1. Primary Care Division C1907250Page 101/06/2014 INFORMATION MANAGEMENT and DEVELOPMENT within PRIMARY CARE SCOTTISH GOVERNMENT HEALTH DEPARTMENT Sheena MacDonald Senior Medical Adviser SGHD/Associate Medical Director (Primary Care) NHS Borders

2. Primary Care Division How did she get to be there?? I have absolutely no idea! Used to be a technophobe Now just a normal user – a mother, a wife, a GP, a patient 22 years in GP Associate Medical Director in Primary Care Medical Adviser in Primary Care Pragmatist...most importantly a clinician – if its not in the best interests of the patients why are we doing it? C1907250Page 201/06/2014

3. Primary Care Division C1907250Page 301/06/2014 INVESTIGATING THE INFORMATION JOURNEY IN PRIMARY CARE WHAT IS PRIMARY CARE? General Practices and their systems – GPASS on the way out EMIS and VISION on the way in OOH – Taycare on the way out, Adastra in in 11 boards – not yet confirmed contract to replace Taycare Community Nursing - MIDAS, EPEX, PMS, GPASS, EMIS, EDIS, EDISON, PAPER, NONE Community Hospitals – HOMER, PMS, Paper ??? Dentistry, optometry, mental health, sexual health etc etc NHS BORDERS 18 SYSTEMS

4. Primary Care Division THE FUTURE The Future is here just unequally distributed The other Future - the demographic challenges – co- morbidities, epidemic of new diseases, aging population, aging workforce The resources - Do more for less The Quality Agenda – and do it better If we always do what weve always done........ we will implode! C1907250Page 401/06/2014

5. Primary Care Division C1907250Page 501/06/2014 Investigating the information journey April 2010 scoping exercise WHAT DO WE HAVE ?..tell me the story of the journey of a development need 1.E health sponsored CLINICAL PORTFOLIO MANAGEMENT GROUP – overseeing development of In Patient Management System 2.E health sponsored PUBLIC HEALTH PORTFOLIO MANAGEMENT GROUP 3.SCIMP, PCCIU, PTI, ISD, NISG, PSD, SEF, CCLG……. ECS, ePCS 4.E pharmacy 5.Eye-care 6.Dental systems 7......and the rest

6. Primary Care Division What have we done? Weve punched above our weight GPASS E prescribing Patient records/summaries Sci gateway ECS ePCS ePharmacy Eyecare Etc etc Despite no overarching governance/oversight C1907250Page 601/06/2014

7. Primary Care Division C1907250Page 701/06/2014 WHAT DO WE NEED? April 2010 scoping exercise the future is here just unequally distributed apply the best to the rest Mandate for change – Primary Care National meetings, individual meetings with key stakeholders Declaration of Strategic Direction- acknowledge the unique nature of Primary Care within NHS Scotland Single point of access/entry with standardised process for raising issues Detailed work up of requests including technical advice, user in put reality check Prioritisation and authorisation Detailed development, testing, procurement

8. Primary Care Division C1907250Page 801/06/2014 OCTOBER 2010 PROGRESS

9. Primary Care Division C1907250Page 901/06/2014 Portfolio Management Portfolio Management is a co-ordinated collection of strategic processes and decisions that together enable the most effective balance of organisational change and business as usual What this means in practice is: A portfolio is a collection of projects and systems that are grouped by a theme. The portfolio can then be managed by a board that are interested in further development of these projects/systems. Portfolio management is about ensuring systems and projects are: –aligned to the organisation strategy; –contribute to the delivery of policy goals; –effectively use resources; and –have clear and measurable benefit that justifies the investment.

10. Primary Care Division C1907250Page 1001/06/2014 Portfolio Management in eHealth The eHealth Programme Board approved the use of Portfolio Management Groups (PMGs) to strengthen governance of existing operational systems within the programme. The aims of portfolio management in eHealth are to: 1.increase the realisation of benefits from existing systems; 2.ensure that changes to existing products are aligned to the strategic direction of the eHealth Programme; and 3.better manage dependencies across the portfolio. It was agreed that four PMGs would be established: –Clinical –Public Health –Business Systems –Infrastructure We are now setting a fifth PMG on behalf of Primary Care Directorate.

11. Primary Care Division C1907250Page 1101/06/2014 Why bother? Portfolio management should mean: –co-ordinated change across Primary Care Directorate –removal of redundant or duplicated projects –more efficient resource utilisation –improved transparency, accountability and organisational governance We will achieve this by ensuring that: –strategic decisions are made based on clear understanding of cost, risk, impact on operational systems and strategic benefits to be realised; –all changes are reviewed frequently in terms of progress, cost, risk, priority, benefits and strategic alignment; and –an improved structure is in place for groups to engage PCD.

12. Primary Care Division C1907250Page 1201/06/2014 BMA

13. Primary Care Division C1907250Page 1301/06/2014 PCPMG PCPMG: –Produce delivery strategy for Primary Care IT –Consider requirements for change and issue commissions –Consider development proposals and make recommendation to eHealth Programme Board/Primary Care Directorate –Monitor dependencies between the systems and projects within and across portfolios –Monitor delivery progress MEMBERSHIP MD chair PCD ISD PSD E health Users Group

14. Primary Care Division THE ENGINE ROOM SPCF: –Channel and prioritise requests from HBs, SCIMP and suppliers –Implement commissions raised by PCPMG –Facilitate specs definition –Provide forum for HBs, SCIMP and suppliers –Support technical work up, testing and procurement – monitor delivery of maintenance and support JUDG –Prioritise users change requests – Provide forum for user groups to discuss specific product issues and National requirements –Provide guidance on commissioned work –Provide framework for local support –Feed requests and input to SPCF C1907250Page 1401/06/2014

15. Primary Care Division C1907250Page 1501/06/2014 Development Proposals

16. Primary Care Division C1907250Page 1601/06/2014 Change Management and Development Proposals A proposal will need to describe: –the enhancement or upgrade –the impact on the underlying programme or services and any dependent projects/programmes/products/services – the cost of implementing and maintaining –what SMART benefits are to be expected –the timescale for completing –the risks of implementing/ not implementing the change. –Appropriate user engagement

17. Primary Care Division C1907250Page 1701/06/2014 Prioritisation Principles To help prioritise the proposals a set of principles have been developed by the existing PMG Members. The Prioritisation Principles are as follows: –Should be linked to the Primary Care or eHealth Strategy –Should be linked to policy objectives and supported by the policy lead as forming part of a coherent solution –Should have 50% coverage of Scotland or if low volume - high impact –Should have clear and measurable benefit that justifies the investment, outlining how and when the benefit will be realised Proposals will be assessed against these principles and a recommendation made. All proposals submitted will receive feedback whether approved or not.

18. Primary Care Division What will we do first? WALK BEFORE WE CAN RUN! Concentrate on GP systems in first instance Urgent issues Confirm engine room including father of SCIMP Migration issues Docman transfer completion Option appraisal for data extraction tool including future of PCCIU and PTI Adastra REAL TIME TEST – Flu vaccination And then - Community nursing, e pharmacy, dentistry, e care.... The world! C1907250Page 1801/06/2014

19. Primary Care Division C1907250Page 1901/06/2014 Questions…

20. Primary Care Division QUESTIONS FOR YOU How can we increase the number of people in the room who feel they can influence the e Health agenda?? The three main GP systems contracts are held by the NHS Boards – how much can we/ should we do at a national level? What are your priorities? What are our CRAP issues? C1907250Page 2001/06/2014