Report by Iain Ross, Head of ehealth on behalf of Deborah Jones, Director of Strategic Commissioning, Planning and Performance

Transcription

1 UPDATE ON ehealth NHS Highland Board 28 November 2017 Item 4.1 Report by Iain Ross, Head of ehealth on behalf of Deborah Jones, Director of Strategic Commissioning, Planning and Performance The Board asked to: Note the contents of this report. 1 BACKGROUND The terms of reference of the ehealth Delivery Group states that The ehealth Delivery Group will provide a bi-annual update to the NHS Highland Board. This is the second of the bi-annual updates to the Board. At the ehealth Delivery Group meeting in April it was agreed that the ehealth Delivery Plan would be refocused to ensure alignment with the Board's Quality and Sustainability Plan. The agreed areas of work to be taken forward are as follows: 1. Delivery of a clinical information sharing solution across primary, secondary, community and social care that will display a patient centric view of clinical information. 2. Delivery of an information sharing solution within the community sector which will reduce the duplication of information being recorded thereby increasing the time available to care for patients. 3. Delivery of a patient status (production board) view of a patient which will allow staff to view the current status of all patients under their care from GP/Community care, into hospital care and back to GP/Community. 4. Support for the Technology Enabled Care Programme. 5. Delivery of electronic information gathering functionality within the clinical setting to replace the need for paper. 6. Delivery of a solution that will allow primary and secondary care clinicians to have an online clinical dialogue about a patient with a view to reducing outpatient attendances Since the last meeting significant work has taken place on the above and the purpose of this paper is to provide the NHS Highland Board with an update on progress with the ehealth delivery plan as well as a general update on the ehealth Department.

2 2 UPDATE ON DELIVERY PLAN 1. Delivery of a clinical information sharing solution across primary, secondary, community and social care that will display a patient centric view of clinical information. This deliverable translates to the implementation of a clinical portal. NHS Highland is working with the other North of Scotland (NoS) Boards in developing a business case for a regional approach to a Clinical Portal. NHS Grampian, NHS Shetland and NHS Orkney have indicated that they would like to be involved in this development. NHS Tayside and NHS Western Isles have indicated that they wish to keep their existing portals and have links to and from a regional portal so that all information would be available. This regional approach would also include links with NHS Greater Glasgow & Clyde which is important for the patient flows within the Argyll & Bute HSCP. The design of the clinical portal includes links with TrakCare PMS, SCI Store, Primary Care, Community, Emergency Care Summary, Social Care and Emergency Departments. Work has progressed with the potential suppliers (InterSystems and Orion Healthcare) with indicative costs and timescales being received. Work is also progressing on seeding the social care system in Northern NHS Highland with the CHI number (Argyll & Bute HSCP have already seeded their social care system). The GP Sub Committee is involved and helping with the development of an information sharing agreement between primary care and NHS Highland. The ehealth Programme Manager for the North of Scotland has been commissioned to take a lead on the development of a North of Scotland business case. The expectation is that the business case will be ready to be shared with the NoS Chief Executives by the end of this year. Reduction in length of stay Allowing patients to remain in their own homes longer Reduction in beds As well as the above the regional clinical portal is required to support the patient and information flows associated with the planned Elective Care Centre in Inverness. The estimated costs for a clinical portal are as follows: Implementation and licencing for a clinical portal 800k Annual support including hosting 400k The above costs do not include VAT.

3 2. Delivery of an information sharing solution within the community sector which will reduce the duplication of information being recorded thereby increasing the time available to care for patients. This deliverable translates in Northern NHS Highland to the implementation of a system called Morse which is in use in NHS Western Isles and NHS Dumfries & Galloway. The Argyll & Bute HSCP is investigating the use of CareFirst to support community staff. The Morse mobile clinical application for community health teams is now configured for use in NHS Highland. Morse is a mobile electronic patient record system for community staff. Staff will use an ipad to access and update clinical information about patients in their home and then share this information with the wider clinical community via SCI Store. A pilot of this application in a live context with a small number of clinical users from one of the Inverness East & West community neighbourhood teams using real patients started on 6 November. The basic aims of this live pilot are to: Ensure that the users/managers are confident that this product meets their expectations and can be used competently and effectively in a live clinical context. Provide feedback to help tailor subsequent training and support. Provide user based feedback to the Inverness East & West community neighbourhood teams to help allay any concerns or fears over moving to Morse. Assist ehealth in ensuring they have achieved all necessary technical/network requirements and/or identifying any further required developments. Assist ehealth in the delivery of on-going technical and service desk support to Morse and its users. Provide the necessary evidence to support a decision by the service leads to roll out Morse to remaining users in the Inverness East & West community neighbourhood teams. On the assumption that the live pilot goes well, the plan is to provide Morse training and subsequent roll out of Morse across the Community Nurses and OTs followed by the Reablement workers afterwards. This roll out will be determined by a combination of training availability, community staff availability and at a rate that the service is comfortable with. It is too early to have a final delivery date for all users but the Project Board has supported a continuation of this project to help ensure a satisfactory roll out by the end of this financial year. Morse comes with a basic Clinical Note as standard which allows for the submission of free text information into SCI-Store but we currently also have the following existing paper based forms digitised and available: Malnutrition Universal Screening Tool (MUST) Community Multi falls screening Community Indicator of Relative Need (iorn) Questionnaire Occupational Therapy functional assessment Waterlow assessment.

4 Allowing patients to remain in their own homes longer Reduction in beds 3. Delivery of a patient status (production board) view of a patient which will allow staff to view the current status of all patients under their care from GP/Community care, into hospital care and back to GP/Community. This deliverable is about the continued rollout of the purchased view products which include: Ward view including community hospitals Admission view Paediatric view Pharmacy view Info view Work is also progressing on the potential development of a Community Virtual View or Community Bridge which will allow community teams (including GPs) to be able to view information on vulnerable patients. Reduction in length of stay Allowing patients to remain in their own homes longer Reduction in beds Improved flow of patients across the health/social care system 4. Support for the Technology Enabled Care (TEC) Programme The TEC team and ehealth held a meeting in August to explore areas where TEC and ehealth can work together to provide support for both the ehealth Delivery Plan and the Quality and Sustainability Plan. It was agreed that there was a number of areas that the teams could work together on including: The use of Attend Anywhere to increase virtual consultations Support for areas that wish to change their model of care by using technology solutions which may include telephone and video consultations Work is now progressing on developing the service models that will support the rollout of Attend Anywhere and traditional video conferencing as an alternative to patients attending an actual clinic consultation. Quality improvements Reduction in travel for both patients and clinical staff

5 5. Delivery of electronic information gathering functionality within the clinical setting to replace the need for paper. This deliverable is split into two parts: (1) The provision of a technical solution that will enable the scanning of patient records into SCI Store and the clinical portal (2) The conversion of paper forms into electronic forms The ehealth department are reviewing the plans for deploying a scanning solution so as we can ensure consistence of approach with our colleagues from NSH Grampian. This means that records scanned in Grampian or Highland will look the same to the clinical staff who view them. The ehealth department has set up a contract with InterSystems (the supplier of the TrakCare PMS) for the development of 9 nursing forms. This will be the start of turning paper forms into a digital format. Improved flow of patients across health/social care New models of care Quality improvements 6. Delivery of a solution that will allow primary and secondary care clinicians to have an online clinical dialogue about a patient with a view to reducing outpatient attendances This deliverable is the implementation of the Clinical Dialogue module of SCI Gateway which will enable two way dialogue between primary and secondary care clinical staff. Phase one of this project will test the technical solution as well as the business processes being implemented and started on 7 November Reduction in the number of outpatient appointments being requested Improvement in flow of patients with health and social care Quality improvements 3 GENERAL ehealth UPDATES The above work is not the sole focus of the ehealth department; this section has been included to provide the Board with an update on the other significant work that the department has been involved in since the last ehealth update to the Board in May. The biggest impact to the ehealth department was the recent flooding incident at Raigmore Hospital on the evening of Sunday, 1 October where the server room located in the basement was damaged by water causing approximately 500k worth of damage. The majority of services were virtually moved to the second server room during Monday, 2 October with the last service becoming operational by 5.30pm on Friday, 6 October.

6 Currently the Board is running on an IT Infrastructure that has no failover capability and work is progressing on returning the environment to a highly resilient state. Funding for the replacement equipment has been provided by the Scottish Government and an alternative location for the equipment is being identified. The department has supported the work involved in the Office Redesign project with 250 laptops provided to staff involved within the project. These laptops have been configured to allow agile and flexible working. As well as this the ehealth department supported the project with the numerous moves required as part of the building decants. At NHS Highland s Board meeting in May, ehealth provided an update on the work plan for ensuring that Adult Social Care (ASC) were migrated from the Highland Council network onto the NHS Highland network. Eight sites have now been transitioned across to the NHS Highland network and the project is reporting that all work is on schedule and to budget. Date for completion of work is 31 March The ehealth department have been supporting the Pharmacy department with the work required for the GP Initiated Serial Prescribing Project. This pilot started on 1 November and the Pharmacy department will complete an evaluation of the pilot. In the last two months the ehealth department has supported the work to transfer referrals from Dental practices electronically to secondary care. This work initially was for the independent dental service, however, is now also being implemented within the salaried dental service. The main priority of the ehealth department is service delivery and as such the department handles approximately 1,400 calls to the service desk each week. As well as dealing with support calls the department conducts a number of Business as Usual (BAU) activities including: Monitoring the server and network environments Upgrading servers to new version of operating system and database environments as required Appling patches to both servers and applications Upgrading applications including conducting appropriate testing. The largest upgrade currently being undertaken is the upgrade to the new version of the TrakCare PMS system which end to end will take approximately 6 months work to complete. Work is continuing on the project to replace the Laboratory system with User Acceptance Testing (UAT) starting on 17 November This project will replace the current laboratory system in use in Northern NHS Highland with a modern system that will allow laboratory results to be sent directly to the GP systems. IAIN ROSS Head of ehealth 13 November 2017