Benefits of Spine Mini
Services
Sue Bracey
Head of software development & Integration
Agenda
• Plymouth ICT Shared Service (PICTS)
• Spine Mini Services
• PICTS SMS implementation
• Benefits and caveats
• Where to next
• Conclusion
Plymouth ICT Shared Service (PICTS)
 Provides IT services and support for the local healthcare
community
- 12,000 + users across multiple sites
- Plymouth Hospitals NHS Trust (PHNT) - largest single
site acute hospital in UK
- Community Interest companies /GP’s/PMS/Others
 Local population of over 500,000
 Tertiary services for 1.5m people
Integration at PICTS
Sending
Systems
iPM (PAS)
TCP
A&E
Maternity
iCM-Orders
iCE-GP Orders
Labs
Receiving
Systems
ENSEMBLE
Integration Engine
FTP
FS
TCP
WEB
Web
SQL
Email
Labs
CRIS
Maternity
Neonatal
Innovian
Viewpoint
Radiotherapy
Infection Control
Radiance
Sonicaid
CACHE
DATABASE
ESR
OLE/ODBC
Spine Update
iCE-GP Results
Trauma Board
Text
Radiology
A&E
iCM-Results
Apply Business Rules
Store
Filter
Transform
Route
Send
iPM
ICNARC
Renal
Stoma Care
Cancer
Registry
Chlamydia screening
Torbay/Treliske Labs
Occ Health
Speech
recognition
Process > 250,000 messages / day
Local solutions
Others -departmental
Spine Mini Services
 What are Spine Mini Services?
 Services that allow you to retrieve information direct from the
spine - in real time.
 SMS options:
 Verify NHS number
 Get NHS number
 Get patient’s demographic details
 Why Mini?
 Reduced options - we can’t update the spine - something we
need to take forward with cfh - hcic
 Having retrieved the data we get to decide what to do with it.
Why introduce spine mini services
• Interested in ITK
• Technology partners of intersystems
• To improve our data quality
– Non spine compliant PAS
– No real time access to up to date demographic
information
– Few NHS numbers for newly registered patients,
reducing our ability to communicate with other
healthcare providers in a timely fashion.
PICTS, SMS Implementation
 Worked with InterSystems and CFH through Common
Assurance Process (CAP)
Are
Patients
Safe?
Is the
Solution
Resilient?
Can we
Audit the
Requests?
Is It
Secure?
You
The Trust
Your
Patients
Trust Operating Model
Is Data
Safe?
Spine Services – Work flow
TIE
(Ensemble)
AE
SALUS
iPM
(PAS)
A01
ADT Flow
A31
Spine
Checker
Other
System
SMSP
Maternity
Refer to data
Quality Team
Spine
Queries to DQ Team
 Spine Mini Services live May 2012
Benefits
 Patient safety - Large reduction in the number of discharge
summaries and other correspondence being sent to the wrong
GP.
 Anecdotally similar reduction in the number of letters
sent to the wrong address.
 Patient safety – documented incident where a patient
was linked to the wrong (deceased) patient. – DQ alerted
in real time.
 Patient safety – documented incident where a patient
was linked to the correct (deceased) patient. – patient
had been incorrectly recorded as deceased on the spine
– DQ alerted in real time, GP informed, spine corrected
Benefits
 Patient safety - documented incident where a long term
regular patient was found to have the wrong NHS
number recorded against them.
 Patient safety - documented incident where a patient
was linked to the wrong patient on iPM and the details
adjusted to match.
 Its quick and saves time - DQ team. They update iPM
and the NHS number appears checked and verified in
seconds.
 Reduction in calls to DQ team.
Caveats
• The spine is a good source of data – but it is not
perfect
• Humans exist on both sides of the primary
secondary care divide. – and humans make
mistakes.
• Bad practice - Documented incident(s) where patient’s
address fields have been used for other purposes,
overwriting their actual address and delaying
treatments.
What next
TIE
Other
System
(Ensemble)
ITK
Federated
messaging
service
ADT Flow
iPM
(PAS)
GP
System
A31
Spine
Checker
SMSP
Work
Flow
Refer
to data
Quality Team
Spine
Trust A
Message
Flow
Summary
• Spine mini services improves patient care, saves time and is
one of the key enablers to the safe sharing of information
across healthcare organisations.
• Spine mini services, in conjunction with business rules
improves data quality at the trust, at the GP practice and on the
spine and helps to identify mistakes early.
• Supported by HSCIC we should look to standardise on
business rules to support spine mini services.
• Supported by HSCIC we should look to standardise on
workflow elements to support spine mini services.
Questions?