Information Communication & Technology enabling strategy and plan

Transcription

1 Information Communication & Technology enabling strategy and plan Introduction Enabling delivery of the Trust Strategy This enabling strategy outlines the strategy for Digitising the Next Chapter to support the delivery of the Trust Strategy It is aimed at providing a strategic framework for IC&T developments within the Trust to enable the delivery of the Trust Strategy and support the delivery of our strategic objectives. Context The Technology aspects of the Trust strategy Deliver a great care experience: Clinical pathways are no longer limited to the boundaries of our Trust and we are focused on working with our system partners to deliver new and innovative care in different settings underpinned by consistent and shared communication and clinical information. Our clinicians and patients require Information Technology that supports not hinders the need for information at the correct time in the correct place without providing additional barriers to its access whilst supporting the need to show we are a trusted custodian of their information. Be a recognised as a leading innovator in healthcare nationally: The Trust strategy looks to embrace new ideas to deliver new, technology enable, financially viable ways of working through the use of technology such as video conferencing, skype, telehealth and remote surveillance. This will enable patients to be treated away from the hospital through remote clinical consultations and advice with patients, GPs, care homes, etc. and patient support in selfcare. Financially secure our strategic goals and objectives: By using better technology and enabling interoperability between different systems and organisations to share information we can assist the creation of more efficient pathways and help eliminate waste. Improve the experience of working in healthcare: The Trust ICT Systems are used by almost every employee in their daily work, slow or unreliable solutions and hardware can cause frustration and inefficiency causing delays to routine tasks and the need for increased resources. By providing technology and solutions that perform reliably and are always available when needed the Trust will improve the experience and efficiency of our workforce. 1

2 Our technology related KPIs: KPI1# Provide increased community-based care to constrain emergency admissions to 2016/17 levels KPI # 3 60% Reduction in Outpatient follow-ups without a decline in outcomes KPI #4 All residential / nursing homes to be supported by technology, training, education and collaboration. KPI#5 Top 10% for efficiency as measured by Carter KPI#8 Top 25% for training and appraisal satisfaction External factors The Trust strategy outlines clearly the requirement to work within a collaborative Suffolk and Northeast Essex health system and Information Communications and Technology will be pivotal in providing solutions and infrastructure to develop and support integrated solutions for our patients in alignment with the Local Digital Roadmap. The Local Digital Roadmap strategy is aligned with a number of programme work streams that dovetail with areas of Strategic objectives and ICT development within the Trust including: Digital Inclusion Patient Online and Transactional Services Digital Workforce Workforce Collaboration and Transformation Information sharing Interoperability Requirements, Shared Care Records Infrastructure Cyber Security, Mobility, enabling the Workforce Business Intelligence Population, Social, Self Service and Research BI The Trust Chief Information Officer and Chief Clinical Information Officers will play an active part in the STP Digital Strategy and Innovation Board and help lead discussions to develop a collaborative discussions within the digital leaders community to collaborate and share in order to break down barriers impacting change. The National Strategy document Personalised Health and Care 2020 calls for better user of data and technology to improve health and care services and the Trust will ensure priorities of the National Information Board are integrated with this enabling strategy and our strategic plans. Our current Information Communications & Technology Infrastructure and Solutions Solutions The Trust current system of record for its Electronic Medical Record is Lorenzo Regional Care which was implemented in 2014 as a fully resilient hosted solution, and as well as providing the basis for the Trust Master Patient Index and the predominant solution for inpatient, outpatient, maternity and emergency care scheduling the Trust has plans to extend it to Theatre Management and Inpatient Electronic Prescribing over the next 12 months. Alongside Lorenzo the Trust s other core clinical information system is Evolve which provides clinical notation, document management, eforms and workflow functionality. The system receives strong clinical engagement and has been core to our reduction to Paperlite medical records within an outpatient environment. However, the system is currently provided through our own datacentre and increasing reliance means business continuity and a hosted environment is a priority to ensure it continues to provide a resilient platform for further improvements including image integration with PAS and improved requests and results functionality. The Trust has a regular programme in place to develop and upgrade/replace is Best of Breed departmental solutions such as Critical Care, Cardiology, Radiology and Pathology etc. 2

3 The Trust has exploited nationally procured and hosted solutions such as the Electronic Staff Record but can do more to exploit available functionality to improve self-service and electronic transactional processes. The Trust financials system is again in a hosted environment and has already automated the electronic ordering and invoice authorisation process. However opportunities to share solutions under our Long Term Partnership and wider STP footprint need to be explored. Access to care partner information and solutions is underway with the Trust using both the National Summary Care Record and the Primary Care Record Viewer to be able to view core primary and community care information isn t being used universally and this needs to be integrated into our core applications to provide ease of access to clinical staff. Infrastructure The Trust telephony infrastructure is in its final year of an upgrade to migrate from legacy analogue technology to a new Voice over IP digital infrastructure which will support the further development of unified messaging, support personal video & tele conferencing, instant messaging and presence to facilitate multi-agency collaboration. The Trust Data network has a planned core network upgrade in 2017/18 but technology refresh is a key component on the ongoing strategy to ensure it remains fit for purpose. The Trust Client and Server infrastructure has a mixed estate and the goal will be to continue to develop a desktop strategy alongside clinical users to ensure the appropriate device for the tasks required are sourced and work on strategies for more rapid deployment and replacement. The Trust hardware estate currently includes: 2950 desktops and laptops; 1600 mobile devices (including IPods); 645 printers; 230 virtual servers; 30 physical servers; and 110 terabytes of total data stored. Introduction to the five priorities Introduction The Trust ICT service currently delivers and supports a breadth of solutions and services to support both clinical and corporates divisions in the operational running and clinical care within the hospital. These services fall broadly into five areas, three based around the commonality in the user or customer of the service: Clinical Systems - Clinicians / Clinical Support Services; Business Systems Support Administrative and Corporate Services; and Patient and User Support - Patients, Carers and the Public. The remaining two areas are underpinning to all three user areas and are essential to the successful provision of services: Business Intelligence and Information; and Infrastructure and ICT Support. How and why we developed the five priorities Through consultation with the Trust ehealth Strategy Group and input from Divisional Plans it is clear that the Trust needs to develop a strategic plan that delivers transformation in each of the themed areas so that the experience between healthcare staff, patients and our partners can be 3

4 enhanced by the effective use of technology and innovation; enabling us to deliver our five year strategy. At the heart of each is the need to shift the Trust IT and information solutions from campus based systems that stop at the boundary of the Trust main hospital site and extend access to our wider system partners or enable interoperability with other system solutions or where possible the development of shared solutions. Priority What it covers (summary description) Our five year priority Integrated Clinical Systems Support Integrated Business Systems Support Accessible Patient and User Support Robust Business Intelligence and Information Resilient Infrastructure and ICT Support Clinical Information systems supporting patient care scheduling, clinical notation, investigations, results, prescribing and clinical decision support. Business Information Systems supporting corporate record keeping, transactional processes finance, workforce, training, and estates. Systems used to document and schedule patient care. Facilities and services provided to improve the patient experience within a healthcare setting. The tool(s) and information used to extract data from all parts of the hospital and care system, along with publicly accessible data on population demographics. Technology, Networks, Computer Hardware and Software, Telephony and the support services required to maintain them. To have single sign and security access for clinical teams accessible at the point of care irrespective of organisation boundaries. To have paperless corporate transactional support services enabled with self-service functionality to support staff to access goods, services and training at the point of need. To provide shared access and ownership to patients of their electronic medical record enabling patients to contribute to their record through online portals, selfmonitoring and management apps/ wearables. To develop our information services to support the delivery of predictive and prescriptive analytics to support and improve care delivery To provide resilient hardware, and software IT support services that enable mobility and cross organisational working to the betterment of patient care and workforce efficiency. Priority 1: Integrated Clinical Systems Support Our aim is to have single sign and security access for clinical teams accessible at the point of care irrespective of organisation boundaries. The Trust s existing clinical systems use disparate end user authentication methods such as smartcards, username and passwords requiring staff to use multiple systems and remember multiple security controls before they can access the necessary information to treat or deliver patient care. The level of information available is often limited by the location of the care or by the infrastructure and devices provided to staff. This leads to inconsistent staff experience and satisfactions and limits the progress to our clinical digital maturity. Increasingly our clinical pathways are cross organisational and our information flow does not support bi-directional exchange of key information to prevent duplication. We will to deliver interoperable digital services and work with partner organisations to ensure clinical information is shared to support patient s health and care needs; ensuring the appropriate consent is obtained from our patients to undertake the sharing of information. 4

5 We will develop with our clinical system suppliers over the next five years to ensure they support a migration of user authentication to support LDAP (Lightweight Directory Access Protocol) and context based patient sharing based around open application programming interfaces and developments. This will mean end users can use a common secure authentication method (i.e. login) to access all core clinical and business solutions. How we will measure our progress We measure the: Reduction in the number of Trust wide core clinical information systems requiring independent login credentials to access; Improvement in system transaction times both pre and post system developments; and Percentage of key patient flow and clinical transactions captured contemporaneously (in real-time at the point of care). We will report on the Trust s Clinical Digital Maturity Index Score in relation to other UK health organisations. Priority 2: Paperless Business Systems Support Our aim is to have paperless corporate transactional support services enabled with self-service functionality to support staff to access goods, services and training at the point of need. To accompany improvements in clinical pathways we need to significantly reduce the amount of manual, paper-based, internal processes that currently hamper efficiency in the way we operate as an organisation. This will benefit both our clinical teams who will be free to spend more time delivering patient care, and our corporate support staff who will be able to spend more time delivering value adding, strategic and operational support We must find new ways of working more efficiently and to reduce the cost of our transactional services so we can maximise the resources available to clinical care. Both staff and our patients are increasingly used to using technology to improve their access to services and information in their personal lives and we should build upon the technology used by them every day in their personal lives to support them at their work. We will achieve this by ensuring electronic systems, eforms and workflow solutions are used to replace paper processes, enabling information to captured and processed in real-time. Providing full audit trails of information flow and facilitating the provision of secure support services from within remote or shared service facilities. The ability for individuals to self-serve will improve data quality, timeliness of delivery and reduce the footprint of corporate services. How we will measure our progress We will measure the: Reduction in Paper / Print volumes; Increased Volume of Electronic Transactions; and Number of ereferrals. 5

6 Priority 3: Accessible Patient and User Support To provide shared access and ownership to patients of their electronic medical record enabling them to contribute to their record through online portals, self-monitoring, and management apps/ wearables. To normalise electronic communication options for patients and carers for the scheduling of care and to support remote clinical interactions where appropriate. Where patients are required to be in hospital we want to improve their experience by providing the opportunity for them to use their own technology without restrictive access controls. We will develop secure patient portals for accessing and contributing to the electronic medical record ensuring continuity with the wider care system. We will explore opportunities and adopt new ways of working using telehealth and remote surveillance in appropriate pathways. We will provide free to air hi-speed patient and public Wifi access and enable patients to provide their own media and entertainment service devices within the hospital. How we will measure our progress We will measure the % improvement in users utilising online services for access to Trust services or care. Priority 4: Robust Business Intelligence and Information What our five year priority is By 2022 we will have developed our business intelligence and reporting to align with our wider system partners. This will enable us to develop our information services to support the delivery of predictive and prescriptive analytics to support and improve care delivery. The Trust and its partners will work together to have established systems and skills to support the use of information to support enhancing the Quality of Care, Population Health and understanding the economics of care it provides. The Trust has many disparate sources of clinical and performance information that are used by a developed analytics capability, but this is focussed largely on analytics for contractual and statutory requirements. Operational reporting is limited mainly to produce historical and current period reporting with limited real-time availability to support and influence change. What we will do to achieve this We will work with our Care System partners to develop a shared resource for the interpretation of business intelligence. We will ensure we have the appropriate governance model to support data sharing and support the delivery of commonly agreed datasets to provide single source of truth for data modelling and forward planning. How we will measure our progress We will use nationally recognised measures of Data Quality and measure the percentage improvement. We will measure the progress in the number of staff reporting they have timely access to the information they need to track the performance of their service and make decisions based on robust information. We will measure our compliance against the seven steps HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM). 6

7 Priority 5: Resilient Infrastructure and ICT Support Our aim is to provide resilient hardware and software services that support mobility and cross organisational working that underpin clinical and operational reliance on automated and digital services and transactions to support patient care. Transforming IT Support services to make use of the latest technology and keep abreast of change and shared opportunities to reduce increased cost of the increasing demand on technology services. Our reliance on IT Systems to support both patient care and operational running of the hospital 24*7*365 has become key and interruptions to service and performance can cause delays or even prevent patient care being delivered in a timely way. Often organisational technology boundaries impede clinical pathway developments and hinder opportunities for innovation around patient care delivery. We will collaborate with our local system partners and look for strategic partners whose core business is the provision of highly resilient and innovative technology solutions that are cloud based or hosted externally to the organisation to support improved availability and performance or core clinical, business and patient based solutions ensuring more efficient use of limited technical resources. How we will measure our progress We will develop our IT Services into a valued and respected partner and measure the % of staff rating IT Support and Service experience as Good or Very Good. We will measure the % of planned and unplanned availability and transactional performance of core clinical and business information systems 24*7*365. Delivering this enabling strategy We will transform the experience between healthcare staff, patients and our partners through the use of information and digital technology automating support processes whilst putting more power in the hands of the public and patients enabling them to access services directly through technology and allowing them to contribute and share their health information. We will work with our clinical and operational teams to continuously improve services, based on data and evidence captured contemporaneously with the aid of Digital Technology at the point of care irrespective of location. We will continue to develop our Systems of Record to maximise the benefit and return on investment but supplement these with interoperable Systems on Engagement that enable agile development and innovation to meet the pace of the changing environment within which we operate and enable out patients and partners to add to a health and social care record to improve outcomes. In order to transform the relationship between our users and technology in the period to 2022 we will: Deliver interoperable digital services and will work with partner organisations to ensure clinical information is shared to support patients health and social care; Develop the right skills, culture and training among our staff and leaders to support the move to digital enabled processes; Make better use of data to enable transformation and improved planning in clinical services and patient care; 7

8 Users need a consistent experience of clinical systems, unaffected by interruption or poor performance we will ensure solutions are designed to be resilient and monitor them to ensure they facilitate and not hinder the pathways of care; Ensure everything will be designed and maintained with the right level of security - in particular for sensitive or personal data; and Ensure public confidence in our use of data and security, building the appropriate cyber and privacy safeguards into our digital infrastructure by ensuring we achieve appropriate accreditation. 8

9 Strategic delivery plans Priority 1: Integrated Clinical Systems Support Action Responsibility Timeframe PACS Digital Imaging Refresh to incorporate single sign on and image viewing within Evolve Clinical Portal Phase 2 Ophthalmology Lorenzo Theatre Scheduling Phase 1 Electronic Inpatient Prescribing Go Live CIO Q1-Q3 2017/18 Q2- Q3 2017/18 Q1-Q3 2017/18 Pathology Results Viewing legacy solution replacement CIO Q2 2017/18 PACS Digital Imaging Refresh to incorporate single sign on and image viewing within Evolve Clinical Portal Develop Collaborative Clinical Systems Strategy alongside the Partnership Child Protection and Information System Alerts Integration for Lorenzo Emergency Care Settings Pharmacy v2016 Upgrade Vital Signs & Assessment System Development Support Emergency Care Data Set Supporting Snomed coding Phase 3 Lorenzo Theatre Scheduling Complete Cloud Based Evolve clinical portal to support mobility and business continuity Critical Care Information System Upgrade Electronic Requesting, Resulting and Acknowledgement across outpatients ereferral 100 Utilisation for 1 st Outpatient Appointment of Clinical Triage services Extend PACS to Nuclear Medicine Imaging CIO Q3 2017/18 CIO/CCIO Q2- Q4 2017/18 Head of Pharmacy/ Technology Trust Medical Director / Head of Programme Operational Lead Emergency Care/ Technology Technology Q2 2017/18 Q1- Q2 2017/18 Q3-Q4 2017/18 Q3-Q4 2017/18 CIO CIO Collaborative Clinical System Integration Vision across STP CIO/CCIO Extend Electronic Discharge Reporting to Radiology / Cardiology etc. Paperless Information Exchange between Health and Social Care Partners CIO 2019/20 CIO / STP 2019/20 9

10 Action Responsibility Timeframe Establish a way of recording all ward moves in real time, identifiable by patient CIO 2018/ /21 Implement a technology enabled approach to enable accurate care planning Electronic Medical Records HIMMS Level 7 Common user front end to access clinical information captured across patient pathways and systems of record All Clinical Notation Inpatients, Outpatients, Emergency Care online supported by SNOMED coding and Decision Support solutions Embed Alliance principles to support teams to work together to treat patients as one person, with one care plan Full Interoperability with Suffolk and North Essex Shared Care Record CIO CIO/STP 2022 CIO 2022 CIO 2022 CIO/ Head of IT/ 2020/ / Priority 2: Paperless Business Systems Support Action Responsibility Timeframe Implement Skype for Business and Collaboration Tools to support the Partnership, Alliance and STP working Encrypted environment for secure communication of identifiable data with system partners Online Presence Review Intranet/Internet Communications for the Partnership Electronic Record Self Service and epay Develop collaborative Partnership business systems strategy Develop Quality Management System Plans CIO Q1-Q3 2017/18 Technology Technology, Head of Communications Deputy Director of Human Resources / CIO/ Deputy Directors of Finance & HR Associate Director of Nursing (Corporate/CIO) Q4 2017/18 Q3-Q4 2017/18 Q4 2017/18 Q4 2017/18 Q3-Q4 2017/18 Develop Self Service and Paper Lite Strategies CIO Q4 2017/18 Space Utilisation and Room Booking Solution CIO / Estates Medical Workforce erostering Solution Director of HR/Medical Director Collaborative Financial Systems Strategy Head of Finance New Online presence Developments live Head of communication / Technology 10

11 Action Responsibility Timeframe Develop a quality management system that supports real time identification of clinical risk Paperless corporate services Automated Stock and Asset Management across clinical and nonclinical environments GS1 compliant solutions Director of Governance / CIO Corporate Service Leads Head of Procurement /CIO Head of Procurement /CIO / Director of Estates & Facilities 2019/ Priority 3: Accessible Patient and User Support Action Responsibility Timeframe Extend remote surveillance opportunities to support patient continuing care Online booking for all 1st outpatient appointments available Pilot Telehealth for virtual clinical presence in care homes Ability to book, cancel and reschedule healthcare appointments on line Improved on site patient entertainment and experience Head of Transformation/CIO Director of Operations /CIO Medical Director / Director of Nursing / CIO Director of Operations /CIO Director of Estates/CIO 2019/ /21 Routine paperless interactions with patients and carers CIO 2021/22 Provide patients and their carers with the tools (e.g. apps), education, support and encouragement to self-manage their condition Medical Director / Director of Nursing / CIO 2021/22 Priority 4: Robust Business Intelligence and Information Action Responsibility Timeframe Patient Level Information Costing Live Develop plans to support real-time reporting and predictive analytics Skill & Needs Analysis to support Information Management & Development Support Deputy Director of Finance / Head of Information Management Management Management Q2 2017/18 Q1 Q4 2017/18 11

12 Action Responsibility Timeframe New NHS Data Standard Compliance Implement real-time operational, forecast reporting Predictive Analytics mainstreamed Shared system level secondary use of information to support patient pathway design and capacity management CIO / Head of Information Management Management Management STP Wide Head of Information Management / COO s Q Priority 5: Resilient Infrastructure and ICT Support Action Responsibility Timeframe PACS shared sign on (with Evolve and Network) Head of IT Q3 2017/18 Improved Cyber Protection and Resilience Ransomware and 3 rd Party Patching Service Desk Refresh and Service Structure in place for Divisional support Head of IT Q3 2017/18 Head of IT Q1 Hyper converged Storage Technology Refresh Head of IT Q1 Ward Based Hardware for Clinical Access Improved Unified Communications and shared infrastructure for Telecommunications and Data / Head of IT Q /18 Head of IT Q2 Collaborative Tools & Wifi with Healthcare partners - Govroam Head of IT Q2 Cloud based business systems and storage Head of IT 2019/20 Lorenzo single sign on (with PACS/Evolve/Network) Head of IT 2020 IT Accreditation for Support Services Head of IT 2020 Single sign-on across core clinical solutions Head of IT