Clinical Collaboration Colin Sweeney Director of ICT King’s College Hospital

1. Clinical CollaborationColin SweeneyDirector of ICT King’s College Hospital

2. Agenda • Background • Some breakthroughs • Clinical involvement • It is not an IT project? • Examples of joint working

3. King’s EPR Milestones • 1999 Implemented pilot of the initial EPR vision • 2002 Completed roll out of orders and results as first stage of EPR • 2000-2 Discharge notifications and TTA drugs • 2003 Replaced old IRC PAS with i.PM • 2004/5 PACS • 2005 First attempt at inpatient prescribing • 2007 Moved i.PM to CSC as part of iSOFT7 • 2009 Inpatient noting • 2008-2010 Inpatient prescribing roll out • 2010 to date – KSSF to help move to paperless/light hospital • 2011 Wardware to calculate Early Warning Scores • 2012 Assessed by HIMSS as a level 5 EMR

4. Breakthrough moments Our Vision A single point of access to information about individual patients in electronic real-time format How do we get there? An EPR is a Strategy not a System

5. i.CM/EPR RIS KCH develop-ments PACS NNB Score-cards Maternity Choose &Book i.PM/ PAS What does that mean? Data Ware-house/ABC Theatres TIE Pharmacy E-PSB Pathology Finance A&E Payroll PICU ESR Specialty systems E-Rost-ering E-Learning NHS Mail

6. This is not an IT Project • It involves: • Software • Hardware • – static and mobile • Infrastructure • Wired and Wireless • Interfaces • Developments • Support • Project Management

7. But who are the users? • Doctors • Nurses • Therapists • Administrators • Diagnostic services • Imaging • Pathology • Pharmacy

8. It is a joint project • All good projects have users at the forefront • It involves significant amounts of technical IT support • It involves significant amounts of change management but: • Don’t expect World peace • Existing processes are not all bad • Don’t underestimate the benefits of simple things like legibility and availability

9. Clinical input has always been important • Clinical Champions : original research team had • A medical and a surgical consultant, • A nurse and change leader • Representatives from diagnostic departments • Implementation team had technical and clinical members • Clinical Analysts – what are they? • Clinical trainer? • Original Project Board chaired by A&E consultant and membership included 2 doctors from the pilot area as well as nursing and diagnostic representatives

10. Our CCIO

11. Jack is not alone • Current IT Strategy Group has 3 consultants including Medical Director and Jack as well as nursing representation • Current EPR Support/implementation team includes 9 members who are either still registered and practice or were nurses previously • My deputy is a microbiologist by background

12. Why is this important? • They understand the process and know what really happens • They know what could be better • They will use the solution • They will break it • They will talk to/encourage their peers • They are sometimes a law unto themselves

13. How do you get them involved? • Engage • “Please ask them not to give me the history of the company and all the trusts they have worked with otherwise I promise I will walk out.” • Meet at their convenience • Listen • On the clinical front they tend to know what they are talking about • Deliver • Phase delivery to show you are making progress and you can achieve goals • Get them to eulogise • In most cases their peers trust them

14. They aren’t always right though

15. Examples of joint working • Original order comms • Diagnostics v clinicians • PACS • Orthopods and templates • Clinical Noting • How do specialties differ? • Electronic Prescribing • Rebellion in the ranks • eClerking • Who decides what is absolutely necessary? • Working outside of the Trust boundaries • Agreeing what is important to share

16. Any Questions? ColinSweeney@nhs.net