Business and Benefits Realisation Advisory Group of the

1
London Programme for IT
Identifying, measuring and monitoring the
benefits that the Community Health Record Service
(RiO) can bring to London Laurence Wells and
Kevin Hopps

• Business and Benefits Realisation Advisory Group
  of the
• Primary Care and Community Health Programme
  Board
• 31 May 2007

2
Why do Benefits Management?
London Programme for IT

• Ensure maximisation of benefits in trusts by
  aligning benefits with business drivers and
  service improvement
• Aid local staff engagement by focussing on
  benefits and impact of changes during process
  design and after deployment
• Inform a benefits led programme that uses
  intelligence on benefits realisation to ensure
  effective engagement, deployment and future
  design and build
• Provide information for the trust and the London
  Programme (BT and LPfIT) to demonstrate the value
  of investment made.

3
Joint working
London Programme for IT

• Working with national CFH Benefits team
  delivering 3 key work packages
• Benefits Measurement
• Benefits Demonstrators
• Benefits Registers and Annual Benefits Review
• Working with SPFIT and other SHAs to share
  evidence and lessons learned
• Working with BT
• Building trust capability
• Collecting benefits and change evidence

4
A robust benefits management approach is required
.
Change Management Approach
Stage 1 Strategic Planning
Stage 2a Pre-deployment Workshops
Stage 2b Location Preparation
Stage 3a Deployment
Stage 3b Deployment Closure
Trust Profile Transformation Objectives
Localised Transformation Approach
Benefits Realisation Plan
Change Benefits Optimisation Action Plan
Change Action Plan
Stakeholder Plan Governance Structure
Go-Live Action Plan
Benefits Register
Benefits Management
Business Case
Reporting
Realisation
Benefits Register
Governance
5
The benefits approach is integrated into the team
change management approach
Change Management Approach
Stage 1 Strategic Planning
Stage 2a Pre-deployment Workshops
Stage 2b Location Preparation
Stage 3a Deployment
Stage 3b Deployment Closure
Trust Profile Transformation Objectives
Localised Transformation Approach
Benefits Realisation Plan
Change Benefits Optimisation Action Plan
Change Action Plan
Define approach, owner, who needs to be involved,
when
Stakeholder Plan Governance Structure
Go-Live Action Plan
Benefits Register
Benefits Management
Business Case
Reporting
Realisation
Benefits Register
Governance
6
The benefits approach is integrated into the team
change management approach
Change Management Approach
Stage 1 Strategic Planning
Stage 2a Pre-deployment Workshops
Stage 2b Location Preparation
Stage 3a Deployment
Stage 3b Deployment Closure
Trust Profile Transformation Objectives
Localised Transformation Approach
Benefits Realisation Plan
Change Benefits Optimisation Action Plan
Change Action Plan
Identify benefits, objectives, outcomes,
enablers, measures
Stakeholder Plan Governance Structure
Go-Live Action Plan
Benefits Register
Benefits Management
Business Case
Reporting
Realisation
Benefits Register
Governance
7
The benefits approach is integrated into the team
change management approach
Change Management Approach
Stage 1 Strategic Planning
Stage 2a Pre-deployment Workshops
Stage 2b Location Preparation
Stage 3a Deployment
Stage 3b Deployment Closure
Trust Profile Transformation Objectives
Localised Transformation Approach
Benefits Realisation Plan
Change Benefits Optimisation Action Plan
Change Action Plan
Agree owners, document baseline, set targets,
agree measures.
Stakeholder Plan Governance Structure
Go-Live Action Plan
Benefits Register
Benefits Management
Business Case
Reporting
Realisation
Benefits Register
Governance
8
The benefits approach is integrated into the team
change management approach
Change Management Approach
Stage 1 Strategic Planning
Stage 2a Pre-deployment Workshops
Stage 2b Location Preparation
Stage 3a Deployment
Stage 3b Deployment Closure
Trust Profile Transformation Objectives
Localised Transformation Approach
Benefits Realisation Plan
Change Benefits Optimisation Action Plan
Change Action Plan
Report benefit achievement against targets
Stakeholder Plan Governance Structure
Go-Live Action Plan
Benefits Register
Benefits Management
Business Case
Reporting
Realisation
Benefits Register
Governance
9
Benefits support for RiO v5
Change benefits optimisation
Deployment
Early engagement
Transformation Approach
Benefits Tracking
Business case
Benefits reports
Benefits reviews
Generic business case benefits consultancy
support
Local benefits register
Local benefits realisation plan
Support for reporting reviews
Support for baselining
Trust benefits training
RiO v5 benefits register
10
Why manage benefits post-deployment?

• Tracking and monitoring benefits
• To maximise value of the system by ensuring
  benefits plans are kept up to date
• To manage dis-benefits, target shortfalls and
  identify corrective action

• Benefits Reporting to the project board
• To help the Board prioritise change activities
• To keep the Board focussed on service improvement
• Undertaking a benefits review
• To demonstrate whether benefits have actually
  been achieved
• To raise the profile of ICT and transformation
  within the trust as an enabler of service
  delivery
• To persuade staff of the value of the change with
  evidence
• To embed a culture of continuous improvement

11
How do you measure benefits?

• Formally reported benefits

• Before and after snapshots

• Anecdotal benefits, eg.
• It has improved turnaround time, but update from
  all staff is essential.

12
What you have told us

• To date RiO version 4 benefits prioritised by the
  trusts have focused on
• Faster access to real time information
• Improved referral management
• Improved caseload management the ability to
  allocate, reallocate and share clients between
  care professionals
• Improved teamwork due to the greater visibility
  of the clinical record, enabling
  multi-disciplinary teams to share and view
  information, within confidentiality guidelines
• Proactive planning of services - management
  information sourced from one data source leading
  to more timely and accurate information
• Reduction in duplicate records
• Improved recording of outcomes

13
Some examples of real RiO benefits

• Increased allocation of patients to both GPs and
  appointment slots
• Prior to RiO paper based, no view of accuracy.
  Now 97 of patients are allocated leading to
  reduced risk of lost income. In Podiatry a report
  can be run in less than an hour that shows all
  patients with no GP to their name, before RiO 15
  teams had to be contacted to do a paper review
  that would take at least a week to do with no
  proof of accuracy
• Reduced DNAs
• In most therapies DNA rates have improved. In 2
  services prior years DNA rate averaged 10, now
  at Feb 07 3.9
• Reduction in Duplicate Records
• First test of duplicate records showed 547
  patients had 1,111 records, with some having 3 to
  4 records. These have now been merged and reviews
  starting in other areas
• Reduced Waiting Times
• In some therapies, due to improved allocation of
  patients, a letter is sent out immediately, a
  request for an appointment is made asking the
  patient when they would like to come in and at
  which location (improved sharing and access to
  information) ensuring minimal waiting time.
• Improved Management Information
• All services are now benefiting from improved
  speed and accuracy and completeness of
  information. Reports are backed up by detailed
  reports enabling improvement in reviews rather
  than reviewing accuracy of data

14
RiO Version 5 Benefits

• Improved access and quality of information
  enabled by more structured and standardised
  clinical data and reporting
• Improved security and access to patient
  information through the Single Sign On and
  compliance to Role Based Access
• Improved recording of clinical information
  provided by annotated clinical diagrams
• Improved client safety due to visibility of
  demographics and allergies in patient banner
• Improved integration, including automatic
  updating of people and organisation details
  through a centralised contacts list
• Improved compliance to local policies,
  consistency of information and version control
  through help text function