NHSScotland eHealth/ IM&T Strategy

1. NHSScotland eHealth/ IM&T Strategy

2. ‘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 MH Pt admin Labs XRay Clinical GP/PHCT Pharmacist Dentist Inpatients National Services(NHS24, screening, jags, CHI, ISD, SBR, SAS)

3. ‘virtual’ care Me at home LA Education • What’s the problem? • Services still largely paper driven Social Care NHSScotland Outpatients/ ACAD • IT, where it exists, is often disparate MH Pt admin Labs XRay Clinical • obstacle to modernisation • pace of change limited by resource GP/PHCT Pharmacist Dentist Inpatients National Services(NHS24, screening, jags, CHI, ISD, SBR, SAS)

4. ‘virtual’ care Me at home LA Education • What are we doing to achieve the vision? • Striving for ‘integrated consistency’ Social Care NHSScotland Outpatients/ ACAD MH Pt admin Labs XRay Clinical GP/PHCT Pharmacist Dentist Inpatients National Services(NHS24, screening, jags, CHI, ISD, SBR, SAS)

5. Corporate telecomms and email • national contracts, central funding element • all hospitals and GP practices linked • programme to extend to pharmacies • dentists under consideration ‘virtual’ care Me at home LA Education Social Care NHSScotland Outpatients/ ACAD MH Pt admin Labs XRay Clinical GP/PHCT Pharmacist Dentist Inpatients National Services(NHS24, screening, jags, CHI, ISD, SBR, SAS)

6. CHI Index • all GP registered patients • single national definitive index • unique number per patient CHI Index name address # xx xxxxx xx ‘virtual’ care Me at home LA Education Social Care NHSScotland Outpatients/ ACAD MH Pt admin Labs XRay Clinical GP/PHCT Pharmacist Dentist Inpatients National Services(NHS24, screening, jags, CHI, ISD, SBR, SAS)

7. 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. eCare Store SCI Store Id Lab XRay Letters Summ xx 3.2 OK CHI Index name address # xx xxxxx xx ‘virtual’ care Me at home LA Education Social Care NHSScotland Outpatients/ ACAD MH Pt admin Labs XRay Clinical GP/PHCT Pharmacist Dentist Inpatients National Services(NHS24, screening, jags, CHI, ISD, SBR, SAS)

8. SCI Gateway • web-based clinical communication • fully encrypted • aiming at all inter-organisation communication eCare Store SCI Gateway SCI Store Id Lab XRay Letters Summ xx 3.2 OK CHI Index name address # xx xxxxx xx ‘virtual’ care Me at home LA Education Social Care NHSScotland Outpatients/ ACAD MH Pt admin Labs XRay Clinical GP/PHCT Pharmacist Dentist Inpatients National Services(NHS24, screening, jags, CHI, ISD, SBR, SAS)

9. Emergency Care Summary • access to key GP information out-of-hours • embryonic National Summary Record eCare Store Emergency Care Summary Id Drugs Alerts xxx xxx xx xx xx SCI Gateway SCI Store Id Lab XRay Letters Summ xx 3.2 OK CHI Index name address # xx xxxxx xx ‘virtual’ care Me at home LA Education Social Care NHSScotland Outpatients/ ACAD MH Pt admin Labs XRay Clinical GP/PHCT Pharmacist Dentist Inpatients National Services(NHS24, screening, jags, CHI, ISD, SBR, SAS)

10. Online Information Services • SHOW as umbrella for 120 websites • HEBSWEB, e-Library SHOW, e-Library etc eCare Store Emergency Care Summary Id Drugs Alerts xxx xxx xx xx xx SCI Gateway SCI Store Id Lab XRay Letters Summ xx 3.2 OK CHI Index name address # xx xxxxx xx ‘virtual’ care Me at home LA Education Social Care NHSScotland Outpatients/ ACAD MH Pt admin Labs XRay Clinical GP/PHCT Pharmacist Dentist Inpatients National Services(NHS24, screening, jags, CHI, ISD, SBR, SAS)

11. SHOW, e-Library etc eCare Store Emergency Care Summary Id Drugs Alerts xxx xxx xx xx xx SCI Gateway SCI Store Id Lab XRay Letters Summ xx 3.2 OK CHI Index name address # xx xxxxx xx ‘virtual’ care Me at home LA Education Social Care What else are we doing to achieve the vision? 2. Filling gaps NHSScotland Outpatients/ ACAD MH Pt admin Labs XRay Clinical GP/PHCT Pharmacist Dentist Inpatients National Services(NHS24, screening, jags, CHI, ISD, SBR, SAS)

12. 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 record SHOW, e-Library etc eCare Store Emergency Care Summary Id Drugs Alerts xxx xxx xx xx xx PACS GCS GCS A&E SCI Gateway SCI Store Id Lab XRay Letters Summ xx 3.2 OK CHI Index name address # xx xxxxx xx ‘virtual’ care Me at home LA Education Social Care NHSScotland Outpatients/ ACAD MH Pt admin Labs XRay Clinical GP/PHCT Pharmacist Dentist Inpatients National Services(NHS24, screening, jags, CHI, ISD, SBR, SAS)

13. SHOW, e-Library etc eCare Store Emergency Care Summary Id Drugs Alerts xxx xxx xx xx xx PACS GCS GCS A&E SCI Gateway So that’s all fine then? SCI Store Id Lab XRay Letters Summ xx 3.2 OK CHI Index name address # xx xxxxx xx ‘virtual’ care Me at home LA Education Social Care NHSScotland Outpatients/ ACAD MH Pt admin Labs XRay Clinical GP/PHCT Pharmacist Dentist Inpatients National Services(NHS24, screening, jags, CHI, ISD, SBR, SAS)

14. Still issues, alas SHOW, e-Library etc Doesn’t meet range of public needs NHS 24 Online in planning eCare Store Emergency Care Summary Id Drugs Alerts xxx xxx PACS GCS GCS A&E xx xx xx SCI Gateway SCI Store Id Lab XRay Letters Summ ‘Only’ 30% referrals so far Minimal discharge letters Pilot stage in two Boards only Roll-out before access to patients Child Health Systems fragmented and ‘too national’ GPASS + 4 commercials Need to establish less and better Slow pace in extending content Most wards still not linked Ageing, expensive mainframe Need more links to local indexes xx 3.2 OK CHI Index name address # xx xxxxx xx ‘virtual’ care Me at home LA Education Social Care NHSScotland Outpatients/ ACAD MH Pt admin Labs XRay Clinical GP/PHCT Pharmacist Dentist Inpatients National Services(NHS24, screening, jags, CHI, ISD, SBR, SAS)

15. Still issues, alas SHOW, e-Library etc eCare Store Emergency Care Summary Id Drugs Alerts xxx xxx xx xx xx • 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 PACS GCS GCS A&E SCI Gateway SCI Store Id Lab XRay Letters Summ xx 3.2 OK CHI Index name address # xx xxxxx xx ‘virtual’ care Me at home LA Education Social Care NHSScotland Outpatients/ ACAD MH Pt admin Labs XRay Clinical GP/PHCT Pharmacist Dentist Inpatients National Services(NHS24, screening, jags, CHI, ISD, SBR, SAS)

16. SHOW, e-Library etc eCare Store Emergency Care Summary Id Drugs Alerts xxx xxx xx xx xx PACS GCS GCS A&E SCI Gateway SCI Store Id Lab XRay Letters Summ xx 3.2 OK CHI Index name address # xx xxxxx xx ‘virtual’ care Me at home • 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? LA Education Social Care NHSScotland Outpatients/ ACAD MH Pt admin Labs XRay Clinical GP/PHCT Pharmacist Dentist Inpatients National Services(NHS24, screening, jags, CHI, ISD, SBR, SAS)

17. Conclusions • Current direction and approach is right … • … but rate of progress isn’t • Over next three years, use any funding boost to support local progress – but based on nationally-agreed priorities and systems. • Consider for adoption NPfIT (or alternative) elements if appropriate for NHSScotland …. • … but defer consideration of wholesale adoption for c. two years.