1

iSOFT in the English National Programme

for Information Technology

Nick HarteSolution Director

2

National Programme for IT (NPfIT) – What is it?

A 10 year programme to modernise delivery of patient care

£6.2bn in England to improve patient experience by delivering;– Contact (email and diary functions across NHS)

– NHS Care Records Service

– Choose and Book

– Electronic Transmission of Prescriptions

– New National Network

– QMAS - supporting GP practices

– Picture Archiving and Communications Systems (PACS)

Totally computerise patient records, appointment bookings and prescriptions onto a central system that is accessible across the UK by 2010

…The biggest civil IT project ever

3

How is it being delivered?

Creation of five equally sized NHS Clusters

One Local Service Provider (LSP) per cluster

National Application Service Provider (NASP)

National Infrastructure Service Provider (NISP)

4

NPfIT – the components

N3 National Network

LSPs

NISP

NASPs

NHSnet / N3 National Network

NorthEast &

Humberside

East&

EastMidlands

London

SouthEast

& South West

ICRS Data Spine

eBooking

eTransfer of Prescriptions

Transaction Messaging Service

NorthWest

& West Midlands

5

NPfIT – regional deployments

6

A typical NHS Cluster – North West & West Midlands

Population 12m

Employees: 300,000 (including IT Staff: 2,500)

SHAs: 6

Health Communities / Economies: 31

Acute Trusts: 50

Mental Health Trusts: 13

Primary Care Trusts: 60

GP Practices: 2,500

Installed systems: 5,700

7

What were they looking for in an application service provider ?

Sustainability

Solution thinking for national/regional health economies

Purpose built for integrated healthcare

Next generation user experience (reduced training)

Service-oriented architecture (reduced disruption)

Terminology services (SNOMED CT)

Modern, standards-based

Workflow as a core service to support process modeling (BPR)

Knowledge management

Builds on and protects investment in existing infrastructure

8

What the NPfIT will deliver

Today 20062004

View patient demographic data

Access to national services

Introduce new / additional clinical functionality e.g. clinical documentation

2010

NHS Care Record Service

Active patient participation

IT support for clinical networks

Meeting local requirements

All Trusts have capable systems

PACS deployment started in Health Communities

Deeper clinical content e.g. NSFs, ICPs & Social Care

9

What is iSOFT providing?

10

Presentation

Monitor

Integration

Data

BusinessServices

Enterprise Services

A Service Orientated Architecture connecting…

National application services Local databasesPublic information sources …

and ProfessionalsCitizens

11

Drug data (reference terminology) Prescribing Medicines administration Pharmacy management

Intelligent searching Multi-facility patient identity

management Demographics, HL7v3 support

for PDS

Structured and un-structured data capture

Dictation and annotation Clinical terms, assessments,

observations Auto-citation, auto-negation

Results mgmt Device interfaces Sanple tracking Laboratory management Radiology management

Knowledge-based clinical requests Equipment requests Service requests

Management information Organisational modelling and planning Screening and surveillance Clinical audit Epidemiology Clinical research

Care plans Care pathways Pathway merging Care-driven resource management

Active decision support (branching)

Passive decision support (alerting)

Evidence-based best practice Authoring support

Duty of care and role declaration Configurability Personalisation Context management User experience Device technologies Citizen participation

Guaranteed delivery between two or more parties (system – system, system-user)

Semantics preserved Notification Escalation Collaboration support Multi-disciplinary team support

Functional map of services

Demand mgmt Resource mgmt Departmental mgmt

Duty of care Encounter mgmt Referral mgmt Capacity mgmt

Debt management Purchasing and supplies

management Self-pay and insurance Financial audit support

12

LORENZO – Information model

13

Healthcare services across care settings

Health economy

Care settings

Healthcare services

14

What will it look like?

15

16

Annotation using TabletPC

17

Medication reminders via mobile phone

18

DiTV services to the citizen

19

The principle is the same…

‘At a glance’ utility

No training

Personalisation

User-centred design

Visual language

Elegance and simplicity

Task-based support

But using a slightly different technology platform

.Net… today’s Bakerlite?

20

The user experience…

21

22

23

24

CABALLERO, Henry H1536255 J1125305 07/06/1966 37yrs Male

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

43

44

45

46

47

48

49

Summary

NPfIT is the largest civil IT project in the world

Actually largest Business Process Re-engineering programme (ever)

Challenging timetable

First truly Citizen focussed healthcare programme (Outcomes)

Health economy wide deployments of advanced clinical and process tools

Emphasis on knowledge management, workflow, terminology and structured care to support rapidly changing healthcare delivery

Extraordinary potential to change the way healthcare is delivered