Dr Colin Brown

1

• Changing Clinical Software
• Dr Colin Brown
• General Practitioner
• SCIMP Director eRecords
• SCIMP Conference
• Dunblane 2007

2

• Why are we doing this?
• Where are we starting from?
• Where are we going?
• How do we get there?

3

• Clinical System Changes Versions referenced
• Ascribe to Vision 3
• EMIS PCS to Vision 3 from GPASS 5x, Vision 3,
  EMIS LV
• GPASS 5x to EMIS PCS, GPass Clinical/2007, Vision
  3 from Torex HMC iSoft Synergy from Meditel,
  Premiere
• SystmOne from EMIS LV, Vision 3
• Vision 3 to GPASS 4x from GPASS 4x, 5x, Seetec,
  Microtest,
• EMIS LV, VAMP Medical

4

• WHY?
• GP systems are specialist engineered products
  with these unique functions
• constructing a life-long record
• audit trail of all users
• unconstrained scale and content
• structured to support computer processing
• security
• usable in front of patients in their 10 mins
• by any users in Primary Care Team

5

• Overall Plan
• Pre-migration practice development status
• - data quality issues
• Data migration issues
• Data freeze period
• Go Live Day
• New-system learning and design issues
• 3rd-party issues
• General and specific Lessons Learned

6

• Practice development status
• Software
• Hardware and system- local, or remote Managed
  Technical Service- use of old system?-
  continuing use after GoLive? concurrent?
• Business processes
• Training - what are the training needs?- IT
  training - Specific new-system training

7

• Data quality pre-migration
• Codes standard? - Read versions 2 and 3,
  SNOMed
• Freetext
• Drug dictionary data another migration?Issues
  - OP, ADRs, BAN/RINN, custom drug items, old
  scripts
• Metadata data about data e.g. Non-standard
  system admin data Priorities Recalls Reviews

8

• Pre-migration Planning
• phone a friend
• ask the audience1 - access the UG2 - the
  patients - involve them3 - check with occasional
  team users
• split the optionsHB support staff?

9

• Data Migration
• Extraction of data from old database Conversion
  of the extracted data to new database
• format, and of old to new
  data types.Quality Assurance.
• Conversion accuracy?
• Coded and Uncoded data
• InPS - 2 utilities provided
• EMIS - these functions built in to the main
  software

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• Data Freeze
• Datafreeze?
• when your old data has gone for conversion, and
  your new system isnt working yet to use the
  converted data
• BUT - your old system is still working So..
• Computer Downtime - Is there any need for this?
• NO .. (mostly)

13

• Go Live DayHints and Tips from Supplier
• Business Continuity Plan as if paperless
• No routine surgeries, clinics
• Print-offs for the datafreeze period
• Hardware and system configuration on site

14

• Data Melt copying back data from the freeze.
• You've got to do this? - not necessarily so
• Clinical value is max. if sooner not later.
• A technological fix?
• Post-GoLive datafreeze update

15

• New System Learning 1
• Function re-modelling
• Predict the functions to be changed. to
  anticipate how your new system will work
  differently and re-model your business processes
• Original s/w method of delivering a function may
  not be the only way
• Version-specific not brand-names

16

• New System Learning 2
• Design issues e.g.
• on-the-fly coding
• Keyboard use
• Appointments
• Better Display gt Data Quality issues

17

• 3rd Party IssuesDocmanLabeltraceSCI Gateway
  (2nd Opinion)
• SCI Store (web access)
• Managed Server

18

• General Lessons Learned
• Clinical - specific benefits
• Detailed Pros/Cons per user
• Practice Management - similar challenges?
• Summarising for training status
• Lloyd George to A4
• Going paperlight
• Changing premises
• Changing partners
• Changing or new job
• Combine some of these?

19

• DO - LIST 1 - for Suppliers
• online connectivity on Go Live Day v
• share the Drug Dix / coding migrations v
• improve handling of non-coded data
• implement post-GoLive datafreeze update
• consider appointments migrations
• customise migration advice for donor system
• custom-configure the initial setup of new system
• guarantee access to archive data audit trails

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• DO - LIST 2 - for NHS Board IT Depts
• Original s/w h/w keep live v
• Prescription mapping pharmacist support v
• Share local expertise in new processes v
• Test install /configure s/w on hardware platform
  before Go-Live.
• Archive data audit trails contract with
  suppliers to retain legibility
• custom data quality fixes pre-migration support
  GMS IT Facilitators

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• DO - LIST 3 - for Users
• custom benefit lists for each user
• prepare
• engage your local friendly new-system user to
  check out your test data.
• engage your patients
• access all UG support

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• DO - LIST 4 - for Scottish NHS
• Share lessons from GP2GP project
• on migrating data between systems on a
  per-patient basis
• Develop GP2GP v2
• A standard intermediate data format for
  migrations?
• Connect to..
• Connecting for Health

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• DON'T ( specific "errors of commission)
• Suppliers
• Change the GoLiveDay
• Use non-standard pseudo-Read codes
• Health BoardsStrip kit needed for original s/w
  to run
• UsersLeave it all to the leaderGo on Holiday!

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• THE END
• .
• www.visioneer.pbwiki.com
• colin.brown99_at_nhs.net