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In this slideshow, Dr Tony Shannon, Consultant in Emergency Medicine and Chief Clinical Information Officer, Leeds Teaching Hospitals, outlines the practical considerations for implementing VistA in the NHS in the context of driving change in people, processes and technology. Dr Shannon presented at the Nuffield Trust seminar: Sharing international experience: Is implementing the VA's electronic health record system an option for the NHS? in July 2012.
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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 Management England
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+
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 Engine ESB
A B C
1
2
3
4
5
Core Process
Core Process
Core Process
Core Process
Core Process
Modular
SOA
Enterprise wide
System X
Cache Gt.M PPM
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 (Via Accordion +/- Tree) Inc external sources Eg Meds Allergies Diagnosis Clinical Docs
Centre
Data Group in focus
Via Chart/Grid/Table
+/- data source to explain data context
(eg Leeds/
Washington)
East
Data 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
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