The Digital Switchover
One Trusts plans to eliminate paper
Dave Lang – Programme Director
THIS
The Health Informatics Service
Informing Healthcare
• An in-house PAS and a series of connected
systems
• Reasonable levels of integration
• Patient centric clinical viewer
• Some financial investment
• User experience variable
• The national programme for IT
The Health Informatics Service is hosted by Calderdale and Huddersfield NHS Foundation Trust
The Health Informatics Service
Informing Healthcare
The Health Informatics Service is hosted by Calderdale and Huddersfield NHS Foundation Trust
The Health Informatics Service
Informing Healthcare
• Reduction in the number of unnecessary tests
• Reduction in length of stay (LOS)
• Increase in patient safety, reduction in
medical errors
• Reduce repeat admissions
• Reduction in paper based transactions
• Reduction in adverse drug events
The Health Informatics Service is hosted by Calderdale and Huddersfield NHS Foundation Trust
The Health Informatics Service
Informing Healthcare
• Overall increase in
patient satisfaction and
outcome….
• Overall increase in staff
satisfaction and well
being….
The Health Informatics Service is hosted by Calderdale and Huddersfield NHS Foundation Trust
The Health Informatics Service
Informing Healthcare
• Your Care, Our Concern will be our mission and our values will be built
around People, Patients, Partnerships and Pride (which is at the heart of
the approach)
• We will be clinically led and treat patients, staff and partners as we would
expect to be treated ourselves
• Collaboration in the interests of patient care will be central to how we
work both within and outside CHFT
• Real time patient information will always be at hand for us and our
partners to provide the best seamless care
• We will ensure regulatory compliance by improving our access to care for
patients and prioritising their safety
• We will meet the financial circumstances and use this challenge as a
driver for change and not solely as a constraint
The Health Informatics Service is hosted by Calderdale and Huddersfield NHS Foundation Trust
EMR Adoption Model
The Health Informatics Service
Informing Healthcare
“Paperless” patient record environment
for highest quality of care,
data continuity & full HIE
Full electronic clinical decision support, and
highest medication safety
Completely electronic diagnostic image
management
Electronic order entry with decision
support and result reporting
Clinical ordering and documentation –
especially nursing care
A patient-centered electronic data
repository
Electronic diagnostic and pharmacy
department information
The Health Informatics Service is hosted by Calderdale and Huddersfield NHS Foundation Trust
Level of investment
The Health Informatics Service
2011 HIMSS Analytics
Informing Healthcare
based on yearly averages from 2007 through 2011 from HIMSS AnalyticsTM Database (U.S.A.)
The Health Informatics Service is hosted by Calderdale and Huddersfield NHS Foundation Trust
The Health Informatics Service
Informing Healthcare
• Three key strands to the Programme
– Infrastructure
– Tactical & New Systems
– Electronic Patient Record
• Developed a strategy for our EPR/Clinical
Systems
• This is supported by a SOC
The Health Informatics Service is hosted by Calderdale and Huddersfield NHS Foundation Trust
The Health Informatics Service
Informing Healthcare
STRATEGIC
TRIED & TESTED GAME CHANGERS
These systems have delivered significant benefit to other
healthcare organisations, but as yet they have not been
fully deployed at CHFT.
These are systems that support strategic initiatives such
as the shared clinical records
EPR
Patient management
Enterprise Scheduling
Bed Management
Electronic Correspondence
Maternity
Theatres
A&E
Order Comms
ePrecsribing
Clinical Docs
Decision Support
caB
CRV
S1
Therapies
Virtual
Ward
Kiosks
Portal
Telehealth
S1
Community
Specialist
Department
RIS
Labs
Digital
Dictation &
VR
S1
Diabetes
Medicine
Mgmt
Pharmacy
Stock Mgmt
Asset
Tracking
PACS
KEY OPERATIONAL
Systems supporting either functions or
services that are currently fit for
purpose, but could be replaced as part
of an EPR
Patient
Ident
Ensemble
Integration
Engine
LEGACY
Considered legacy systems, need to
be replaced as part of the EPR/PAS
replacement programme
The Health Informatics Service is hosted by Calderdale and Huddersfield NHS Foundation Trust
The Health Informatics Service
Informing Healthcare
Portal
EPR
Patient management
Enterprise Scheduling
Bed Management
Electronic Correspondence
Maternity
Theatres
A&E
Order Comms
ePrecsribing
Clinical Docs
Decision Support
S1
Therapies
S1
Community
CRV
S1 Diabetes
Telehealth
Virtual
Ward
Specialist
Department
Ensemble
Integration
Engine
CaB
Kiosks
Asset
Tracking
• Hybrid Solution
• Still will have an IE
(Ensemble) at its core
• Decisions about portal
to be made
• Some functionality
may be developed
Labs
Digital
Dictation &
VR
RIS
PACS
Medicine
Mgmt
Pharmacy
Stock Mgmt
The Health Informatics Service is hosted by Calderdale and Huddersfield NHS Foundation Trust
The Health Informatics Service
Informing Healthcare
Full EPR
Programme
Initial cost
Annual ongoing
Deployment
Mid point
6 Year cost
£4m - £10m
£1m - £2.2m
£5m-£7m
£22.6m
Of which:
Core EPR
£16.5m
Vital Pack
£1.8m
E-prescribing
£300k - £800k
£75k - £200k
£200k – £300k
The Health Informatics Service is hosted by Calderdale and Huddersfield NHS Foundation Trust
£1.6m
The Health Informatics Service
Informing Healthcare
Benefits
• These have been taken from a handful of other
EPR Business Cases
• They have been adjusted for the size of CHFT
• They have been further reduced to take into
account some tangible benefits CHFT have
already accrued through good practice and the
LEAN work in place at CHFT
• The table shows some preliminary work forecasting
benefits accrual over years
Year
1
2
3
4
5
6
7
Early Clinical quick wins
569
1516
1516
651
651
488
5389
EPR main
273
6557
9971
12613
14329
14572
58316
0
223
562
832
994
1098
3709
842
8296
12049
14095
15974
16159
67414
EPR additional
Total
The Health Informatics Service is hosted by Calderdale and Huddersfield NHS Foundation Trust
The Health Informatics Service
Informing Healthcare
• Developing Governance model and designing
Structure
• Getting clinical buy-in
• Engaging with the organisation
• Deploying Infrastructure & Tacticals
• Market Research including site visits, demo’s
and conferences
The Health Informatics Service is hosted by Calderdale and Huddersfield NHS Foundation Trust
The Health Informatics Service
Informing Healthcare
•
•
•
•
•
Continue to explore the market
Develop OBS
Consider our procurement options
Develop the FBC
Procure a solution
The Health Informatics Service is hosted by Calderdale and Huddersfield NHS Foundation Trust
The Health Informatics Service
Informing Healthcare
ID
Description
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Nov
Dec
Jan
Feb
Mar
Pre-Procurement
1
Organisational Readiness
2
Patient Involvement
3
Develop FBC
4
Demos & Do See
5
Develop Vision
6
Board Sign off Vision
7
Workshops
8
Develop OBS
9
Board Sign off OBS
10
Agree Shortlist
11
Understand Procurement Options
12
Board sign off FBC
13
Procurement
14
Trust signs contract with EPR Supplier
15
EDMS (Document Management)
Tactical's
16
Maternity
17
Theatres
18
eWhiteboards (Bed Management)
19
Digital Dictation and Voice Recognition
20
Vital signs
21
eRostering
22
Self service ESR
23
Wireless Projects
24
eHealth
DD
VR
Infrastructure
25
Video Conferencing
26
Community Agile Working Pilot
27
Wireless Network - CRH
28
Wireless Network - HRI
29
Single sign-On
30
Core IT Infrastructure
31
Acre Mills
32
Unified Comms
33
Replacement PC's
EPR
Enabler
EPR
Enabler
EPR
Enabler
EPR Enabler
The Health Informatics Service is hosted by Calderdale and Huddersfield NHS Foundation Trust
The Health Informatics Service
Informing Healthcare
• We recognise this as the biggest programme
ever for CHFT
• Not trying to do anything new (reinvent
wheel)
– We want to learn from what other people are
doing
– Test our thinking
– Maybe we can help each other
The Health Informatics Service is hosted by Calderdale and Huddersfield NHS Foundation Trust
The IM&T modernisation
programme…
Dave Lang
THIS