 WTE for the duration of the WCP/WRRS implementation which is estimated at 12 to 15 months. This might be possible within existing resources as several smaller ICT projects are due to close within the next few months. 4. WRRS Project Sponsor: Someone senior within the organisation is required to take ownership of the WRRS implementation and be a point of contact for the Project Manager. Hospital staff will be required to take delivery of the WRRS system, enrol for training, assist in User Acceptance testing etc. Staff engagement may require encouragement from a senior figure within the organisation. A Locality Manager would be ideal or possibly the Medical Director. Cost Savings The WRRS project is fundamentally about improving services for patients, removal of risk and saving staff time both clinical staff and hospital administrative staff. Money will be saved in the following ways: Licensing costs for the ICE system saves 6k per annum Reduction in number of diagnostic tests carried out. Since all test results will be available to all clinicians involved in the care of the patient the number of repeated tests will reduce possibly to zero. A figure cannot be put on this however because no data is collected on the numbers or types of repeated tests. Hospital staff will save a lot time not having to phone labs for test results. This has become routine in some of our hospitals. IT Support staff will have fewer systems to support. The ICE system and the Indigo system have both been problematic recently. Cost Savings Longer Term Welsh Clinical Portal is becoming the electronic patient records system for hospitals. When fully implemented it will reduce and may remove altogether the need for paper Case Note files. This is similar to what clinical systems have achieved in General Practice (EMIS, INPS and others). The eventual cost savings to the Health Board in not having to store, transport and spend time tracking Case Note files is difficult to quantify but will be significant probably hundreds of thousands of pounds. Ian Ruse 2 March 2017

3 Implementation Timescale PTHB has previously expressed an interest in having WRRS and it has recently been connected to our instance of WCP. Currently there are no users accessing the WRRS module but an implementation could begin as resources are available. The implementation timescale is likely to be 12 to 15 months. This is based on 12 weeks to get the project initiated and the first hospital live. The lead time for each hospital after that is estimated at about 5 weeks. That should allow sufficient time to install and test the system and train the staff. See Appendix E for an outline project plan. Ian Ruse 3 March 2017

4 Appendix A: Current Position Ian Ruse 4 March 2017

5 Appendix A: Current Position Ian Ruse 5 March 2017

6 Appendix B: Results Reporting via WRRS Ian Ruse 6 March 2017

7 Appendix C Main responsibilities of the WCP System Manager Is the WCP Product Specialist for Powys Maintain expert knowledge in all areas of the Portal Establish (and probably chair) a local WCP User Group Represent Powys users on the national Service Management Board etc. for WCP Create accounts for new users /Deactivate accounts when staff leave Assign user roles within the WCP application for MTeD, WRRS etc. Oversee User Acceptance Testing for new software releases Train staff (or manage a training resource) Monitor system performance Understand the product development roadmap Provide local support for WCP assisting users as required and advising the Service Desk on WCP related incidents Be the single point of contact for NWIS in all WCP related matters Ian Ruse 7 March 2017

8 Appendix D WCP Key Components (Light Blue Powys is currently implementing) Component Function Implementation under way or complete Myrddin PAS Provides patient demographics to All Health Boards WCP Powys implementation complete MTeD WRRS TRRR: Results Reporting TRRR: Test Requesting Medicines transcribing and electronic Discharge Summaries. All-wales repository of lab test results and Radiology reports Electronic results reporting Pathology and Radiology Electronic communication with labs for Test Requests (simplifies and speeds up process) PTHB, BCU, C&V, CT, Hywel Dda CT completed a successful pilot in 2016 Nationally available from Feb All Health Boards except Powys. (Powys to implement WRRS) All Health Boards except Powys. (WRRS dependency) WIAS National store of PACS Images CT Piloting Available in 2017 depending on outcome of pilot WPRS WGPR Patient Referral System. Electronic referrals visible within WCP Summary of GP record available in Secondary Care ABMU, C&V, CT, Hywel Dda, All Health Boards Powys will implement in 2017 (subject to NIIAS) WCCG Phase 2 Clinic Letters available within WCP ABHB, ABMU WCRS Document Management System containing electronic copies of all documents that pass through WCCG Referrals, Discharge Summaries, Clinic Letters etc. Also capable of storing scanned copies of documents e.g. paper based patient records Cardiff & Vale Piloting CT Piloting Available in 2017 depending upon outcome of pilots Ian Ruse 8 March 2017

9 Appendix E: Draft Implementation Plan WCP/WRRS Implementation Plan (15 Months) Project Initiation Form implementation team /Agree management arrangements Confirm which Pathology labs in Wales are currently feeding test results into WRRS (See Note 1) Confirm timescale for English test results being available in WRRS (See Note 2) Communication with Locality Managers / Locality Teams / Individual Hospitals as necessary Readiness Tasks: Hospital 1 WCP/WRRS system demonstration Agree training dates - several sessions will be required to capture all staff Obtain a list of users and create user-accounts on the system Train Staff Agree support arrangements with National and Local IT Service Desks Implementation Hospital 1 Go live Close monitoring and support WRRS becomes "Business as Usual" Readiness Tasks: Hospitals 2 to 9 (See Note 3) Implementation Tasks: Hospitals 2 to 9 (See Note 3) Project Closure Prepare Closure Report - including Lessons Learnt and Benefits Realisation Notes 1. The availability of laboratory feeds into the WRRS will determine the rollout sequence for PTHB hospitals 2. Work is underway to feed results from English Pathology Labs into WRRS (Hereford and Shrewsbury laboratories) 3. It will take approximately 3 months to get the first hospital up and running. Thereafter the project team would aim to make one hospital live per month. Ian Ruse 9 March 2017