1. e-Health in NHS Scotland
Dr Stuart Scott
Clinical Director e-Health NHS Grampian GP

2. And What Does eHealth Do For Clinicians???
Facilitate Communication National system Internet Access SCI Gateway SCI Store
First point of contact Health Records
Allows Labs/Radiology etc to function
Primary Care
Acute Care
Self Care
Get results to the treating clinician
Support /Develop clinical systems for recording clinical data
Reduces Clinical Risk CHI
Linking areas Networked PCs Firewall protection
Provide Information Service planning WL Management

3. NHS Scotland Strategic Aims
Core Application
Labs
Others
A&E
PACs Rx
PAS
Others
Single Record

4. NHS Scotland Strategic Aims
PACs
PAS
Labs Rx
Others
A&E
Single Record
HUB

5. NHS Scotland Strategic Aims

6. GP Practice Hospital CHI Elgin Radiology SCI Store eLinks GP Portal
PCI
CHI
PAS
Abdn Radiology
Elgin Radiology
Other Systems:
A&E
PROTOS
Clinical Vision
CHEO Care
Pharmacy
Labs
INDIGO 4 Labs
Lung Cancer
SCI Discharge
EMAS
TOM CAT
ECS
ERFS
SCI Store
All non-sensitive Labs results
Radiology Reports
PAS/CHI Demographics
PAS ADT/OP
Clinical Letters
A&E Summaries
eLinks
Legacy Systems
GP Portal
SCI Store
PCI
PAS
CGI
ECCI Letter Browser
Other reference web links
GCS
GP Practice
Hospital
ECCI Letters
ECCI Letters V2
SCI Gateway
Standard Referral Letters (1-2)
Cancer Ref. Letters (1-2)
Lung Cancer IDL (2-1)
A&E Summaries (2-1)
CGI
X400 Referrals

7. I wouldn’t start from here….
Federated approach doesn’t work
Speed of standardisation
Not enough levers
Political pressure growing
England all sorted then!

8. 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

9. PACS Access to images where and when required
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

10. HEPMA Safety Governance Clinical clamour Available products Case for
Case against
Available products

11. Theatre Systems Case for Major area of workload Governance
Risk management
Case against
Back to the waiting lists again
Bean counting mentality

12. Order Entry Safety Data quality Time saving Governance
Embed in referral
Add-on for SCI Store
Separate procurement

13. Infrastructural elements
Much of the eHealth programme dependent upon robust and reliable telecoms
Business continuity – no longer a luxury
Standards

14. Consent Public engagement Emergency Care Summary – First Engagement
total records in the store 4,433,431
total no patients who have withdrawn consent 219

15. NPfIT aka CfH
Why are we messing around trying to do our own thing?

16. Scottish Telemedicine Centre
Delivering for Health proposed it
Based in Aberdeen

17. 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

18. Single logon / Authentication
Security model needs enhanced to cope with increasing mix of systems/users/roles
Need technology
Need resource to manage

19. Comms capacity What is the projected life of existing bandwidth?
Users expect it to limitless….

20. Business Continuity Are we covered for clinical/key systems?
Managed Service vs Local Board Level Provision
24/7 Support

21. Current Risks iSOFT Gpass National Procurement/Local Implementation
NHS Board Revenue Capabilities

22. Questions?