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INFORMATION MANAGEMENT and DEVELOPMENT within PRIMARY CARE SCOTTISH GOVERNMENT HEALTH DEPARTMENT. Sheena MacDonald Senior Medical Adviser SGHD/Associate Medical Director (Primary Care) NHS Borders. How did she get to be there??. I have absolutely no idea! Used to be a technophobe

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information management and development within primary care scottish government health department

INFORMATION MANAGEMENT and DEVELOPMENT within PRIMARY CARESCOTTISH GOVERNMENT HEALTH DEPARTMENT

Sheena MacDonald

Senior Medical Adviser SGHD/Associate Medical Director (Primary Care) NHS Borders

C1907250 Page 127/11/2014

how did she get to be there
How did she get to be there??
  • I have absolutely no idea!
  • Used to be a technophobe
  • Now just a “normal” user – a mother, a wife, a GP, a patient
  • 22 years in GP
  • Associate Medical Director in Primary Care
  • Medical Adviser in Primary Care
  • Pragmatist
  • ...most importantly a clinician – if its not in the best interests of the patients why are we doing it?

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investigating the information journey in primary care
INVESTIGATING THE INFORMATION JOURNEY IN PRIMARY CARE

WHAT IS PRIMARY CARE?

  • General Practices and their systems – GPASS on the way out EMIS and VISION on the way in
  • OOH – Taycare on the way out, Adastra in in 11 boards – not yet confirmed contract to replace Taycare
  • Community Nursing - MIDAS, EPEX, PMS, GPASS, EMIS, EDIS, EDISON, PAPER, NONE
  • Community Hospitals – HOMER, PMS, Paper ???
  • Dentistry, optometry, mental health, sexual health etc etc

NHS BORDERS 18 SYSTEMS

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the future
THE FUTURE
  • “The Future is here just unequally distributed”
  • The other “Future” - the demographic challenges – co-morbidities, epidemic of new diseases, aging population, aging workforce
  • The resources - Do more for less
  • The Quality Agenda – and do it better
  • If we always do what we’ve always done........ we will implode!

C1907250 Page 427/11/2014

investigating the information journey
Investigating the information journey
  • April 2010 scoping exercise

WHAT DO WE HAVE ? ..tell me the story of the journey of a development need

  • E health sponsored CLINICAL PORTFOLIO MANAGEMENT GROUP – overseeing development of In Patient Management System
  • E health sponsored PUBLIC HEALTH PORTFOLIO MANAGEMENT GROUP
  • SCIMP, PCCIU, PTI, ISD, NISG, PSD, SEF, CCLG……. ECS, ePCS
  • E pharmacy
  • Eye-care
  • Dental systems
  • .....and the rest

C1907250 Page 527/11/2014

what have we done
What have we done?
  • “We’ve punched above our weight”
  • GPASS
  • E prescribing
  • Patient records/summaries
  • Sci gateway
  • ECS
  • ePCS
  • ePharmacy
  • Eyecare
  • Etc etc

Despite no overarching governance/oversight

C1907250 Page 627/11/2014

what do we need
WHAT DO WE NEED?
  • April 2010 scoping exercise

“the future is here just unequally distributed” “apply the best to the rest”

  • Mandate for change – Primary Care National meetings, individual meetings with key stakeholders
  • Declaration of Strategic Direction- acknowledge the unique nature of Primary Care within NHS Scotland
  • Single point of access/entry with standardised process for raising issues
  • Detailed work up of requests including technical advice, user in put reality check
  • Prioritisation and authorisation
  • Detailed development, testing, procurement

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october 2010 progress
OCTOBER 2010 PROGRESS

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portfolio management
Portfolio Management

‘Portfolio Management is a co-ordinated collection of strategic processes and decisions that together enable the most effective balance of organisational change and business as usual’

What this means in practice is:

  • A portfolio is a collection of projects and systems that are grouped by a theme.
  • The portfolio can then be managed by a board that are interested in further development of these projects/systems.
  • Portfolio management is about ensuring systems and projects are:
    • aligned to the organisation strategy;
    • contribute to the delivery of policy goals;
    • effectively use resources; and
    • have clear and measurable benefit that justifies the investment.

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portfolio management in ehealth
Portfolio Management in eHealth

The eHealth Programme Board approved the use of Portfolio Management Groups (PMGs) to strengthen governance of existing operational systems within the programme.

The aims of portfolio management in eHealth are to:

  • increase the realisation of benefits from existing systems;
  • ensure that changes to existing products are aligned to the strategic direction of the eHealth Programme; and
  • better manage dependencies across the portfolio.

It was agreed that four PMGs would be established:

  • Clinical
  • Public Health
  • Business Systems
  • Infrastructure

We are now setting a fifth PMG on behalf of Primary Care Directorate.

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why bother
Why bother?

Portfolio management should mean:

  • co-ordinated change across Primary Care Directorate
  • removal of redundant or duplicated projects
  • more efficient resource utilisation
  • improved transparency, accountability and organisational governance

We will achieve this by ensuring that:

  • strategic decisions are made based on clear understanding of cost, risk, impact on operational systems and strategic benefits to be realised;
  • all changes are reviewed frequently in terms of progress, cost, risk, priority, benefits and strategic alignment; and
  • an improved structure is in place for groups to engage PCD.

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slide12

BMA

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pcpmg
PCPMG
  • PCPMG:
    • Produce delivery strategy for Primary Care IT
    • Consider requirements for change and issue commissions
    • Consider development proposals and make recommendation to eHealth Programme Board/Primary Care Directorate
    • Monitor dependencies between the systems and projects within and across portfolios
    • Monitor delivery progress
    • MEMBERSHIP
    • MD chair
    • PCD
    • ISD
    • PSD
    • E health
    • Users Group

C1907250 Page 1327/11/2014

the engine room
THE ENGINE ROOM
  • SPCF:
    • Channel and prioritise requests from HBs, SCIMP and suppliers
    • Implement commissions raised by PCPMG
    • Facilitate specs definition
    • Provide forum for HBs, SCIMP and suppliers
    • Support technical work up, testing and procurement
    • monitor delivery of maintenance and support

JUDG

  • Prioritise users change requests
  • Provide forum for user groups to discuss specific product issues and National requirements
  • Provide guidance on commissioned work
  • Provide framework for local support
  • Feed requests and input to SPCF

C1907250 Page 1427/11/2014

development proposals
Development Proposals

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change management and development proposals
Change Management and Development Proposals

A proposal will need to describe:

  • the enhancement or upgrade
  • the impact on the underlying programme or services and any dependent projects/programmes/products/services
  • the cost of implementing and maintaining
  • what SMART benefits are to be expected
  • the timescale for completing
  • the risks of implementing/ not implementing the change.
  • Appropriate user engagement

C1907250 Page 1627/11/2014

prioritisation principles
Prioritisation Principles

To help prioritise the proposals a set of principles have been developed by the existing PMG Members.

The Prioritisation Principles are as follows:

  • Should be linked to the Primary Care or eHealth Strategy
  • Should be linked to policy objectives and supported by the policy lead as forming part of a coherent solution
  • Should have 50% coverage of Scotland or if low volume - high impact
  • Should have clear and measurable benefit that justifies the investment, outlining how and when the benefit will be realised

Proposals will be assessed against these principles and a recommendation made.

All proposals submitted will receive feedback whether approved or not.

C1907250 Page 1727/11/2014

what will we do first
What will we do first?

WALK BEFORE WE CAN RUN!

Concentrate on GP systems in first instance

Urgent issues

  • Confirm engine room including father of SCIMP
  • Migration issues
  • Docman transfer completion
  • Option appraisal for data extraction tool including future of PCCIU and PTI
  • Adastra

REAL TIME TEST – Flu vaccination

And then - Community nursing, e pharmacy, dentistry, e care .... The world!

C1907250 Page 1827/11/2014

questions
Questions…

???

C1907250 Page 1927/11/2014

questions for you
QUESTIONS FOR YOU
  • How can we increase the number of people in the room who feel they can influence the e Health agenda??
  • The three main GP systems contracts are held by the NHS Boards – how much can we/ should we do at a national level?
  • What are your priorities?
  • What are our CRAP issues?

C1907250 Page 2027/11/2014