LTC-iHub Update

November 2011

Lanarkshire LTC-iHub1. Brief reminder of what the

project is about2. Progress to date and current

status3. What has been learned so far4. How success will be/is being

evaluated5. Potential for wider applicability

1. Brief reminder of what the project is about

TrakCare/Vision/MiDiS EDM Diagnostics

Interventions

Communication DigitalData

Capture

2. Progress to date and current status

Clarification of Requirement 1

Long Term Conditions-iHub

TrakCare

Labs

ECGs PACS

KnowledgeG

uidelines etc

Business

Intelligence

Interactive

Meteor

Other

ECS

MiDis

Vision

SCIStore

Ensemble

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

P2

….Links to other applications….

New Referrals

My clinic list My Theatre list

Lab & Rad Reports

Unread emails

Newly diagnosed LTC patients

Activity

Data

Journal

Links

P1User Details and Photo

MiDis TrakCare Meteor Athena

Recently viewed patients

Patient SearchSean Brennan

Clarification of Requirement 3

Miscellaneous

Allergies &Adverse events

ClinicalHistory

Notifications & Legals

Investigations& Results

Demographics & Contacts

Sean Brennan d.o.b 9th.August.1982?

Social & Personal

Alerts & Risks

HealthcareEncounters

Admin & PatientPreferences

Correspondence

Medications & Devices

ClinicalNotes

ObservationsNotifications& Legal

All records

3rd PartyDocuments

….Links to other applications….

P1 P2

Portal Level 1 (P1)

Information From?My Clinic ListMy Theatre ListsNew ReferralsNew LTC patientsClinical Activity Data

TrakCareTrakCareTrakCare ? MiLan

Portal Level 2 (P2)

Category GROUP Information

PATIENT HEALTH SUMMARY

1 1. Past medical history 2. Current problem list 3. Current medications (Including

GP/Hospital/Chemo etc)4. Allergies 5. Alerts

1. TrakCare/Vision 3602. GP Vision 3603. GP Vision 360/ECS

4. Vision360/ TrakCare5. Vision360/TrakCare

CLINICAL LETTERS  

1 1. Referral 2. Hospital discharge 3. Outpatient clinic

1. SCI Gateway2. Winscribe3. Winscribe

DIAGNOSTIC TESTS RESULTS  

1 1. Laboratory results 2. Radiology results and images 3. Other diagnostic text results

1. SCI Store/Labs2. RIS3. Various

KNOWLEDGE SUPPORT  

2 1. Local clinical guidelines 2. National clinical guidelines 3. eBNF

1. FirstPort2. FirstPort3. FirstPort

ADDITIONALFUNCTIONALITY(LATER PHASE)

3 Context searching and switching to enable Order Communications, etcGP cardiovascular risk scores, a DAS (disease activity score) calculator, Access to MUSE ECG Images EchogramsAccess to Meteor Rheumatology system

Clarification of Requirement 2

NHS-L LTC-iHub Project Board

Vision

360

Hea

rt F

ailu

re

Rhe

umat

olog

y

CO

PD

LTC-iHub Steering Group

NHS-L Portal Programme

EnsembleInterface/Design

Single

Sign On

Technical Projects

DataCapture

Incl digital dictation

LTC-iHub & Wider Portal Programme: Interdependancies

PortalDesign

Labs/IG/

Access

LTC-iHub Project

? E

lder

lyEDM

OCSMidis

• 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

Objective How 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: SurveyOrganisation: 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 reconciliation Analysis 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

Digital Pen sub project

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

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

OCR and Validation

Form filled in – Pen Strokes Form filled in – Pen Strokes

Digital Pen Evaluation1. 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.

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;