April 2005Dawn Friend
Facilitating a new Primary Care System
PRIMIS
Fifth Annual Conference 11 – 12 May 2005
Piecing Together the Future
Dawn FriendCharlotte Warburton
April 2005Dawn Friend
Facilitating a new primary care system
Dawn FriendPrimary Care NPfIT Project Manager
Greater Peterborough Primary Care Partnership
Charlotte WarburtonBusiness Change and Training Lead
Accenture
April 2005Dawn Friend
• Local background• The practice• Migration activities• Where are we now?• Challenges, challenges, challenges
Overview
April 2005Dawn Friend
• NPfIT Local Health Community– GPPCP (2 PCTs and Adult Social Care)– Local (foundation) Acute trust
• GPPCP– 33 GP practices (plus 1 RAF base and 1 prison)– PRIMIS team since 2000 (currently 3 people)
• 1 ‘early adopter’ GP practice, with migration of other practices planned to start 2005
• Primary Care ‘think-tank’ group (GPs and PMs) and Primary Care project board
Greater Peterborough and NPfIT
April 2005Dawn Friend
Early adopter project• P1R1B project (with Central Norfolk LHC) • Practice signed-up• PID written with Accenture• ‘Go live’ date planned end Nov 2004• Accenture project team and local project
manager• Project activities planned from October
NB - Things don’t always go to plan…
April 2005Dawn Friend
The practice• Westwood Clinic• 2 GPs (senior partner is PEC chair)• Practice manager vacancy• Struggling clinical system (Torex 6000 4b)
– Slow, problems, no contract manager/QMAS• Accenture offering Torex Synergy based
product– Fewer training issues anticipated
April 2005Dawn Friend
Migration activities
• New equipment (PCs) & N3 connection
• Hardware & software testing
• Helpdesk arrangements • Communication (staff &
patients)• Testing (pre and post
cutover)• Training and post go-live
support
• Baselining
• ‘Kick off’ meeting
• Business change workshops
• TNA and role mapping
• Registration Authority (RA)
• Exeter reconciliation
• Data migration activities
April 2005Dawn Friend
Baselining – forming the ‘as is’• Huge spreadsheet! Lots of information
required by Accenture business change lead
• Site info, functionality, IT, staff, data migration, templates & reports, business change, training needs…
• We did not want to ask the practice about all of it – especially with no practice manager in post…
April 2005Dawn Friend
So what do we already know?• Site, IT, current system – Practice IT
Support Analyst and primary care team
• Who might know about practice staff, roles, use of system, templates, reports, training needs, business processes…?
Any ideas…???
April 2005Dawn Friend
….our friendly neighbourhood PRIMIS team!
• Worked with Accenture BC lead to discuss baseline information – knew a lot already (after 4 years!)
• Met with practice and Accenture to work through remaining information required
• Supporting and taking some of the pressure off the practice staff, for baseline and other forthcoming activities…
April 2005Dawn Friend
ICI - kit and connections!
• 3rd party hardware and desktop support contract with standardised desktop
• Rollout of new kit• Testing PCs and software (eg LSP, RA)• N3 connected (eventually!) • Moving to local shared services helpdesk as first
line at NPfIT go live (liaison with LSP and National service desk)
April 2005Dawn Friend
‘Kick off’ meeting• Whole practice team• Local NPfIT team• PRIMIS team• Accenture project manager, leads, and
product specialist• Demo of Torex product• Business change workshops
April 2005Dawn Friend
Accenture - business change approach
As-Is process gathering: Understanding of current practice ways of working; roles and responsibilities, application usage, data capturing templates, reporting capability.
Local impact assessment: Gap Analysis of current and future ways of working, identification of change areas and individuals impacted.
Business Change Plan: Action plan listing interventions and recommendations to implement new ways of working
Communications: Communications plan identifying key messages, timing, owner and feedback mechanism
April 2005Dawn Friend
• Change Champion & Key practice Stakeholder sign off Business Change Plan
• Review of solution by practice staff
• Thorough review of solution by Change Champion - ½ day
• Update gaps / impacts
Create Business Change
Plan
Agree Impacts /Gaps
Review To Be Solution
Conduct Gap Analysis / Impact
Assessment
Gather “As Is” Data
• Assess practice’s existing features and processes
• Review practice templates and reports
• Conduct detailed review of practice processes
• Identify likely gaps and impacts on organisation
• Develop draft recommendations for addressing impacts / gaps
• Create full list of impacts / gaps
• Agree with rest practice
• Finalise recommendations
• Develop action plan to implement recommendations
• Assign responsibilities (Practice/PCT/ LSP)
• Understand budget & time implications
Local Impact Assessment
Business Change Plan
As Is Data Gathering
Accenture – Business Change Activities
April 2005Dawn Friend
Training needs and roles• Identify all users (not staff) - 13 practice employees, but 25
users. • Basic computer skills TNA
– questionnaire, and less formal ‘local knowledge’ of staff by practice/PRIMIS
• Identify user role and current system access• Clinical system role mapping - joint effort
– IT trainer understood the product training modules– PRIMIS facilitator and practice understood the current access and
team roles– Map current user roles to Accenture training modules (or sections
within modules)
April 2005Dawn Friend
Training• IT trainer attended Accenture TTT course
– Wasn’t familiar with GP systems– (At the time) no ‘play’ system available for training– PRIMIS team arranged visit to a friendly Torex practice
to ‘play’ with Mickey Mouse. Test training scenarios in a ‘real’ system.
• PRIMIS team would support trainer – eg questions & queries at early sessions
• Training plans– Using the role mapping, training plan developed for
each user
April 2005Dawn Friend
Data migration
• Added complication of 4-byte to 5-byte
• Planned for PRIMIS team to factor in Read code training (4-5 byte differences)
• Initial data migration reports – code conversion issues, demographic issues
• Exeter reconciliation – 18 field
April 2005Dawn Friend
Things don’t always go to plan…• End October project put ‘on hold’• Keeping the practice engaged
– Concentration on making existing system workable– Working with Torex - response times, technical
problems, QMAS!• Accenture alternative GP system now available
– Practice have choice – Torex or Phoenix– Support practice to make choice the choice -
demonstrations and discussions• Then we will get back with the plan!
April 2005Dawn Friend
Migration activities
• New equipment (PCs) & N3 connection
• Hardware & software testing
• Helpdesk arrangements • Communication (staff &
patients)• Testing (pre and post
cutover)• Training and post go-live
support
• Baselining
• ‘Kick off’ meeting
• Business change workshops
• TNA and role mapping• Registration Authority (RA)
• Exeter reconciliation • Data migration activities
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April 2005Dawn Friend
Challenges for general practice….• New IT systems…
– Understanding functionality– Data migration– Data quality (and nGMS)– Security (RA)– Training & support
• … but much more than ’just’ new IT systems!– Concept change (a new service)– Working with LSP colleagues– Business change – This is all about people!
April 2005Dawn Friend
Thank youDawn Friend
Primary Care NPfIT Project ManagerGreater Peterborough Primary Care Partnership
Charlotte WarburtonBusiness Change and Training Lead
Accenture