iSOFT in the English National Programme for Information Technology

1. iSOFT in the English National Programmefor Information Technology Nick Harte Solution 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 eTransfer of Prescriptions eBooking ICRS Data Spine NASPs Transaction Messaging Service NorthEast &Humberside East&EastMidlands London SouthEast& South West NorthWest & West Midlands LSPs NHSnet / N3 National Network NISP N3 National Network

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 2004 2006 2010 • View patient demographic data • Access to national services • Introduce new / additional clinical functionality e.g. clinical documentation • All Trusts have capable systems • PACS deployment started in Health Communities • Deeper clinical content e.g. NSFs, ICPs & Social Care • NHS Care Record Service • Active patient participation • IT support for clinical networks Meeting local requirements

9. What is iSOFT providing?

10. A Service Orientated Architecture connecting… Citizens and Professionals Presentation Monitor Business Services Enterprise Services Integration Data National application services Public information sources Local databases …

11. Functional map of services • Debt management • Purchasing and supplies management • Self-pay and insurance • Financial audit support • Management information • Organisational modelling and planning • Screening and surveillance • Clinical audit • Epidemiology • Clinical research • Knowledge-based clinical requests • Equipment requests • Service requests • Results mgmt • Device interfaces • Sanple tracking • Laboratory management • Radiology management • Care plans • Care pathways • Pathway merging • Care-driven resource management • Active decision support (branching) • Passive decision support (alerting) • Evidence-based best practice • Authoring support • Structured and un-structured data capture • Dictation and annotation • Clinical terms, assessments, observations • Auto-citation, auto-negation • Duty of care and role declaration • Configurability • Personalisation • Context management • User experience • Device technologies • Citizen participation • Intelligent searching • Multi-facility patient identity management • Demographics, HL7v3 support for PDS • Drug data (reference terminology) • Prescribing • Medicines administration • Pharmacy management • Guaranteed delivery between two or more parties (system – system, system-user) • Semantics preserved • Notification • Escalation • Collaboration support • Multi-disciplinary team support • Duty of care • Encounter mgmt • Referral mgmt • Capacity mgmt • Demand mgmt • Resource mgmt • Departmental mgmt

12. LORENZO – Information model

13. Healthcare services across care settings Healthcare services Care settings Health economy

14. What will it look like?

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…

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

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