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NHSScotland eHealth/ IM&T Strategy. ‘virtual’ care. Me at home. LA. Education. What’s the vision? From many care settings, fragments of information assembled, accessed securely online, at point of patient care, respecting patient consent. Social Care. NHSScotland. Outpatients/ ACAD. - PowerPoint PPT Presentation
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NHSScotland eHealth/ IM&T Strategy
Outpatients/ACAD
Outpatients/ACAD
GP/PHCTGP/PHCT
InpatientsInpatients
DentistDentist
PharmacistPharmacist
MHMH
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
Pt admin
Labs
XRay
Clinical
Me at homeMe at home
Social CareSocial Care
EducationEducation
NHSScotland
LA
What’s the vision?
• From many care settings,• fragments of information
assembled,
• accessed securely online,
• at point of patient care,
• respecting patient consent.
‘virtual’ care‘virtual’ care
Outpatients/ACAD
Outpatients/ACAD
GP/PHCTGP/PHCT
InpatientsInpatients
DentistDentist
PharmacistPharmacist
MHMH
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
Pt admin
Labs
XRay
Clinical
Me at homeMe at home
Social CareSocial Care
EducationEducation
NHSScotland
LA
What’s the problem?
• Services still largely paper driven
• IT, where it exists, is often disparate• obstacle to modernisation
• pace of change limited by resource
‘virtual’ care‘virtual’ care
Outpatients/ACAD
Outpatients/ACAD
GP/PHCTGP/PHCT
InpatientsInpatients
DentistDentist
PharmacistPharmacist
MHMH
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
Pt admin
Labs
XRay
Clinical
Me at homeMe at home
Social CareSocial Care
EducationEducation
NHSScotland
LA
‘virtual’ care‘virtual’ care
What are we doing to achieve the vision?
1. Striving for ‘integrated consistency’
Outpatients/ACAD
Outpatients/ACAD
GP/PHCTGP/PHCT
InpatientsInpatients
DentistDentist
PharmacistPharmacist
MHMH
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
Pt admin
Labs
XRay
Clinical
Me at homeMe at home
Social CareSocial Care
EducationEducation
NHSScotland
LA
‘virtual’ care‘virtual’ care Corporate telecomms and email
• national contracts, central funding element
• all hospitals and GP practices linked
• programme to extend to pharmacies
• dentists under consideration
Outpatients/ACAD
Outpatients/ACAD
GP/PHCTGP/PHCT
InpatientsInpatients
DentistDentist
PharmacistPharmacist
MHMH
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
Pt admin
Labs
XRay
Clinical
Me at homeMe at home
Social CareSocial Care
EducationEducation
NHSScotland
LA
‘virtual’ care‘virtual’ care CHI Index • all GP registered patients• single national definitive index• unique number per patient
name address # xx xxxxx xx
CHI Index
Outpatients/ACAD
Outpatients/ACAD
GP/PHCTGP/PHCT
InpatientsInpatients
DentistDentist
PharmacistPharmacist
MHMH
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
Pt admin
Labs
XRay
Clinical
Me at homeMe at home
Social CareSocial Care
EducationEducation
NHSScotland
LA
‘virtual’ care‘virtual’ care SCI Store • Local Integrated Care Record• + acts as a ‘services hub’ for
other systems • various stages of implementation
in all NHS Board areas• 99.9% GP practices with online
access• similar concept planned for NHS -
L.A.
eCareStore
name address # xx xxxxx xx
CHI Index
Id Lab XRay Letters Summ xx
SCI Store
OK3.2
Outpatients/ACAD
Outpatients/ACAD
GP/PHCTGP/PHCT
InpatientsInpatients
DentistDentist
PharmacistPharmacist
MHMH
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
Pt admin
Labs
XRay
Clinical
Me at homeMe at home
Social CareSocial Care
EducationEducation
NHSScotland
LA
‘virtual’ care‘virtual’ care
eCareStore
name address # xx xxxxx xx
CHI Index
Id Lab XRay Letters Summ xx
SCI Store
OK3.2
SCI Gateway • web-based clinical communication• fully encrypted• aiming at all inter-organisation
communication
SCI Gateway
Outpatients/ACAD
Outpatients/ACAD
GP/PHCTGP/PHCT
InpatientsInpatients
DentistDentist
PharmacistPharmacist
MHMH
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
Pt admin
Labs
XRay
Clinical
Me at homeMe at home
Social CareSocial Care
EducationEducation
NHSScotland
LA
‘virtual’ care‘virtual’ care
eCareStore
name address # xx xxxxx xx
CHI Index
Id Lab XRay Letters Summ xx
SCI Store
OK3.2
Emergency Care Summary • access to key GP information out-
of-hours• embryonic National Summary
Record
SCI Gateway
Id Drugs Alerts xxx xxx xx xx xx
Emergency Care Summary
Outpatients/ACAD
Outpatients/ACAD
GP/PHCTGP/PHCT
InpatientsInpatients
DentistDentist
PharmacistPharmacist
MHMH
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
Pt admin
Labs
XRay
Clinical
Me at homeMe at home
Social CareSocial Care
EducationEducation
NHSScotland
LA
‘virtual’ care‘virtual’ care
eCareStore
name address # xx xxxxx xx
CHI Index
Id Lab XRay Letters Summ xx
SCI Store
OK3.2
Online Information Services
• SHOW as umbrella for 120 websites
• HEBSWEB, e-Library
SCI Gateway
Id Drugs Alerts xxx xxx xx xx xx
Emergency Care Summary
SHOW, e-Library etc
Outpatients/ACAD
Outpatients/ACAD
GP/PHCTGP/PHCT
InpatientsInpatients
DentistDentist
PharmacistPharmacist
MHMH
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
Pt admin
Labs
XRay
Clinical
Me at homeMe at home
Social CareSocial Care
EducationEducation
NHSScotland
LA
‘virtual’ care‘virtual’ care
eCareStore
name address # xx xxxxx xx
CHI Index
Id Lab XRay Letters Summ xx
SCI Store
OK3.2
SCI Gateway
Id Drugs Alerts xxx xxx xx xx xx
Emergency Care Summary
SHOW, e-Library etc
What else are we doing to achieve the vision?
2. Filling gaps
Outpatients/ACAD
Outpatients/ACAD
GP/PHCTGP/PHCT
InpatientsInpatients
DentistDentist
PharmacistPharmacist
MHMH
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
Pt admin
Labs
XRay
Clinical
Me at homeMe at home
Social CareSocial Care
EducationEducation
NHSScotland
LA
‘virtual’ care‘virtual’ care
eCareStore
name address # xx xxxxx xx
CHI Index
Id Lab XRay Letters Summ xx
SCI Store
OK3.2
SCI Gateway
Id Drugs Alerts xxx xxx xx xx xx
Emergency Care Summary
GCS
SHOW, e-Library etc
Secondary + Managed Clinical Care
• A&E system procurement complete
• PACS procurement nearly complete
• Generic Clinical System just underway - SCI Diabetes as inspiration
• ? GCS for anaesthetic recordA&E
PACS
GCS
Outpatients/ACAD
Outpatients/ACAD
GP/PHCTGP/PHCT
InpatientsInpatients
DentistDentist
PharmacistPharmacist
MHMH
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
Pt admin
Labs
XRay
Clinical
Me at homeMe at home
Social CareSocial Care
EducationEducation
NHSScotland
LA
‘virtual’ care‘virtual’ care
eCareStore
name address # xx xxxxx xx
CHI Index
Id Lab XRay Letters Summ xx
SCI Store
OK3.2
SCI Gateway
Id Drugs Alerts xxx xxx xx xx xx
Emergency Care Summary
SHOW, e-Library etc
GCSA&E
PACS
GCS
So that’s all fine
then?
Outpatients/ACAD
Outpatients/ACAD
GP/PHCTGP/PHCT
InpatientsInpatients
DentistDentist
PharmacistPharmacist
MHMH
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
Pt admin
Labs
XRay
Clinical
Me at homeMe at home
Social CareSocial Care
EducationEducation
NHSScotland
LA
‘virtual’ care‘virtual’ care
eCareStore
name address # xx xxxxx xx
CHI Index
Id Lab XRay Letters Summ xx
SCI Store
OK3.2
SCI Gateway
Id Drugs Alerts xxx xxx xx xx xx
Emergency Care Summary
A&E
PACS
GCS
GCS
SHOW, e-Library etc
Ageing, expensive mainframe
Need more links to local indexes
Pilot stage in two Boards only
Roll-out before access to patients‘Only’ 30% referrals so far
Minimal discharge letters
Child Health Systems fragmentedand ‘too national’
GPASS + 4 commercials
Need to establish less and better
Slow pace in extending content
Most wards still not linked
Still issues, alas
Doesn’t meet range of public needs
NHS 24 Online in planning
Outpatients/ACAD
Outpatients/ACAD
GP/PHCTGP/PHCT
InpatientsInpatients
DentistDentist
PharmacistPharmacist
MHMH
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
Pt admin
Labs
XRay
Clinical
Me at homeMe at home
Social CareSocial Care
EducationEducation
NHSScotland
LA
‘virtual’ care‘virtual’ care
eCareStore
name address # xx xxxxx xx
CHI Index
Id Lab XRay Letters Summ xx
SCI Store
OK3.2
SCI Gateway
Id Drugs Alerts xxx xxx xx xx xx
Emergency Care Summary
SHOW, e-Library etc
GCSA&E
PACS
GCS
Particular issues in hospitals(apart from gaps and plethora of stand-alone systems)
eg.- 8 different PAS systems - 41 Outpatient systems - A&E uptake- revenue and support pressures
Still issues, alas
Outpatients/ACAD
Outpatients/ACAD
GP/PHCTGP/PHCT
InpatientsInpatients
DentistDentist
PharmacistPharmacist
MHMH
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
National Services(NHS24, screening, jags,
CHI, ISD, SBR, SAS)
Pt admin
Labs
XRay
Clinical
Me at homeMe at home
Social CareSocial Care
EducationEducation
NHSScotland
LA
‘virtual’ care‘virtual’ care
eCareStore
name address # xx xxxxx xx
CHI Index
Id Lab XRay Letters Summ xx
SCI Store
OK3.2
SCI Gateway
Id Drugs Alerts xxx xxx xx xx xx
Emergency Care Summary
SHOW, e-Library etc
GCSA&E
PACS
GCS
and then there’s NHS England …
• funding hike post Wanless report• like us, were spending c. 2% on IT• looking to increase to nearer 4%
• embarked on an ambitious and radical programme
• what to do when in bed with an elephant?
1. Current direction and approach is right …
2. … but rate of progress isn’t
3. Over next three years, use any funding boost to support local progress – but based on nationally-agreed priorities and systems.
4. Consider for adoption NPfIT (or alternative) elements if appropriate for NHSScotland ….
5. … but defer consideration of wholesale adoption for c. two years.
Conclusions
