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Informing Healthcare

Informing Healthcare. An Overview David Ll. Davies – Programme Manager Deborah El Sayed – Single Record Project Manager. What is it?. A strategy and an implementation programme In summary:

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Informing Healthcare

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  1. Informing Healthcare An Overview David Ll. Davies – Programme Manager Deborah El Sayed – Single Record Project Manager

  2. What is it? • A strategy and an implementation programme • In summary: ‘…………..It is a significant and strategic approach to investing in information and communications technologies infrastructure and to modernising service delivery by supporting new ways of working…………………..’

  3. Principles (what’s different?) • Ministerial support • Corporate and All Wales • Comprehensive scope • Long term Investment (£91 m first 3 years) • User led • Incremental implementation • Evidence based development • F,D,I,E • Concept of ‘dependencies’ & ‘readiness’

  4. Benefit Areas • Single integrated electronic health record for every patient • Service improvement supported by technology • Empowerment of the workforce through information literacy and tools • Empowerment of patients through shared decision making • High quality knowledge and information management

  5. Informing Healthcare Strategy Implementation Programme Board Users Executive Resources Benefit Groups Chair & Director Design & Support Offices Staff/second Stakeholders Health Services Projects Products Programme Organisation

  6. Progress – Setup and Personnel • Year 1 Programme Plan approved by Programme Board • Support Office Commissioned in Bro Morgannwg Trust (Glanrhyd) • Ian Kelsall appointed as Chair • Bob Grindrod, Interim Director last 12 months • Substantive Director appointment in progress • 2 of 5 Benefit Directors appointed – Drs Rhodri Evans & Adrian Edwards • Programme Manager, Deputy PM’s and PSO Director in place. • Other key appointments being made

  7. Progress - Activity • Technical Proof of Concept Project completed • Projects moving forward from programme plan in areas of: • Single record development phase 1 • Training and development • Knowledge management • Infrastructure and access devices • Confidentiality and security • Research and development • Readiness planning progressing in Trusts and LHBS • £18m + invested in 2004/5

  8. Progress – Activity (2) • Engagement of users/stakeholders • Developing relationships with related areas e.g. • England • Diagnostic Services Review • Social Care • Wanless • Innovations in Care • ESR • Three year Programme ‘Route Map’ in preparation

  9. So what’s in it for nursing staff? • Recognition – nurses run the show! • Electronic support for day to day work: • structured ‘intelligent’ records • nursing record and access to all other relevant records • new electronically supported processes • orders and results • medicines management • referrals, admissions, transfers and discharges • bed management • scheduling • alerts and reminders • pathways/decision support

  10. So what’s in it for nursing staff (2)? • Training and skills to maximise benefit from electronic systems • Skills as informaticians – evidence based professionals • Benefits: • actions supported by timely accurate information • automation of routine tasks • reduced possibility of error • reduced wasted effort • improved and safer services for patients • less stressful more rewarding working conditions for staff

  11. Strategy to delivery ( Single Record) • Structure and objectives of the Single Record Phase 1 Development Project • How we plan to deliver this • Progress Made to date • Next steps

  12. Core: Functionality Presentation Usability Record structure Process Redesign Dependency Network Patient Identification Staff Identification Service Management Overview of Work-Streams

  13. Dependency Objective Network The ability of the network to Support the Single Record Dependency Network Patient Identification Staff Identification Service Management Overview of Work-Streams

  14. Dependency Objective Patient Identification The ability to uniquely identify patients in electronic systems Dependency Network Patient Identification Staff Identification Service Management Overview of Work-Streams

  15. Dependency Objective Staff Identification The ability to uniquely identify staff accessing Single Record access Dependency Network Patient Identification Staff Identification Service Management Overview of Work-Streams

  16. Dependency Objective Service Management The ability to deliver a co-ordinated service management function to manage the services to be provided within SR:P1 Dev Project Dependency Network Patient Identification Staff Identification Service Management Overview of Work-Streams

  17. Core: Functionality Presentation Usability Record structure Process Redesign Functionality What will the system actually do? Which clinical processes will it support? Overview of Work-Streams

  18. Core: Functionality Presentation Usability Record structure Process Redesign Presentation What will the system look like? How will it differ to support the range of professional groups? Overview of Work-Streams

  19. Core: Functionality Presentation Usability Record structure Process Redesign Usability How easy is the system to use? How intuitive is it? How ergonomic is it? Overview of Work-Streams

  20. Core: Functionality Presentation Usability Record structure Process Redesign/Change Management Record structure How should patient data be structured within the record? Overview of Work-Streams

  21. Core: Functionality Presentation Usability Record structure Process Redesign/Change Management Process Redesign/ Change Management The largest and most complex part of this project is the change management aspect. A good technical system overlaid onto an inefficient process will not deliver improved patient care Overview of work-Streams

  22. Development of Outline Business Case • An Outline Business Case in five case model form is being developed for Single Record • The Programme is also subject to the Office of Government Commerce (OGC) Gateway process • Purpose • To provide external/independent assurance • Review at key decision points to ensure that the project is ‘ready’ to progress to the next stage. • Dates for Gateway Reviews to be agreed

  23. Methodology for getting it right • The services and functionality delivered MUST be guided by NHS stakeholders across NHS Wales • All Wales stakeholder events • Design Teams established • Reference Groups established • Clinically focused Project Board • Constant engagement process to maximise numbers of clinicians and NHS staff involved in design, decision making, consultation and validation.

  24. Stakeholder Events and Clinical Representation • Three stakeholder workshops were held during September and early October for all stakeholders. • In excess of 200 people attended to provide views on the approach to Single Record across Wales. • This included clinicians from various disciplines and accounted for 20% of the attendees • Further development of the options has taken place through a further six OBC options meetings involved over 60 stakeholders. • Design Team and Reference Group meetings initiated

  25. Stakeholder Prioritisation of Scope for Phase 1 Result of the workshops to date have prioritised the following* • Access to accurate, consistent corporate patient demographic information • Access to basic clinical information for all Welsh patients • Enhanced demographics • Requests and results reporting • Referrals (1°care to 2°care and tertiary referrals) • Discharge summaries from 2°care (including death notification) *shown in rank order

  26. Design Team and Reference Group dates for 2004 • Design Team: 23rd November 30th November 7th December 14th December 21st December • Reference Group: 9th December • 25 people register for Design Team • 54 registered for Reference group

  27. Other issues for consideration • The current requirements of each organisation are likely to be different – Need a corporate approachto deliver benefits to patients across Wales • The Requirements of different professional groups will be different need to ensure we have an approach that ensures representation of all of the key professional groups to ensure that we deliver a cohesive service to patients • The current experience for patients is difference based upon where they live and the approach taken by their local hospital or the pace of development – Need to develop an approach that gives equity of patient experience wherever possible.

  28. Next steps: Scope • Focus for Design Teams and Reference Group • Outline Business Case ( defines and approves the options and high level scope) • Develop Clinical (business) Processes for each area of functionality (defines the detailed scope) • Develop the requirements of systems to support these processes ( refines detailed scope) • Develop a specification to drive forward procurement activity

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