ICT Developments in
Greater Glasgow NHS
Board
Joanne Frame, ICT Culture Change Programme Manager
Katie Thomson, Stroke ICT Project Facilitator
Janice Watson, Heart ICT Project Facilitator
The NHSGG ICT Strategy and the
‘Clinical Portal’
Why a Portal Toolkit?
The Big Picture!
Clinical Portal
Clinical Data Flows
Discharge
Diabetes
InterAgency
Information
Mental
Health
Integration
Clinic
Letters
SCI Store
Middleware
Direct
Access
Blood
Pressure
Appointment
Booking
Renal
Test
Requesting
Cancer
Labs
XRay
PAS
HISS
PIMS
Pharmacy
GP
Systems
Appointment/
Resource
Scheduling
Core Patient Information Systems
Disease/Specialty-Specific Systems
Heart
Disease
Referral
What’s in the Toolkit?
• Single Sign On and Patient Context,
with Results Viewing
• Security, Privacy and Consent
• Clinical Workflow
• Medical Transcription/discharge
letters
• Complex Scheduling
• Order Communications
The ICT Culture Change
Programme
Glasgow
- wide
Project
Management
Method
(ELMP)
Leadership & Team
Development
IT Training
Programmes
Project Management
Tools, Techniques
& Support
Supporting Staff
Through Change
(mentoring and coaching)
Stroke ICT Project
Katie Thomson
Project Facilitator
NHS GG ICT Strategy
To “really make a
difference” to patient
care by providing, to the
right person, the right
information, under the
right safeguards,
whenever and wherever
required.
Referral
Diabetes
Discharge
Heart
Disease
Building the Electronic Record
Clinic
Letters
SCI Store
Repository
Real-time
“Fetch”
Embed
System
Mental
Health
Inter
Agency
AHPs
Etc.
Stroke
PAS
HISS
PIMS
GP
Systems
Labs,
X-Ray
Appointment/
Resource
Pharmacy
Scheduling
Patient Information Systems
Disease/Specialty-Specific Systems
Clinical Information Flows
Building the
Electronic Record
Project Background
•
•
•
•
Commissioned by the Stroke MCN
Pan Glasgow Approach
Have 5 Acute Hospitals & 3 Rehab Hospitals
All using different documentation, outcome
measures and processes
• Follow the full patient journey from acute care
through to long term follow up in the community
Data sets
• Build on existing documents
• Not an ICP
• In a format suitable for an EHR
Aims of EHR
• To have the same clinical system used across
Stroke care in Glasgow
• To make clinical information more accessible (for
those who need to see it)
• To prevent duplication of effort
• To capture audit data automatically
• To use guideline based decision making aids
• To improve patient care
Progress to date
•Formed multi-disciplinary working groups
•Agree data standards for all professional groups
•Piloted data sets on paper
•Identified a pilot site
•Working towards our first electronic pilot
Use of EHR:
• Real time data capture
• Mobile working with wireless technology
• Integrate with other systems eg. Labs, Order
Comms, IDLS
• Reduce paperwork
• Produces GP Letter, Patient Information,
Referrals etc
Progress to date
• Basic IT & Next Steps Training has been offered
to all staff
• All staff have e-mail accounts & Internet access
• Basic training on electronic records has been
provided
Progress to date
• Desktops installed
• Wireless points being installed
• Mobile devices on order
Culture Change:
• Use of technology
• Change in working practice
• Culture Change Strategy
Culture Change Strategies:
• Information & Communication
• Opportunity to be involved
• Training and drop in sessions
• Start small & work at their pace
Links with National Activity
• Data Standards for Stroke
• Links with other areas undertaking similar
projects
• National Advisory Group
• Scottish Stroke Care Audit
Heart ICT Project and
other considerations
Janice Watson
Project Facilitator
Referral
Diabetes
Discharge
Heart
Disease
Building the Electronic Record
Clinic
Letters
SCI Store
Repository
Real-time
“Fetch”
Embed
System
Mental
Health
Inter
Agency
AHPs
Etc.
Stroke
PAS
HISS
PIMS
GP
Systems
Labs,
X-Ray
Appointment/
Resource
Pharmacy
Scheduling
Patient Information Systems
Disease/Specialty-Specific Systems
Clinical Information Flows
Building the
Electronic Record
Project Background
• Commissioned by the Heart MCN
• Pan Glasgow Approach - spans 5 acute hospitals
•
• All using different documentation, outcome measures and
processes
• Cardiac in-patients in CCU, cardiology and acute receiving
wards and cardiac rehabilitation
• Scope - patients admitted to A&E given a cardiac referral for
chest pain or breathlessness
Data sets
• Build on existing documents
• Not an ICP - added value
• In a format suitable for an EHR
• In alignment with NCDDP national data
standards and initiatives (generic, CHD core
data set, cardiac rehab, SCI ACS etc.)
Progress to date
•Formed multi-disciplinary working groups
•Almost finalised data standards for all professional
groups
•Pilot data sets in electronic format (unlike stroke)
•Identified a pilot site
•Working towards our first electronic pilot
Issues, challenges and
considerations
• People
• Organisational
• Aspirational
People - patients
• Security and confidentiality
– We must ensure that:
• the patient consents to use of their information
• every user can see all appropriate information
• every user is prevented from seeing inappropriate
information
• there is a robust and complete record of
“who viewed what”
• Balance between usability and strict security – requires
close co-operation between clinical and technical experts
– formation of Clinical Reference Group
– creation of a security matrix for Glasgow
People - patients
• Consultation
– patient focus public involvement
– links with national bodies (e.g. consumer
council)
People - staff
• Build in a culture change infrastructure first
• Identify and provide the right tools - e.g. email
access, mobile devices, wireless technology etc
• Identify the training issues
– ensuring staff are released for training
– recognising and responding to fear of
technology
– using Agenda for Change (KSF and job
descriptions) to facilitate the culture change
People - staff / technical
• Articulating service needs
• Understanding what the technology can do for you
– paper view vs electronic view
• Data quality issues
– ownership
– CHI awareness - learning maps, group discussions
– continuous process monitoring and improvement
Organisational Issues
• High degree of co-ordination and communication
between local and national initiatives
• Constantly changing environment
• Build in a project management ethos
• SCI Store
– delivering when necessary
– national CHI - availability and cross boundary
issues
Aspirational
• Long term investment needed
– people
– organisation
– technology
Thanks for listening!
Any questions?