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https://nww.stuff.nhs.uk. Or Whither NHS net. Why?. Long personal involvement Central to all the changes that surround us Knowledge is power Pretending it isn’t going to affect us is not an option. Why?. Not for coding clerks. Who don’t have a long term future.

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https nww stuff nhs uk

https://nww.stuff.nhs.uk

Or Whither NHS net

slide2
Why?
  • Long personal involvement
  • Central to all the changes that surround us
  • Knowledge is power
  • Pretending it isn’t going to affect us is not an option
slide3
Why?
  • Not for coding clerks.
    • Who don’t have a long term future.
  • Not just for the IT department.
  • For us all, clinical workers and management workers alike.
slide4
What?
  • The NHS plan.
  • Information for health.
      • 1998
      • Our LIS.
      • Our local funding.
  • Building the information core.
      • Jan 2001.
  • Other bits from all over.
strands in all this
Strands in All This
  • Communications
  • Records
  • Information
new ways of working
New Ways of Working
  • Not bolting computers onto existing practices
  • About redesigning work
  • Redesigning care
  • New pathways in the jargon
net targets
Secondary care

Clinical and support staff;

25% have desktop access by now

Really is 20% ‘ish

100% by 2002

Primary care

GPs and managers

95% practices connected by now

Really is 80% ‘ish

90% desktop access by now

Really 50% ‘ish

All 100% by 2002

NET Targets

But but but but but !

uses now
Email

Net browsing

Information source

Fax out (doesn’t work!)

NSTS (not that reliable!)

Reading the stuff the NHSe no longer publishes – cures insomnia.

National address book?

GP registration links.

GP IOS links – for the brave.

Uses Now
security
Security
  • Lags behind
  • Caldicott
    • Awareness
    • Safe havens etc etc
  • National audit scheduled for Dec 2001
    • To BS7799
  • NHS cryptography
    • Roll out spring 2002
    • Public key encryption
what next uses of nhs net
What Next? – Uses of NHS net
  • National priorities are pathology requests and reports.
  • Then xray reports and requests.
  • Booking.
  • Discharge information.
jargon
Jargon

EPR

  • Electronic Patient Record
    • ? Attainable

EHR

  • Electronic health record
    • ? Holy grail
clinical terminologies
Clinical Terminologies
  • Coding viz classifications
  • Read 3
    • Ends 2003
  • SNOMED – CT
    • Starts 2003
  • ? Legacy coding and classifications
epr level 3
EPR Level 3
  • Integrated patient master index.
      • PAS.
      • Departmental systems (all departments)
  • Electronic clinical orders and results reporting.
  • Prescribing software.
  • Multi-professional care pathways.
epr primary care
EPR – Primary Care
  • RFA99 legalises electronic records.
  • RFA99 roughly equates with levels 4-5 of secondary care EPRs.
  • Big problem is hospital letters.
    • ? Scanning.
    • ? EDI.

? 90% of practices by 2003

epr primary care16
EPR – Primary Care
  • Integrated nursing and medical EPRs are coming.
  • National framework expected in Sept 2001.
  • End of many Korner MDS expected in next month or two.
  • Local initiatives already underway.
epr out of hours
EPR – Out of Hours
  • National programme
  • To make summaries of GP EPRs available 24 hours a day
  • First to GP out of hours services
  • Then to A+E departments
  • ?? 2005
epr mental health
EPR – Mental Health
  • Separate plans for mental health EPR.
  • Separate funding stream.
  • Integrated social and health records.
  • Shared with social services.
  • 25% by 2003 ?
  • Locally ahead of the game.
epr acute hospitals
EPR – Acute Hospitals
  • Weird set of levels defined by the NHS
  • 35% of acute trusts to have a level 3 EPR by 2002
  • 100% by 2005
  • Plenty of words and management speak out here – few systems!
local status
Local Status
  • 9 practices have full desktop NHS net connection.
  • All practices should be connected by end of year.
  • 16 practices have new LANs.
  • 6 practices “paperless.”
  • 5 practices going “paperless.”
local status21
Local Status
  • FHN has connection.
  • FHN has too poor a LAN for full desktop access.
  • We have started a project for pathology reporting and requesting.
  • We hope to add in radiology soon.
  • Networking information sources is proceeding.
information
Information
  • NICE
  • NeLH
  • Protocols
  • Policies
  • Guidelines
  • HiMPs
  • CHiMPs

And uncle tom cobbly….

payroll and hr
Payroll and HR
  • A national payroll and HR system is planned to start rolling out in 2004.
  • Doing away with individual organisational arrangements.
caveats
Caveats
  • Knowing that nurses share the same records and can rapidly communicate with doctors will allow more task sharing, profoundly changing the nature of medical work.
caveats25
Caveats
  • A lush information landscape where information is shared with patients leaves some things unknown:
  • If 1% of patients join the worried well?
  • Sharing all records with patients?
caveats26
Caveats
  • How much extra time to spend capturing and structuring records?[1] – 30 minutes plus per day.
    • [1] Tierney et al JAMA 1993;269:379-83.
caveats27
Caveats
  • Are we ready to share our information with patients ?
    • The strategy says there are irresistible arguments for this.
caveats28
Caveats
  • Control
  • Governance
  • Accreditation (and Re- )
  • Performance related pay
  • Politics

Or just my depixol dose is late.

a personal hope
A Personal Hope

Clinical Needs

Not

Technology for its own sake