practical support for clinical governance www'prodigy'nhs'uk

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PRODIGY

• Louise Wilson
• Sowerby Centre for Health Informatics at
  Newcastle (SCHIN)
• 8 November 2001

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Todays session

• 2.30pm Introducing PRODIGY
• 2.45pm What does PRODIGY look like?
• 3pm Breakout groups
• 3.30pm Breakout groups feedback
• 4pm Close

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Welcome to PRODIGY!
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Modern icons
Bringing a bit of the north with us!
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The challenge for the NHS is to harness the
information revolution and use it to benefit
patients. Rt. Hon. Tony Blair, All Our
Tomorrows Conference, Earls Court, London. 2nd
July 1998
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Paradigm shift
Information is power
Information sharing is power
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Medical Information Explosion

• To keep up to date would need to read up to 50
  journals in some specialist areas

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Reported time available for reading information
to support decision making (Oxford)
Minutes reading
90
45
0
Med Student
HO
SHO
Reg
Sp Reg
Consultant
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PRODIGY practical support for clinical
governance
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What is PRODIGY?Major initiative to develop and
evaluate computerised decision support for
primary care

• It is a computerised decision support system for
  GPs
• It sits within current GP software
• It offers authoritative, appropriate and up to
  date advice
• Adapts national guidelines to the PRODIGY model
• It can be used during the consultation or as a
  reference tool outside the consultation
• It involves the patient in making decisions
• It provides practical support for clinical
  governance

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What it is not

• Free standing program
• Limited to advice on drug therapy
• Diagnostic system
• Mandatory system of guidance

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Who developed PRODIGY?

• Sowerby Centre for Health Informatics at
  Newcastle University (SCHIN)
• Based on a Dutch idea, Prescriptor
• PRODIGY is funded by Department of Health
• GP users - over 900 had the opportunity to use
  PRODIGY in development phase
• Involved the GP clinical system suppliers

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Demonstration

• A look at the PRODIGY (Release One) browser
• Available at www.prodigy.nhs.uk
• or on a GP clinical system

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Clinical Governance

• A framework through which NHS organisations
  are accountable for continuously improving the
  quality of their services and for safeguarding
  high standards of care by creating an environment
  in which excellence in clinical care will
  flourish

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Clinical governance

• Clinical governance embraces several concepts,
  including
• evidence based health care
• improving patient care
• clinical audit
• risk management
• life long learning

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University of Leicester (June 2000)Survey of the
development of clinical governance in England and
Wales

• Aim
• To identify local groups strategies for clinical
  governance, and what support they need in its
  implementation
• Method
• Postal questionnaire to 506 PCGs and LHGs in
  England and Wales (65 response rate)
• Results (I)
• 96 are developing a strategy for clinical
  governance
• 81 are organising education/training events
• Most see their role to be coordination (top
  answer) and leadership

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Summary report findings (2)Support needed to
implement clinical governance

• Protected time (91.5)
• Development of information systems (65)
• Data handling (60.8)
• Advice on accountability (60)
• Advice on strategy development (55.6)
• Advice on the best ways to share good practice
  (49.8)
• Developing leadership and facilitation skills

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PRODIGY and Clinical Governance (1)

• evidence-based practice is in day-to-day use
• risk management tool
• facilitates patient involvement
• facilitates clinical audit of diagnosis,
  treatment and care of patients
• supports GPs in updating their knowledge and
  skills

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PRODIGY and Clinical Governance (2)

• Offers a manageable chunk of change
• Structured, contained and not too scary approach
  to informatics and using the clinical computer
  system
• Facilitates individual and organisational
  learning
• Facilitated communications and access to a
  community of practice

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PRODIGY National Dissemination Programme

• To enable, educate, support and facilitate GPs
  and other stakeholders to understand, use and
  access PRODIGY effectively.

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The ApproachReviewing the literature

• Training and education was central to the
  implementation of guidelines.
• Where possible existing educational sessions
  were used.
• Multiple active strategiesfell into three main
  categories
• (1)   local change agents and opinion leaders
• (2)  training and education, and
• (3) advertising
• Hall L Eccles M (2000)

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Using the computer in the consulting room
Room layout is a compromise
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Breakout Groups

• 3 groups with transparencies or flipcharts and
  pens
• 30 minutes to discuss elect someone to feedback
  for 5 minutes
• Group One How might the use of PRODIGY enable
  better team-working?
• Group Two What training needs would a group of
  clinicians have about using PRODIGY? How might
  the needs be met?
• Group Three How might you measure the success of
  implementing a tool like PRODIGY (individual,
  locality and nationally)?

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Breakout groups feedback
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Where next for PRODIGY?

• Ongoing research and development
• PRODIGY 2 scheduled
• Improved guidance specificity (e.g. more
  appropriate recommendations)
• Wider choice of treatment available
• Improved referral guidance
• Improved usability (Windows interface)
• Direct support for NSFs (e.g. data collection
  items)
• Improved condition (particularly chronic disease)
  management
• Improved scenario specificity
• Capacity for data collection and just in time
  decision-support
• Improved reminders functionality
• Capacity for joined-up-working through use of the
  guidance across the practice and professions
• Improved data quality

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The Tube
It is tomorrow's laptop. Voice recognition makes
a keyboard optional and a flexible liquid-crystal
display changes the form from a square to a
scroll that rolls out. Low voltage lets a
pared-down processor do most tasks, and wireless
access connects you to the Net for such
heavy-duty applications as language translation.
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Contacting the team

• Sowerby Centre for Health Informatics at
  Newcastle
• University of Newcastle
• 16/17 Framlington Place
• Newcastle upon Tyne NE2 4AB
• PRODIGY NDO 0191 243 6196
• Fax [phone]
• prodigy-enquiries_at_schin.ncl.ac.uk