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e-Health in NHS Scotland

e-Health in NHS Scotland. Dr Stuart Scott Clinical Director e-Health NHS Grampian GP. Self Care. Acute Care. Primary Care. And What Does eHealth Do For Clinicians???. Facilitate Communication - National email system - Internet Access - SCI Gateway - SCI Store.

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e-Health in NHS Scotland

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  1. e-Health in NHS Scotland • Dr Stuart Scott • Clinical Director e-Health NHS Grampian • GP

  2. Self Care Acute Care Primary Care And What Does eHealth Do For Clinicians??? • FacilitateCommunication- National email system - Internet Access - SCI Gateway - SCI Store • First point of contact- Health Records • Allows Labs/Radiology etc to function • Get results to the treating clinician • Support /Develop clinical systems for recording clinical data • Reduces Clinical Risk- CHI • Linking areas - Networked PCs - Firewall protection • ProvideInformation- Service planning - WL Management

  3. NHS Scotland Strategic Aims Core Application Labs Others A&E PACs Rx PAS Others Single Record

  4. NHS Scotland Strategic Aims PACs PAS Labs Rx Others A&E Single Record HUB

  5. NHS Scotland Strategic Aims

  6. PCI CHI PAS AbdnRadiology ElginRadiology • Other Systems: • A&E • PROTOS • Clinical Vision • CHEO Care • Pharmacy Labs INDIGO 4 Labs • Lung Cancer • SCI Discharge • EMAS • TOM CAT • ECS • ERFS • SCI Store • All non-sensitive Labs results • Radiology Reports • PAS/CHIDemographics • PAS ADT/OP • Clinical Letters • A&E Summaries eLinks LegacySystems • GP Portal • SCI Store • PCI • PAS • CGI • ECCI Letter Browser • Other reference web links GCS GP Practice Hospital ECCI Letters ECCI Letters V2 • SCI Gateway • Standard Referral Letters (1-2) • Cancer Ref.Letters (1-2) • Lung Cancer IDL (2-1) • A&E Summaries (2-1) CGI X400 Referrals

  7. I wouldn’t start from here…. • Federated approach doesn’t work • Speed of standardisation • Not enough levers • Political pressure growing • England all sorted then!

  8. Generic Clinical System • Pressing ahead but should we be? • What do we require to implement? • Training • Support • IM&T Staff • Project management • Authentication • Single sign-on • SCI-Store pre-requisites • Prioritisation – Local/National

  9. PACS • Advantages • Access to images where and when required • Remote diagnostic support • Financial savings • Political • Should beef up the locally available kit • Improved use of CHI number • Disadvantages • Expensive • More technical than cultural • Political

  10. HEPMA • Case for • Safety • Governance • Clinical clamour • Case against • Safety • Governance • Available products

  11. Theatre Systems • Case for • Major area of workload • Governance • Risk management • Case against • Back to the waiting lists again • Bean counting mentality

  12. Order Entry • Safety • Data quality • Time saving • Governance • Embed in referral • Add-on for SCI Store • Separate procurement

  13. Infrastructural elements • Much of the eHealth programme dependent upon robust and reliable telecoms • Business continuity – no longer a luxury • Standards

  14. Consent • Public engagement • Emergency Care Summary – First Engagement • total records in the store 4,433,431 • total no patients who have withdrawn consent 219

  15. NPfIT aka CfH • Why are we messing around trying to do our own thing?

  16. Scottish Telemedicine Centre • Delivering for Health proposed it • Based in Aberdeen

  17. PC Infrastructure • Mix of ancient kit will slow apps and increase support • Microsoft Enterprise Agreement • Patches/Virus/Security • Mix of software stacks • Cost of maintaining

  18. Single logon / Authentication • Security model needs enhanced to cope with increasing mix of systems/users/roles • Need technology • Need resource to manage

  19. Comms capacity • What is the projected life of existing bandwidth? • Users expect it to limitless….

  20. Business Continuity • Are we covered for clinical/key systems? • Managed Service vs Local Board Level Provision • 24/7 Support

  21. Current Risks • iSOFT • Gpass • National Procurement/Local Implementation • NHS Board Revenue Capabilities

  22. Questions?

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