Presentation on theme: "E-Health in NHS Scotland Dr Stuart Scott Clinical Director e-Health NHS Grampian GP."— Presentation transcript:
e-Health in NHS Scotland Dr Stuart Scott Clinical Director e-Health NHS Grampian GP
First point of contact - Health Records Support /Develop clinical systems for recording clinical data Linking areas - Networked PCs - Firewall protection Facilitate Communication - National system - Internet Access - SCI Gateway - SCI Store Provide Information - Service planning - WL Management Allows Labs/Radiology etc to function Get results to the treating clinician Primary Care Acute Care Self Care And What Does eHealth Do For Clinicians??? Reduces Clinical Risk - CHI
NHS Scotland Strategic Aims Single Record Core Application PACs A&ELabs RxPAS Others
NHS Scotland Strategic Aims Single Record HUB PACs A&E LabsRx PAS Others
NHS Scotland Strategic Aims
SCI Store All non-sensitive Labs results Radiology Reports PAS/ CHI Demographics PAS ADT/OP Clinical Letters A&E Summaries SCI Gateway Standard Referral Letters (1- 2) Cancer Ref. Letters (1-2) Lung Cancer IDL (2-1) A&E Summaries (2-1) GP Portal SCI Store PCI PAS CGI ECCI Letter Browser Other reference web links eLinks PAS CHI Labs Abdn Radiology Elgin Radiology Legacy Systems Other Systems: A&E PROTOS Clinical Vision CHEO Care Pharmacy Lung Cancer SCI Discharge EMAS TOM CAT ECS ERFS CGI INDIGO 4 Labs X400 Referrals ECCI Letters PCI GCS Hospital GP Practice ECCI Letters V2
I wouldnt start from here…. Federated approach doesnt work Speed of standardisation Not enough levers Political pressure growing England all sorted then!
Generic Clinical System Pressing ahead but should we be? What do we require to implement? –Training –Support –IM&T Staff –Project management –Authentication –Single sign-on –SCI-Store pre-requisites –Prioritisation – Local/National
PACS Advantages –Access to images where and when required –Remote diagnostic support –Financial savings –Political –Should beef up the locally available kit –Improved use of CHI number Disadvantages –Expensive –More technical than cultural –Political
HEPMA Case for –Safety –Governance –Clinical clamour Case against –Safety –Governance –Available products
Theatre Systems Case for –Major area of workload –Governance –Risk management Case against –Back to the waiting lists again –Bean counting mentality
Order Entry Safety Data quality Time saving Governance Embed in referral Add-on for SCI Store Separate procurement
Infrastructural elements Much of the eHealth programme dependent upon robust and reliable telecoms Business continuity – no longer a luxury Standards
Consent Public engagement Emergency Care Summary – First Engagement total records in the store 4,433,431 total no patients who have withdrawn consent 219
NPfIT aka CfH Why are we messing around trying to do our own thing?
Scottish Telemedicine Centre Delivering for Health proposed it Based in Aberdeen
PC Infrastructure Mix of ancient kit will slow apps and increase support Microsoft Enterprise Agreement Patches/Virus/Security Mix of software stacks Cost of maintaining
Single logon / Authentication Security model needs enhanced to cope with increasing mix of systems/users/roles Need technology Need resource to manage
Comms capacity What is the projected life of existing bandwidth? Users expect it to limitless….
Business Continuity Are we covered for clinical/key systems? Managed Service vs Local Board Level Provision 24/7 Support
Current Risks iSOFT Gpass National Procurement/Local Implementation NHS Board Revenue Capabilities