1. NHS Fife eHealth Clinical Strategy February 2016

2. Purpose- eHealth current & Future state Outline eHealth landscape within Fife Offer opportunity to comment on current limitations Consolidate a view of Gaps Inform Clinical Strategy & eHealth strategy for the future Introduction

3. NHS Fife – Strategic products

4. Clinical Portal Key Message Part of the South East Consortium – can view data (results, letters, healthcare encounters) from NHS Lothian, NHS Dumfries & Galloway and NHS Borders All data held with sci-store is visible in the portal – digital dictated letters, Immediate Discharge Letters, Labs/Radiology/Endoscopy results. Ability to manually scan & upload document into sci-store therefore visible in the portal eg Correspondence from Medinet Healthcare encounters for 1 year in past and 1 year forward visible in the portal – this is key if patients are receiving treatment within Lothian. Emergency Care Summary (ECS) information is visible in the portal as is Electronic Key Information Summary (eKIS). For staff who require to view information with boards which are not part of the consortium we have store-store sharing via sci-store – NHS Tayside, NHS Forth Valley, NHS GGC and NHS Golden Jubilee (Single Sign On) Statistics Over 4000 staff including GP’s have access Between 14000-18000 patients viewed every month through the portal NHS Fife have over 14000 patients in Fife with an eKIS

5. Oasis/TrakCare Key Message Oasis manages patient pathways from referral to outpatient waiting list to inpatient Produces the Boards national reporting information for ISD A&E real-time whiteboard for the management of patients in VHK A&E, QMH MIU, St Andrews MIU and Adamson MIU Feeds multiple other systems with real-time information around admissions, discharges and transfers (eg Patientrack and Wardview) Plan to move off Oasis and onto National PMS System – TrakCare by Spring 2017 Statistics Over 2000 staff use the Patient Management System (PMS) Oasis All NHS Fife hospital sites use Oasis to manage the patient pathway System is used 24/7 365 days Additional Benefits of TrakCare Built in Order Comms – initially for Labs & Radiology with a view to expand eg ECG Built in Referral Management System Ability to send letters to sci-store therefore visible in the Clinical Portal Ability to send letters electronically to the GP via EDT System used by 9 other NHS Scotland Boards

6. Gateway and Electronic Document Transfer (EDT) Key Message SCI Gateway The capability to send referrals electronically to hospital services. Referrals sent via SCI Gateway go into SCI Store – therefore are in the Clinical Portal. Ensures speedy, complete, legible referrals can be sent. EDT EDT ensures GP systems are kept up to date with hospital service communications. Allows GP intervention where required i.e gets into their workflow. Sends IDLs electronically to GPs and SCI Store. Allows the sharing of information between Boards where this has been agreed Statistics SCI Gateway Use 57 GP Practices 43 Optometrists 64 Dentists 12000 referrals made per month via SCI Gateway EDT A total of 603,400 Documents transferred via EDT during 2015 including: Adastra – 92,500 Bowel Screening – 3,000 Breast Screening – 4,000 Immediate Discharge Letters – 15,000

7. GP Systems Key Message Practice re provisioning to web based platforms 2018 LMC support single system Realisation that key data requires to be shared Wider community integration to be explored GP data streaming for “Disaster Recovery” commenced Statistics 58 GP Practices Mixed economy (15 INPS) 7 further migrations to EMIS Online services enabled 8476 repeat prescriptions requested on line this FY 2202 Appointments booked on line this FY 10508 Patients logging in this FY 702 Appointments cancelled this FY

8. Laboratory & Radiology Key Message Cyberlab & iCRIS Electronic ordering across Acute & Community Results available via Clinical Portal (validated & unvalidated laboratory results are available direct from Labcentre) All results available to all clinicians with appropriate access rights Future Existing labs ordering continues to be rolled out What happens to unvalidated results & blood transfusion? How do we increase uptake? Trakcare will be enabled from 2018 to deal with order communications and results reporting (worklists) Statistics 67% of all Laboratory workload now processed through Cyberlab 82% Acute uptake where rolled out 88% uptake by GP’s. Available for use by all Approximately 19% of radiology requests go through iCRIS 3.5k requests / month Used throughout Acute – wards & clinics Not used in GP practice

9. Tiara Key Message Primarily a Patient Administration system for Allied Health professionals i.e manages referrals and waiting lists Provides the ability to record clinical information for 2 services Statistics 940 Users 8 Services

10. Patientrak Key Message Real-time mobile visibility of the sickest patients, on the Patientrack ward view and across the hospital, for the first time Transparent ward level performance. This has driven the biggest and fastest change in clinical practice seen by staff involved Significant improvement in vital signs observations – now more accurate scoring A step towards achieving Scotland’s national drives on the deteriorating patient, reducing harm, lowering avoidable mortality, quality improvement and enhancing patient safety The system automatically calculates and communicates early warning scores for deteriorating patients to the people who need to intervene Ward managers have instant visibility of priority patients and can ensure they receive the care needed One of the most clinically relevant safety huddles in Scotland – live data is available for meaningful discussion about patients current status. Statistics Immediate reduction in cardiac arrests by up to two thirds in one of the busiest areas of the hospital

11. Wardview – Supports patient flow / focus on IDD SKYPE – Internal communications / links with other boards IM&VC Real time Dashboards (800 accesses per month) Ascribe – Pharmacy Stock Control upgrade Telehealth – How could it help ? Other Capability

12. Points to note- ICT is expensive and needs to be targeted Services are required to co own business cases – investment vs savings Policy of “Buy not Build” within NHS Scotland Common Understanding

13. Questions / Discussion