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Yorkshire Ambulance Service Information Communications Technology NYHDIF Presentation 14 th January 2011 David Johnson Assistant Director - ICT.

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Presentation on theme: "Yorkshire Ambulance Service Information Communications Technology NYHDIF Presentation 14 th January 2011 David Johnson Assistant Director - ICT."— Presentation transcript:

1 Yorkshire Ambulance Service Information Communications Technology NYHDIF Presentation 14 th January 2011 David Johnson Assistant Director - ICT

2 My presentation… Some Ambulance Facts Intro to YAS ICT What weve done Resilience The Changing World Things Id like you to know and support: Emergency Care Solution (ECS) Communication Enabled Business Applications (CEBA) Clinical Hub Capacity Management System (CMS) Directory of Services (DOS) SystmOne Ask Questions as we go along…

3 My presentation… Some Ambulance Facts Intro to YAS ICT What weve done Resilience The Changing World Things Id like you to know and support: Emergency Care Solution (ECS) Communication Enabled Business Applications (CEBA) Clinical Hub Capacity Management System (CMS) Directory of Services (DOS) SystmOne

4 A&E Response Standards & Activity Category A - 8 minute 70.84% Category A - 19 minute 96.71% Category B - 19 minute 91.1% Nationally bottom April-Nov 2010 Category A - 8 minute 76.1% Category A - 19 minute 97.8% Category B - 19 minute 94.6% 5 th position nationally Activity: 999 Calls = 711, Incidents Attended = 599,000 (1650 per day) Transports to Hospital = 485,000 Not Hospital = 114,000 PTS = 1,200,000 (4,300 per day)

5 A&E Response Standards Winter pressures Demand increases System pressures across the health service Huge improvements in response performance Delivering our Operational Improvement Plan

6 Adverse Weather Interesting Facts

7 A&E Resources New stations - York, Hull East, Hull West, Wetherby, Penistone New deployment points New vehicles - 41 ambulances, 19 RRVs, 19 out- of-hours doctors cars, neonatal vehicle New equipment New staff New ways of working Over 750 new staff recruited 51 student paramedics graduated with a Foundation Degree in Paramedic Science, and an additional 30 commenced their year one programme Nearly 100 technicians were successfully supported to achieve Paramedic qualification

8 My presentation… Some Ambulance Facts Intro to YAS ICT What weve done Resilience The Changing World Things Id like you to know and support: Emergency Care Solution (ECS) Communication Enabled Business Applications (CEBA) Clinical Hub Capacity Management System (CMS) Directory of Services (DOS) SystmOne

9 ICT - Some Background Information (1) 1 st July 2006: Merger of- SYAS WYMAS TENYAS 36 WTE

10 ICT - Some Background Information (2) Budget : £000s Pay1,232 Non-Pay4,212 Total5,444 (2.9%) Net of £440k CRES saving Capital1,500 (11%) Support Service: All 1 st and 2 nd Line Support Network, Desktops, Servers, Applications, Telephony & Radio 24 / 7 / 365 – Service Desk 09:00 to 17:00 Monday to Friday Project Support and Application Development Supporting 3 rd Parties with e-learning and ECS Reporting Dell, Cisco, Nortel, Microsoft

11 ICT - Supporting Patient Services: A&E Operations 999 Communication Centres Patient Transport Services GP Out Of Hours Supporting Support Services

12 My presentation… Some Ambulance Facts Intro to YAS ICT What weve done Resilience The Changing World Things Id like you to know and support: Emergency Care Solution (ECS) Communication Enabled Business Applications (CEBA) Clinical Hub Capacity Management System (CMS) Directory of Services (DOS) SystmOne

13 What Have We Completed? From 3 to 2 Communication Centres VIRTUALISATION From 3 to 1 PTS System Resource Management Fleet Management Finance System HR / Payroll ESR Domain / / Intranet / Internet Management Information New Telephony and Call Centre Management Tools Emergency Call Management and Call Connect Support Desktop and Network Infrastructure Standardisation WAN Upgrades and Encryption Estates Reconfigurations GP OOH software upgrade and hardware refresh

14 Continued… Mobile Data System Radio System Controlled Drugs and Access Control PTS Mobile Data PTS Communication Centre Re-design Telephony Management – GUI and IVR Enterprise Backup / Virtualisation / Archiving Sharepoint Enterprise Expanded Citrix Farm Lone Worker Protection

15 My presentation… Some Ambulance Facts Intro to YAS ICT What weve done Resilience The Changing World Things Id like you to know and support: Emergency Care Solution (ECS) Communication Enabled Business Applications (CEBA) Clinical Hub Capacity Management System (CMS) Directory of Services (DOS) SystmOne

16 Pstn. / BTOS Vodafone APN Airwave Digital Radio Infrastructure Airwave Digital Radio Infrastructure Envoy Enterprise **CEBA Hosting (under development) Envoy Enterprise **CEBA Hosting (under development) VPN Wakefield S-Hill 1 Wakefield S-Hill 2 York Fairfields York DR Fairfields GPOOH & Remote Sites iSDN Services (2 x Independent Suppliers) iSDN Services (2 x Independent Suppliers) YAS WAN Fibre 100MB 30MB Telephony Digital Radio Telephony Digital Radio Telephony Digital Radio SAN Mirrored Application Infrastructure CAD Cleric DNS NAS Fleet SAN Mirrored Application Infrastructure CAD Cleric DNS NAS Fleet YAS LAN YAS LAN YAS LAN YAS LAN YAS PTS Control Room YAS A&E Control Room YAS A&E Control Room YAS DR Control Room Centricity PDA & MDT & Lone Worker Support Common YAS Desktops Common Telephony & Contacts Database Common Digital Radio Interface Common YAS Desktops Common Telephony & Contacts Database Common Digital Radio Interface Multiple Channels Of iSDN Delivery Multiple Channels Of iSDN Delivery Multiple Channels Of iSDN Delivery External Service Delivery Physical Site YAS ICT Infrastructure Control Room Operations Technical & Operational Interoperability BCP & DR 999 & Non-999 Telephone Traffic **CEBA is a multi-channel automated Multi-media contact management platform Yorkshire Ambulance Service – NHS Trust Service Delivery & Interoperability Architecture

17 Virtualised CAD System Infrastructure SAN- CX300 WAN Centricity SMG Terrafix MDT BT EISEC PSIAM 100 MB PSIAM BT EISEC CS1K CC6 Centricity Pilot 999 & non-999 for Central-North-South SAN- CX MB CAD traffic only Terrafix MDT Vodafone York C3 AQUA 999 & non-999 for Central-North-South

18 My presentation… Some Ambulance Facts Intro to YAS ICT What weve done Resilience The Changing World Things Id like you to know and support: Emergency Care Solution (ECS) Communication Enabled Business Applications (CEBA) Clinical Hub Capacity Management System (CMS) Directory of Services (DOS) SystmOne

19 The Changing World: Doing more with less (ICT as enabler) Green IT KPIs CPIs Clinical Outcomes Clock Start Cat B The complete patient experience PbR Calls Hear & Treat See & Treat See & Convey Clinical Hub – Pathways (CMS-DOS) - 111

20 My presentation… Some Ambulance Facts Intro to YAS ICT What weve done Resilience The Changing World Things Id like you to know and support: Emergency Care Solution (ECS) Communication Enabled Business Applications (CEBA) Clinical Hub Capacity Management System (CMS) Directory of Services (DOS) SystmOne

21 My presentation… Some Ambulance Facts Intro to YAS ICT What weve done Resilience The Changing World Things Id like you to know and support: Emergency Care Solution (ECS) Communication Enabled Business Applications (CEBA) Clinical Hub Capacity Management System (CMS) Directory of Services (DOS) SystmOne

22

23 Clearly this is not good… For the Ambulance Service, Or The Receiving Hospital. We know the problems/limitations of paper!!! However, there is a tradition for the Ambulance PRF… Where are we heading?

24 What, Why and When: The Emergency Care Solution (ECS) from CSC An Electronic Patient Report Form for Pre-Hospital Care Panasonic Toughbook 3G/GPRS Bearer Access to Protocols, Drug lists, links to Medical Equipment, etc To Improve data capture, transfer and ultimately patient care. Over the next 2-3 years Over 600 vehicles Over 2000 staff

25 ECS? This is not a stand alone product Integration to wider NPfIT solutions is key Our primary interface is with our patient receiving locations (RLs) Engagement…

26 Completed Roll-out: Current Stations: Wakefield South Kirby Castleford Sherburn Over 30 vehicles 24/7 Over 120,000 e-PRFs Current Hospitals with RLs: Pontefract General Hospital Pinderfields General Hospital Dewsbury District Hospital Leeds Teaching Hospitals Barnsley & District General Hospital Doncaster Royal Infirmary Montagu Hospital Bassetlaw Hospital Fieldhead Hospital Bradford Royal Infirmary Thanks to: SHA Support and Staff at Hospital Receiving Locations

27 Completed : Hull Royal Infirmary Link to ED Ambulance pre-Arrival information Electronic Capture of Patient Handover Information to Support ED Escalation process Extend usage to RRV Vehicles in the Wakefield Area Training Department (mainstreaming…) HART Vehicles Officers

28 Continuing the project: Engage with other Hospitals to provide RLs Roll out to other Ambulance Areas Complete Hull and East Riding Improve access to Clinical Audit Information Provide Paramedic access to their individual reports Upgrade to Release 5 (Sept 2011) Further integration – Pathways / CMS, SystmOne…

29 Summary: The ECS is a key part of the Modernisation of the NHS It is designed to be a solution integrated with the wider NHS Now it is about making it happen across Yorkshire to improve patient care…

30 My presentation… Some Ambulance Facts Intro to YAS ICT What weve done Resilience The Changing World Things Id like you to know and support: Emergency Care Solution (ECS) Communication Enabled Business Applications (CEBA) Clinical Hub Capacity Management System (CMS) Directory of Services (DOS) SystmOne

31 CEBA – Modernising PTS

32 Automated Journey Confirmation

33 Automated On-Day Journey Status

34 CEBA – Message Cascade & Major Incidents

35 Automated Incident Management

36

37 My presentation… Some Ambulance Facts Intro to YAS ICT What weve done Resilience The Changing World Things Id like you to know and support: Emergency Care Solution (ECS) Communication Enabled Business Applications (CEBA) Clinical Hub Capacity Management System (CMS) Directory of Services (DOS) SystmOne

38 Clinical Hub…Changing the Response… Capacity Management System (CMS) Directory of Services (DOS) = PATHWAYS = Reduced ED Admissions = most appropriate patient care = supporting the informed patient. SystmOne…

39 SystmOne Implementation Project

40 Access to full patient data on SystmOne will only be made by Clinical Hub staff who are clinically qualified. The information on SystmOne will be used by Clinical Hub staff to support better patient care. It will support decision making on the best course of action such as an alternative care pathway or other care advice. Patient Data Access

41 Patient Consent and Governance Patients, with conditions appropriate for telephone advice, will be asked for their consent to view the data by the emergency call receiver. This consent will be entered onto the control logs and be passed on to the Clinical Hub advisors. The patient data will not be retrieved in the case of an explicit refusal.

42 If no explicit consent/refusal can be obtained, the box Consent not asked would be checked and only if the presenting condition warranted would access to data be undertaken, any access would be supported - stating the reason why the data was retrieved and this recorded in the call logs. Where the patient cannot be found or where there are multiple patients matched and the correct one cannot be identified on SystmOne with complete certainty, no patient information will be retrieved. Current YAS processes will be used. Patient Consent and Governance

43 Patient Record Update and Communications The Clinical Hub advisors will update the patient record with a brief statement of the action taken. This text will be selected from a list of options which is to be agreed. An automatic task will be sent to the SystmOne GP/User informing them of the access of the patient record by the YAS 999 Communication Centre. All patients not found on SystmOne will be handled within current processes.

44 How will YAS use SystmOne? ? Category A or B Category C non life threatening YAS will ask if the caller wishes to speak to a clinical advisor? If No then YAS will refer back to a If Yes then we will gain all personal information and request authorisation to access their GP medical records Clinical Response Transfer call to Clinical Advisor 999 CallYAS Comms Triage

45 Clinical Advisor The clinical advisor will confirm all patient details and that there is consent to access the patients GP record. The advisor will only read review the records for pre-existing conditions and present pharmacology before calling the patient back. Following the outcome of the call the advisor will make an entry into the journal to inform the Primary Care SystmOne user of the YAS Clinical Hub record access and patient care advice. Any follow on actions will be a decision for the Primary Care SystmOne user.

46 Clinical Health desk Clinician on scene requests referral to alternative care pathway e.g. falls, diabetic after gaining the patients permission to authorise - informing their GP by accessing their medical record. The health desk will complete the referral documentation and forward it to the required team. The health desk will access SystmOne and leave a message for information only to the Primary Care user of YAS actions/referral to an alternative response.

47 Benefits of using SystmOne Better and more informed patient care. Increased caller satisfaction by improving the quality of information and pro-active support. Reducing unnecessary emergency ambulance responses and transports to ED.

48 My presentation… Some Ambulance Facts Intro to YAS ICT What weve done Resilience The Changing World Things Id like you to know and support: Emergency Care Solution (ECS) Communication Enabled Business Applications (CEBA) Clinical Hub Capacity Management System (CMS) Directory of Services (DOS) SystmOne

49 Thank you for your time. …the end…


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