1 / 39

Neil Pound ISUG 2012

Neil Pound ISUG 2012. Plan. How we transferred from Isoft to TPP (And a little bit about why) How we switched What went right & wrong What to ask the suppliers at the demos Where we are now What I wish I had known 12 months ago. This isn’t going to be…. Advice on which system to choose

waylon
Download Presentation

Neil Pound ISUG 2012

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Neil Pound ISUG 2012

  2. Plan • How we transferred from Isoft to TPP • (And a little bit about why) • How we switched • What went right & wrong • What to ask the suppliers at the demos • Where we are now • What I wish I had known 12 months ago

  3. This isn’t going to be… • Advice on which system to choose • A plug for TPP (but we do like it now) • A model example of best practice But it will be warts and all truthful!

  4. Background • Woodlands Medical Practice, PMS PFI 10yrs ago • Sutton in Ashfield, deprived • 9200 pts, increasing • 5.2wte doctors, 4wte nurses (NP) • F2 training • 4 reception, 2 nurse admin, 2 script admin, 2 data quality, low staff turnover • Host nursing home coordinator service

  5. Background: IT • Isoft Premiere 10+ yrs (Microdoc) • Apollo SQL/Apolloscan (8 yrs) • Frontdesk/Contract+ • Easylabeller • Cardiosoft ECG • Welch Allyn ABPM • GPintranet

  6. Background: Organizational • Paper-light • Nurse Clinical coder (QOF) • Touch screen check in / Jayex • On line appointments / script ordering • Pathlinks (one local provider) • Data “cleansed” (IM&T DES) • No dedicated IT person

  7. Me • Ex nurse/IT trainer/programmer/systems analyst • GP (9.5 clinical sessions) • Federation chair • QOF/IT lead • No links to Isoft/TPP • My views are my own!

  8. Why did we change? • Isolation • Functionality • Disastrous trials ETP/C&B • Lack of support (local / Isoft) • Complexity of integration • Lack of robust hosted solution • Future uncertainty

  9. Choosing a system (Avon IM&T) • Practice (clinical benefits / strategy / impact) • Strategic fit (local / national) • System (status / roadmap / functionality) • Financial implications (practice / PCT) • Management considerations (practice / PCT) • Decide priorities • NO SYSTEM MEETS ALL REQUIREMENTS

  10. What to look for • Don’t just consider the clinical consultation • Functionality: gains vs losses • Where do you want/need to be in the future • Commissioning • Add-ons (current/integration/necessary) • QOF (updates) • Reporting • Current software & developments

  11. What to look for: data sharing • Locality teams (DN, palliative, MH, sec care, HV) • Templates • Formularies • Organisation • Messaging • ? Problems / access / “ownership”

  12. What to look for at the demo • Sales reps will have an orchestrated demonstration: break it up, use real time demo if poss, ask Q’s ‘show me’ • Beware airware • Involve as many staff as practical and at least one reception/admin/nurse • Arrange a second demonstration • Examples (eg set up template / search / recall communication)

  13. Important questions for new provider (1) • What data loss during the transfer? • Reference sites (local) • Is data in other systems (eg Frontdesk) part of the clinical record & will this transfer? • What happens to data fields not mappable?

  14. Important questions for new provider (2) • How is potential data loss (Premiere) handled? • Does deleted data transfer? • Will recalls be directly transferred? • Will prescription history & reauthorizations transfer? • How about pts not currently registered

  15. Important questions for current supplier • How long will your database be accessible? • What happens if we need access to the data after this period (costs & how long)? • Will you provide a named contact for data queries (for the transfer)? • Do you need info from any other systems (FDW)?

  16. Questions for IT • Will current hardware suffice (full survey) • Costs? • Branch surgeries • Extras (new equipment) • N3 link issues / reliability

  17. Timescales • August-Sep 2010 demonstrations providers • Sep-Oct shortlisting, further demo & technical queries • October 2010 decision to change • March 2011 project initiation • September 1st data cut & verification • October 26th 2011 TPP go live

  18. Planning (6+ months) • Pick a go live date and fix it • Try and have all GPs present • Consider absences, QOF, holidays • Arrange locum support in advance • Backfill for ALL staff • Training needs assessment (differences)

  19. Planning (months) • Form project team in practice (?PM) • Monthly meetings in house • Supplier/training/IT meetings • IT survey (hardware) • Backup verification • Smart cards

  20. Planning (weeks) • On schedule? • Data cuts (verification/validation for migration) • Test system available? • Detailed training schedule • Backfill/locum • Tell patients • Rota (less ? no routine) • Repeat prescriptions • Operational/business procedures (with trainers) • Training (system administration)

  21. Planning (days) • Trainers on site (process review) • Training in test environment • Prepare (some) data for live site (templates, formularies, staff, configuration) • Hardware installation & configuration

  22. Planning (D-2) • Last data cut • No scanning/pathlinks (manual systems) • Consultations ? Paper ? Old system • Shared list appointments (any practitioner) • No QOF, no “routine” work • Training • Heaven!

  23. Planning (D-1) • Technical go live • Hardware testing (IT on site) • (check data) • Training • Set up staff rotas • Transfer to live system (staff/templates/formularies)

  24. Go-live day • IT & multiple trainers on site ? in room if nec • Longer appointments with breaks • Review lunch & end of afternoon • “Emergencies” only: no routine work

  25. Post go-live (days) • More training (scanning/pathlinks/letters) • Catch up (scanning/pathlinks) • Template modification • Consolidation training • Back to usual appointment system • Routine work resumes

  26. Post go-live (weeks) • Templates modifying (still) • Recalls updating • Repeat prescriptions restarting • Scanning/pathlinks catch up • Data re-entry from system downtime • Reports - reestablishing • QOF resuming

  27. What went well • Data transfer • Negotiation with migration team • IT hardware (touchscreen, Jayex, printers) • Well planned project management • Patient appointments & scripts • Manual procedures pathlinks/documents • Electronic pathlinks & documents

  28. What went a bit wrong • Communications & messages • Patient reminders • Templates • Scanning & document management • Configuration users & screens • QOF catchup

  29. What went horribly wrong • Training (inconsistent, inflexible) • Post go-live workload underestimated • Repeat script catch up • Scanning/pathlinks catch up • Christmas & the flu season (weather?) • Holidays • Recalls not serviceable • Appointments (searching)

  30. What did we do? • Panic • Review, discuss & change (daily team & monthly practice meetings) • Looked at other practice’s use of system • Tried not to change too much too quickly (process) • Extra work (me)

  31. Overall Review • Training: quality, duration, consistency • Business process management: don’t change it if you don’t have to • Time bombshell • 3 months to be up to any speed • 6 months to be back where we were • 9+ months to be ahead of this

  32. Costs? • Very difficult to quantify • Main cost to practice is lost time & productivity • Backfill & locum costs • Extra time to configure system (me) • QOF / complaints / stress

  33. Regrets? • Lack training environment early • Didn’t realise poor quality training & little understanding how GP’s (us) work • Didn’t recognise trainers misconception that all practices work to same IT level • Didn’t look at how other practices use their system early enough • Complacent (go live), lost overview

  34. Currently • 11 months on • Functionality better (templates/macros) • Data sharing (safeguarding) • Prompt letters • ICE ordering & access to pathology • Reliable • Working remotely

  35. What do I like? • Functionality better: Templates & macros • Formularies (Read/drugs) • Reporting (fast, easy) • Alerts • Customized views & configurability • Data sharing (safeguarding) • Prompt letters, ICE & access to pathology • Reliable • Working remotely

  36. What do I miss? • Frontdesk • Upto date reporting • Error messages • Upgrades & multilex updates • ISUG conference • ? control

  37. Finally • Good luck: you will cope • GP’s flexible & resilient: cope with change • But timescales, so many changes, complexity… • It will be difficult but plan ahead • Think disaster recovery, what if scenarios • Ask for help (SNUG)

  38. Useful links • http://www.gp.aimtc.nhs.uk/GPSoC_Change.asp • http://www.gpchoice.org/gp-choice/decision-to-change-systems.aspx • http://www.connectingforhealth.nhs.uk/systemsandservices/gpsupport/gpsocce.org/gp-choice.aspx

More Related