Healthcare Change in the NHS

Practical considerations of VistA

Dr. Tony Shannon

Tony Shannon

M.B. B.Ch. B.A.O. Ireland

Fellow of College of Emergency Medicine England

Fellowship in Informatics USA

MSc in IT ManagementEngland

Consultant in Emergency Medicine, Leeds Teaching Hospitals

Chief Clinical Information Officer, Leeds Teaching Hospitals

(Clinical Lead, NHS Connecting for Health – National Programme for IT)

(Chair, Clinical Review Board, openEHR Foundation)

Honorary Research Fellow, University College London

Key points

• Healthcare Change– People, Process & Technology

• VA & Vista International Leaders• Challenges in the NHS– Integration– Code & Community– UI & Usability

• Next Steps– Towards Gold Standard

NHS Model Communities: People + Process + Technology

Thinking in silos Clash between process and IT

Archetypes

Templates Standards & Interoperability

Generic

Specific

Test Requirement

Build Design

AoMRC Generic Medical Documentation

eHealth Ecosystem

International Standards

Local Innovators

eHealth Bodies

& Vendors

International Leaders

NHS Innovation- from Bottom Up

• Leeds, England• 4 Hospital Site• 14,000 employees• £800m annual budget• £7m annual IT spend

• Clinically Led• Process Improvement• Agile OS development

200+

System X

CUI Clinical Portal

TIE

A B C

1

2

3

4

5

PAS

Scheduling

Orders Results

ePrescribing

Clinical Docs

Primary Care

Informatics Strategy

Clinical Portal: Patient Oriented & User Centred

Leeds TH 200+

VA Vista Enterprise Wide

Common Web UI

Integration EngineESB

A B C

1

2

3

4

5

Core Process

Core Process

Core Process

Core Process

Core Process

ModularSOA

Enterprise wide System X

Cache Gt.MPPM

SQL

Challenge # 1: Integration

Challenge 2: Code & Community

Challenge 3: UI & Usability

LeedsTH NHS: Steps towards VistA

• User Centred Design– Clinically Led

• Agile Development– 10 Days

• Technology– ExtJS4– EWD– Mumps– Gt.M/Cache NoSQL

North- User Context

West

Navigation(ViaAccordion+/- Tree)

Inc external sources

Eg MedsAllergiesDiagnosisClinical Docs

CentreData Group in focusVia Chart/Grid/Table+/- data source to explain data context (eg Leeds/Washington)

EastData in Detail

Create Data Update/Delete Data

Create/Update/Delete Data

Data Entry done in popup

NB may be external component

Save

Clinical UI Patterns

High level- Aggregate Patient Data

ClinUiP.wordpress.com

Mid level- Patient Group Data

Low level- Patient Detail Data

Patient Detail Data- Data Entry

ClinUiP on Vista

ClinUiP Benefits

• Intro to OS EHR development

• Intro to ExtJS/EWD/GtM• Introduction to Mumps & Vista

• Align towards Vista/Vista Integration

Next Steps

• Knowledge Transfer in the NHS• Gold Standard for NHS– Standards- CUI & AoMRC – Admission, Handover & Discharge– Integration with a.n.other

• Explore Integration with Vista & Others– EWD & NodeJS- XML, Mumps/Javascript – NoSQL & SQL

...towards evolving ecosystem….

International Standards

Local Frontline Innovators

National eHealth Bodies

& Vendors

Regional

Key points

• Healthcare Change– People, Process & Technology

• VA & Vista International Leaders• Challenges in the NHS– Integration– Code & Community– UI & Usability

• Next Steps– Towards Gold Standard

Thank you

tony.shannon@frectal.comwww.frectal.com