Technology Enabled Change A 3 Year IT Strategy for Southern Health and Social Care Trust Mark Hindle March 2013
Introductory Observations The Trust has been extremely fortunate in that the foundation work already completed by IT in previous years has established a robust and scalable technical infrastructure that allows a strategy such as TEC to be commissioned. The Trust has another core asset which has been instrumental to this commission, its people. The support and positive engagement from staff has been outstanding The support of the Trust Senior Management Team has been a key enabler for the success of the TEC engagement. 2
Themes, Priorities & Recommendations 3
Themes & Recommendations Enabling Infrastructure Service Innovation & Efficiency Service User Engagement Safety & Governance Employee Engagement & Support
Enterprise Scheduling
Recommendations Enabling Infrastructure Internet access to online resources needs to be extended, which requires a change to the Regional ICT Security Policy, or decisions made at local Trust level (INFLUENCE) Investment in Mobile Device Management Software either locally or at a Regional level, to enable mobile working using mobile devices such as smartphones or tablets/ipads (INVESTMENT) Implement a Social and Digital Media policy, to decide how, by whom and for what purposes it is used (POLICY) Investment in a Risk Stratification tool for intelligent case finding such as patients with long term conditions this is a primary care enabling technology (INVESTMENT) Web conferencing and video conferencing (including primary care) needs to be mainstreamed and maximised (MAXIMIMISE USE OF EXISTING TECHNOLOGY) Extend availability of Single Sign on technology (SSO) to non clinical areas where more than 1 password is used (MAXIMISE USE OF EXISTING TECHNOLOGY) Regional ECR needs to be exploited and maximised as an enabler to a paperless HSCNI. The Trust needs to influence the phased Regional development of ECR (INFLUENCE) 6
Voice of the Customer? Service User Engagement Safety & Governance 7
Recommendations Service User Engagement Modernise & redesign the Trust website and it needs to be dynamically updated (INFLUENCE) Have a social media presence, where Facebook and twitter, for example, are available the Trust to communicate, but also for user feedback (POLICY) Development of a Patient App such as My Southern Trust for users to have access to a wide variety of resources such as health promotion materials, appointment booking, communication ( INVESTMENT & POLICY) Introduce a Maternity app to take the current good practice of mothers carrying their own case notes, into a paperless process, reducing the 25 year legal records management requirement (POLICY & INVESTMENT) Extend the choice of patient communication, which at present is either telephone, text or letter (POLICY) Development of a patient portal for patients to access their records (INVESTMENT & POLICY) Provide public Wi-Fi, with (in line with England) recurrent costs recouped through a 5 per day access charge, or preferably invest in a bedside computer and entertainment strategy to improve staff access to PCs and patient access to TV, DVD, internet etc. (INVESTMENT) Safety & Governance Translation software to reduce interpreting (MAXIMISE USE OF EXISTING TECHNOLOGY) 8
Recommendations Service Innovation & Efficiency Enterprise scheduling Self check-in and self booking management (including choose and book and the ability for GPs to book appointments for patients in their surgeries) Electronic appointment confirmation services (enhancement to text remind) (INVESTMENT) E-rostering (INVESTMENT) E-nurse - creating a paperless nursing process (INVESTMENT) Paperless pre-operative assessment (INVESTMENT) Digitisation of whiteboards on wards (INVESTMENT) Document scanning and paperless case notes and archiving (INVESTMENT) Virtual clinic roll out, including national options to specialists (MAXIMIMISE USE OF EXISTING TECHNOLOGY) Digital pens (to record and store documents in PDF format electronically) (INVESTMENT) Voice recognition roll out (MAXIMIMISE USE OF EXISTING TECHNOLOGY) Telehealth as mainstream service delivery (STRATEGY) Telecare hospital at home which requires further visioning (STRATEGY) Order comms roll out and closure of paper ordering which is still currently an option in the Trust to electronic ordering (MAXIMIMISE USE OF EXISTING TECHNOLOGY) 9
Recommendations Safety & Governance HCAI (Health Care Acquired Infection) management solution (INVESTMENT) A solution for patient and safety audit requirements (INVESTMENT) Electronic physiological monitoring and hand held observations (INVESTMENT) Medical/Nursing handover roll out and further development of Clinical Noting (INVESTMENT) Patient tracking via RFID (Radio Frequency Identification) (INVESTMENT) NIRAES improvement including e-discharge to GPs (MAXIMIMISE USE OF EXISTING TECHNOLOGY) ECS (Emergency Care Summary data from GPs allergies and medications) mainstream availability across the Trust (MAXIMIMISE USE OF EXISTING TECHNOLOGY) Mobilisation of Community Information System from outset of implementation (MAXIMIMISE USE OF EXISTING TECHNOLOGY) Mental Health Risk Assessment tool replacement from Filemaker to a more stable environment (INVESTMENT) Policy compliance software to improve communication & awareness (INVESTMENT) Performance Dashboards, aggregating disparate information into a management dashboard (INFLUENCE) Social Care Contract Management System with Governance Links e.g. to Datix (INVESTMENT) Procurement and Contracts Management System with automated Contract Review (INVESTMENT) 10
Recommendations Employee Engagement & Support Bring Your Own Device (BYOD) Policy and change to IT security policy to allow this (POLICY) Staff app to allow staff to download policies, procedures, messages, communication, mileage collation on their own device (POLICY) Modernise CPD with availability of social media some staff are already using twitter to share standards and non- patient specific advice on twitter (POLICY) Generally mobilise data electronically (MHealth) through availability of all data, messages and communication on mobile devices, preferably staff own devices where they have smartphones etc (POLICY) Consider the potential option for Skype or virtual meetings for example with staff on long term sick leave to reduce travel time and cost and for general team meetings (POLICY) Lone worker SOS (POLICY) Roll out e-learning on desktops, followed by mobilisation of e-learning available on staff own device (MAXIMIMISE USE OF EXISTING TECHNOLOGY) Mainstream Sharepoint as the single point for staff to access version controlled standards and guidelines, facilitate discussion forums, FAQs, new faces, virtual notice board, staff surveys, podcasts (MAXIMIMISE USE OF EXISTING TECHNOLOGY) 11
R Phasing 12
Enabling, Non-financial Priorities INFLUENCE POLICY STRATEGY DEVELOPMENT Regional ICT Security Policy changes Use of ECR and phased development New Trust website Dashboard introduction (SMT influence on content) Social media Patient application My Southern Trust Patient Portal Patient choice of communication Maternity record app Bring Your Own Device (BOYD) Staff app Lone worker SOS app Telehealth Telecare 13
Suggested Priorities Year 1 YEAR 1 (1 st April 2013 31 st March 2014) Recommendation Capital Cost Recurrent Cost Mobile Device Management Risk Stratification Tool Digitalisation of Whiteboards Pre-operative Assessment Visioning and planning for telecare (hospital at home) HCAI management HCAI patient safety audit software Policy Compliance software Performance Dashboards Mainstream Sharepoint staff access and communication Extend use of Single Sign on Ordercomms roll out Voice Recognition roll-out Roll out of e-learning to desktops Virtual meetings/skype extension CIS mobilisation ECS/ECR/NIRAES maximisation TOTAL *Services rolling out voice recognition need to meet the recurrent costs through savings in typing 125,000 220,000 (bid submitted) 150,000 (bid submitted) 50,000 (bid submitted) 25,000 180,000 15,000 (bid submitted) 50,000 (bid submitted) Funded Funded Funded Funded * Funded Funded 815,000 25,000 35,000 12,000 from yr 4 5,000 80,000 5,000 * Funded Funded 162,000 14
Suggested Priorities Years 2 & 3 YEAR 2 (1 st April 2014 31 st March 2015) Recommendation Capital Cost Recurrent Cost Self check-in and clinic way finding Choice of patient communication Electronic appointment confirmation service Enterprise scheduling E-rostering Document Scanning and Archiving Digital pens for mental health Physiological monitoring Mental Health Risk Assessment replacement Lone Worker SOS Website re-design Social Care and Procurement System Bedside technology and patient entertainment 150,000 (bid submitted) 150,000 400,000 100,000 250,000 50,000 25,000 30,000 100,000 (outsourced) 15,000 from yr 4 40,000 from yr 4 5,000 (resources required) 5,000 2,100 (assuming BSO host) 10,000 To be determined TOTAL 1,255,000 77,100 YEAR 3 (1 st April 2015 31 st March 2016) Recommendation Capital Cost Recurrent Cost e-nursing Patient app My Southern Trust Patient Portal RFID patient wristbands Bring Your Own Device (BOYD) and staff app Maternity app Mobile Learning Telehealth/Telecare implementation as mainstream 25,000 (assuming ECR) 375,000 25,000 15,000 Strategy required tbc To be determined TOTAL 440,000 + telecare To be determined 15
Strategic Recommendations 1. Procure a Software Development Partner to Take Forward Bespoke Solutions Pre-operative Assessment solution HCAI patient safety audit software Physiological monitoring digitisation Mental Health Risk Assessment replacement E-nursing solution Patient App My Southern Trust 2. Develop a Telecare Hospital At Home Strategic Vision 3. Establish Internal Processes To Keep TEC Live In The Trust 16
Conclusion Adopting TEC solutions will further advance the Trust which is already high performing and well respected and may bring opportunities for TYC implementation Strong organisational leadership and change management will be required to effect the necessary programme of change It will take some time to consult, negotiate and agree some recommendations. It is recommended that the Trust agree leadership and governance for each of these recommendations to be taken forward SHSCT can lead the way as a digital Trust in the region, and provide leadership for a digitally enabled and technologically ambitious Northern Ireland