1. eHealth Records Programme Therapies EPR Project Service Design Meeting Gaelle Fertil, Therapies Project Manager Monday 19 th July 2010

2. Agenda: 1.Project Background 2.Project Objectives 3.Project Scope 4.Stage 1 – Referrals Go-live 5.Stage 2 – Electronic clinical noting 6.Scanning and Upload Solution 7.External Suppliers 8.Hardware Requirements 9.Testing Overview 10.Outstanding issues 11.Current Statement of Revenue Costs Therapies EPR Project Service Design

3. Project Background:  Existing Therapies system (TSS) reached end of life 2006.  Directorate encouraged to replace with solution delivered via “core systems”.  “Therapies Clinical Notes” work stream identified in 2007 “eHealth Project Brief”.  Therapies EPR Project approved at February 2009 CPB as Trust Risk Rating 1.  Clive Mellish took over management of project June 2009, followed by Anthony McCourt in March 2010, followed by Gaelle Fertil in June 2010.  Significant analysis undertaken to identify requirements and enable definition project scope and objectives.  Project split in two:  immediate interim delivery – Phase 1, divided into 2 stages:  Pan Trust Referrals Go-live – 19 th July  Therapies Directorate OP electronic noting staged Go-live  long term strategic delivery (via re-invigorated eHealth strategy) - TBC  Project re-start and associated costs signed off by CPB in November 2009. Therapies EPR Project Service Design

4. Project Objectives:  To enable a paper-lite environment across the Central Therapies Directorate.  To deliver solutions in response to Therapies requirements which can be then be reused and applied Trust-wide. Therapies EPR Project Service Design Project Scope:  Phase 1  “Native” iCM functionality  Scanning and Upload solution to capture residual paper  Delivery to outpatient pathways in:  Foot Health  Nutrition and Dietetics  Occupational Therapy  Patient Appliances  Psychology  Physiotherapy  Social Work Support and Hospital Discharge Department/Safeguarding  Speech and Language Therapy  Spiritual Health

5. Stage 1 – Referrals Go-live 19 th July  Using native iCM Functionality, referrals are orders in EPR.  14 Referrals going live (x1 Psychology deferred): Physiotherapy OUTPATIENT Referral Occupational Therapy INPATIENT Referral Occupational Therapy OUTPATIENT Referral Hand Therapy OUTPATIENT Referral Patient Appliances Referral (OP and IP use) Patient Appliances Order (OP and IP use) Speech & Language Therapy INPATIENT Referral Speech & Language Therapy OUTPATIENT Referral Foot Health Referral (OP and IP use) Nutrition & Dietetics Referral (OP and IP use) Chaplaincy Referral Social Services Section 2 Referral Social Services Section 5 Referral Adult Safeguarding Referral  Training has been provided by the project  Security rights have been set up: 2 levels of security rights - Order and Modify. Training tracker has been updated  IT Apps have been provided with briefing about the Go-live Therapies EPR Project Service Design

14. Stage 2 – Electronic clinical noting  Figures show total number of items of each category that need to be configured in iCM (i.e. not volumes).  Results relate to submission via the “Results Submission” solution and require an order item in iCM and an order requisition form to be created.  Reports will be bespoke Crystal reports, where they can be created – requirements for reports are in discussion. Therapies EPR Project Service Design 6 11

15. Stage 2 - Scanning and Upload Solution  Figures show count of document type to be scanned in to iCM (i.e. not volume).  S&U Solution is as per King’s supplied and built solution, on EPR+ framework.  Monthly volume is 16,000 per month. Therapies EPR Project Service Design

16. Stage 2 - Scanning and Upload Solution Therapies EPR Project Service Design

17. External Suppliers:  Scanning and Upload solution – King’s College London  No service agreement in place  EPR+ framework – King’s College London  No service agreement in place  Growth Chart (TBC) – Harlow Printing Ltd  Solution in requirements and design phase  Subject to further discussions at CPB Therapies EPR Project Service Design

18. Hardware Requirements Therapies EPR Project Service Design  Figures show approximate count of expected requirement for hardware to enable effective, efficient use of solution but will be confirmed during hardware review later in project.  Number of scanners required dependent on solution adopted. Figures shown are expected minimum required (one per distinct location).  Number of “PCs” denotes number of input devices required, not necessarily desktop computers: could be laptops, tablets, PDAs etc.  Additional technology may also be required e.g. smart pens, magic whiteboards, annotation tablets etc. which will be determined during the hardware review.

19. Testing Overview:  iCM:  Configuration Testing  User Acceptance Testing  Performance Testing – using Syntel  S&U solution:  System Testing (currently failed) – Development team  Performance Testing – using Syntel  Growth Chart (TBC) – Harlow Printing Ltd  System Testing – Development team  User Acceptance Testing Therapies EPR Project Service Design

20. Outstanding Issues:  Outstanding service level agreements with external supplier  Assume the currently service agreement with EPR is sufficient  Ability for EPR to function on wireless network  ER18 – iCM “crashing issue”  Other outstanding iCM issues identified during initial round of UAT  Scanning and Upload issues  Agreement on scope of performance testing by Syntel Therapies EPR Project Service Design

21. Current Revenue Costs as signed off in PID: Therapies EPR Project Service Design DescriptionCost PA Reactive Support Assumption for number of calls taken by service desk for project is 30 calls / month. Same amount for referring problems on and problem resolution (2nd and third line). £4,500 Proactive Support Relationships and supplier management. 20 days / year for "large project" like this. Every business area meets with Application Support Manager to look at how 'things are going'. Application Support Manager also meets with suppliers on a quarterly basis. For large project = £400 / day = £8000 / year. Handover / training = £400 / day @ 5 days = £2000 / year. Capacity planning: 5 day / year (includes meetings to discuss capacity etc) at £400 / day = £2000 / year. 3 rd Line Development activities (15 days / year) for Scanning and Upload Solution Disaster recovery: minimum 20 days for large project - not applicable for Therapies EPR project. £8,000 £2,000 £6,300 Change Changes to configurable items (e.g. changes to flowsheets / knowledge trees, printer reconfiguration etc.) System administration (user management) 20 days @£400 / day = £8000£8,000 Training Assuming an estimated attrition rate of 10% 0.5xFTE at Band 6 (£16,000 pa)£16,000 Annual Total:£51,300  “IT Operations" costs excluded, as IT&T had no metrics to estimate these costs

22. ? Discussion: Service Design Therapies EPR Project