1. LTC-iHub Update November 2011

2. Lanarkshire LTC-iHub 1.Brief reminder of what the project is about 2.Progress to date and current status 3.What has been learned so far 4.How success will be/is being evaluated 5.Potential for wider applicability

3. 1. Brief reminder of what the project is about

4. TrakCare/ Vision/ MiDiS EDMDiagnostics Interventions Communication Digital Data Capture 2. Progress to date and current status

5. Clarification of Requirement 1

6. Long Term Conditions-iHub Trak Care Labs ECGs PACS Knowledge Guidelines etc Business Intelligence Interactive Meteor Other ECS MiDis Vision SCI Store Ensemble

7. Information Strategic Application ( Vision; TrakCare; MIDID; MAS) Acute Application (Theatres; Cardiology; PACS; Photoware) Community/PC Application (Dental; SCI-DC; NASH;OOH; PIMS) Other Applications (NHS Mail; EDM; eKSF; eExpenses; EDT etc) Portal Options: Orion/MiDis/CareFX/Trak/Ensemble Integration & Interoperability: Ensemble NHS Lanarkshire Applications Strategy

8. P2 ….Links to other applications…. New Referrals My clinic listMy Theatre list Lab & Rad Reports Unread emails Newly diagnosed LTC patients Activity Data Journal Links P1 User Details and Photo MiDis TrakCareMeteor Athena Recently viewed patients Patient Search Sean Brennan Clarification of Requirement 3

9. Miscellaneous Allergies & Adverse events Clinical History Notifications & Legals Investigations & Results Demographics & Contacts Sean Brennan d.o.b 9th.August.1982? Social & Personal Alerts & Risks Healthcare Encounters Admin & Patient Preferences Correspondence Medications & Devices Clinical Notes Observations Notifications & Legal All records 3 rd Party Documents ….Links to other applications…. P1 P2

10. Portal Level 1 (P1) Information From?  My Clinic List  My Theatre Lists  New Referrals  New LTC patients  Clinical Activity Data TrakCare ? MiLan Portal Level 2 (P2) CategoryGROUPInformation PATIENT HEALTH SUMMARY 11.Past medical history 2.Current problem list 3.Current medications (Including GP/Hospital/Chemo etc) 4.Allergies 5.Alerts 1.TrakCare/Vision 360 2.GP Vision 360 3.GP Vision 360/ECS 4.Vision360/ TrakCare 5.Vision360/TrakCare CLINICAL LETTERS 11.Referral 2.Hospital discharge 3.Outpatient clinic 1.SCI Gateway 2.Winscribe 3.Winscribe DIAGNOSTIC TESTS RESULTS 11.Laboratory results 2.Radiology results and images 3.Other diagnostic text results 1.SCI Store/Labs 2.RIS 3.Various KNOWLEDGE SUPPORT 21.Local clinical guidelines 2.National clinical guidelines 3.eBNF 1.FirstPort 2.FirstPort 3.FirstPort ADDITIONAL FUNCTIONALITY (LATER PHASE) 3Context searching and switching to enable Order Communications, etc GP cardiovascular risk scores, a DAS (disease activity score) calculator, Access to MUSE ECG Images Echograms Access to Meteor Rheumatology system Clarification of Requirement 2

11. NHS-L LTC-iHub Project Board Vision 360 Heart Failure Rheumatology COPD LTC-iHub Steering Group NHS-L Portal Programme Ensemble Interface/Design Single Sign On Technical Projects Data Capture Incl digital dictation LTC-iHub & Wider Portal Programme : Interdependancies Portal Design Labs/ IG/ Access LTC-iHub Project ? Elderly EDM OCS Midis

13. A lot of project inter-dependencies –Ensemble development –Single Sign On –EDM –Vision 360 –Digital Dictation Must adopt national standards were possible Feeder system issues –Labs –Cardiology Clinical Coding may be an issue. 3. What has been learned so far

14. ObjectiveHow it will be measured Patients; more effective interaction with the clinician they are seeing Clinician feedback: Survey Clinicians; efficiency and satisfaction Organisation; better use of existing systems and improved quality Clinician feedback: Survey Organisation: Information/IT Review National Objective – The ability of other NHS Boards to use templates developed as needed locally Adoption of templates by other NHS Boards Reduced admissions for some people with long term conditions due to improved access to information to inform decision making. Pre and Post project admissions analysis Improved prescribing via better medicines reconciliationAnalysis of the effect of the LTC: iHub by live audit undertaken by clinicians on a sample of patients. More patient centred care via involvement and improved use of information about health planning Capture feedback from a sample of patients? 4. How success will be/is being evaluated

15. Digital Pen sub project

16. Digital Pen One heart failure nurse Data Capture form created/revised Hardware delivered (one pen/docking station) Dry run with forms 3 month trial Evaluation

17. A new approach to Paper Complete form Send via mobile Check & edit of form data on AuraQ forms management portal prior to publishing (if required) Or Review error messages on mobile, make corrections and re-send Publish data and forms to internal systems Dock with PC Automatic routing of form images via email if no data editing required

22. OCR and Validation Form filled in – Pen Strokes

23. Digital Pen Evaluation 1.A quantitative account of how long it takes to put the info into the computer program now. This is at the office, before and after the pen 2.A quantitative account of how many patients are seen and for how long before and after, to ensure that any benefits are not lost elsewhere 3.a qualitative account of whether there is a change in time for data capture in consultation 4.a qualitative account of whether there is a downside to quality of consult when using the system 5.a qualitative account of what any freed up time is used for 6.a quantitative account of communication with Drs./ others. How long to get letters out faxes out etc., before and after pen.

24. Issues What happens if…………. Meteor : off-shore based. IG and GP data Roll-out/Timescales What happens if mixed notes (e.g. Rheumatology patient attends for a routine general surgical episode etc) Incremental : –ACP’s ; KIS;