e-Health in NHS Scotland

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e-Health in NHS Scotland

• Dr Stuart Scott
• Clinical Director e-Health NHS Grampian
• GP

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And What Does eHealth Do For Clinicians???

• Facilitate Communication - 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

• Provide Information - Service planning
  - WL Management

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NHS Scotland Strategic Aims
Core Application
AE
Labs
Others
PACs
Rx
PAS
Others
Single Record
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NHS Scotland Strategic Aims
PACs
PAS
Labs
Rx
Others
AE
Single Record
HUB
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NHS Scotland Strategic Aims
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PCI
CHI
PAS
Abdn Radiology
Elgin Radiology
Labs

• Other Systems
• AE
• PROTOS
• Clinical Vision
• CHEO Care
• Pharmacy

INDIGO 4 Labs

• Lung Cancer
• SCI Discharge
• EMAS
• TOM CAT
• ECS
• ERFS

• SCI Store
• All non-sensitive Labs results
• Radiology Reports
• PAS/CHI Demographics
• PAS ADT/OP
• Clinical Letters
• AE Summaries

eLinks

• GP Portal
• SCI Store
• PCI
• PAS
• CGI
• ECCI Letter Browser
• Other reference web links

Legacy Systems
GCS
GP Practice
Hospital
ECCI Letters

• SCI Gateway
• Standard Referral Letters (1-2)
• Cancer Ref. Letters (1-2)
• Lung Cancer IDL (2-1)
• AE Summaries (2-1)

ECCI Letters V2
CGI
X400 Referrals
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I wouldnt start from here.

• Federated approach doesnt work
• Speed of standardisation
• Not enough levers
• Political pressure growing
• England all sorted then!

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Generic Clinical System

• Pressing ahead but should we be?
• What do we require to implement?
• Training
• Support
• IMT Staff
• Project management
• Authentication
• Single sign-on
• SCI-Store pre-requisites
• Prioritisation Local/National

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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

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HEPMA

• Case for
• Safety
• Governance
• Clinical clamour
• Case against
• Safety
• Governance
• Available products

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Theatre Systems

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

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Order Entry

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

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Infrastructural elements

• Much of the eHealth programme dependent upon
  robust and reliable telecoms
• Business continuity no longer a luxury
• Standards

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Consent

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

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NPfIT aka CfH

• Why are we messing around trying to do our own
  thing?

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Scottish Telemedicine Centre

• Delivering for Health proposed it
• Based in Aberdeen

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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

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Single logon / Authentication

• Security model needs enhanced to cope with
  increasing mix of systems/users/roles
• Need technology
• Need resource to manage

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Comms capacity

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

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Business Continuity

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

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Current Risks

• iSOFT
• Gpass
• National Procurement/Local Implementation
• NHS Board Revenue Capabilities

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Questions?
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