1 iSOFT in the English National Programme for Information Technology Nick Harte Solution Director

2 National Programme for IT (NPfIT) – What is it? A 10 year programme to modernise delivery of patient care £6.2bn in England to improve patient experience by delivering; –Contact ( and diary functions across NHS) –NHS Care Records Service –Choose and Book –Electronic Transmission of Prescriptions –New National Network –QMAS - supporting GP practices –Picture Archiving and Communications Systems (PACS) Totally computerise patient records, appointment bookings and prescriptions onto a central system that is accessible across the UK by 2010 …The biggest civil IT project ever

3 How is it being delivered? Creation of five equally sized NHS Clusters One Local Service Provider (LSP) per cluster National Application Service Provider (NASP) National Infrastructure Service Provider (NISP)

4 NPfIT – the components N3 National Network LSPs NISP NASPs NHSnet / N3 National Network North East & Humberside East & East Midlands London South East & South West ICRS Data Spine eBooking eTransfer of Prescriptions Transaction Messaging Service North West & West Midlands

5 NPfIT – regional deployments

6 A typical NHS Cluster – North West & West Midlands Population 12m Employees: 300,000 (including IT Staff: 2,500) SHAs: 6 Health Communities / Economies: 31 Acute Trusts: 50 Mental Health Trusts: 13 Primary Care Trusts: 60 GP Practices: 2,500 Installed systems: 5,700

7 What were they looking for in an application service provider ? Sustainability Solution thinking for national/regional health economies Purpose built for integrated healthcare Next generation user experience (reduced training) Service-oriented architecture (reduced disruption) Terminology services (SNOMED CT) Modern, standards-based Workflow as a core service to support process modeling (BPR) Knowledge management Builds on and protects investment in existing infrastructure

8 What the NPfIT will deliver Today View patient demographic data Access to national services Introduce new / additional clinical functionality e.g. clinical documentation 2010 NHS Care Record Service Active patient participation IT support for clinical networks Meeting local requirements All Trusts have capable systems PACS deployment started in Health Communities Deeper clinical content e.g. NSFs, ICPs & Social Care

9 What is iSOFT providing?

10 Presentation Monitor Integration Data Business Services Enterprise Services A Service Orientated Architecture connecting… National application servicesLocal databasesPublic information sources… and Professionals Citizens

11 Drug data (reference terminology) Prescribing Medicines administration Pharmacy management Intelligent searching Multi-facility patient identity management Demographics, HL7v3 support for PDS Structured and un-structured data capture Dictation and annotation Clinical terms, assessments, observations Auto-citation, auto-negation Results mgmt Device interfaces Sanple tracking Laboratory management Radiology management Knowledge-based clinical requests Equipment requests Service requests Management information Organisational modelling and planning Screening and surveillance Clinical audit Epidemiology Clinical research Care plans Care pathways Pathway merging Care-driven resource management Active decision support (branching) Passive decision support (alerting) Evidence-based best practice Authoring support Duty of care and role declaration Configurability Personalisation Context management User experience Device technologies Citizen participation Guaranteed delivery between two or more parties (system – system, system-user) Semantics preserved Notification Escalation Collaboration support Multi-disciplinary team support Functional map of services Demand mgmt Resource mgmt Departmental mgmt Duty of care Encounter mgmt Referral mgmt Capacity mgmt Debt management Purchasing and supplies management Self-pay and insurance Financial audit support

12 LORENZO – Information model

13 Healthcare services across care settings Health economy Care settings Healthcare services

14 What will it look like?

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16 Annotation using TabletPC

17 Medication reminders via mobile phone

18 DiTV services to the citizen

19 The principle is the same… ‘At a glance’ utility No training Personalisation User-centred design Visual language Elegance and simplicity Task-based support But using a slightly different technology platform.Net… today’s Bakerlite?

20 The user experience…

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24 CABALLERO, Henry H J /06/ yrs Male

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49 Summary NPfIT is the largest civil IT project in the world Actually largest Business Process Re-engineering programme (ever) Challenging timetable First truly Citizen focussed healthcare programme (Outcomes) Health economy wide deployments of advanced clinical and process tools Emphasis on knowledge management, workflow, terminology and structured care to support rapidly changing healthcare delivery Extraordinary potential to change the way healthcare is delivered