Date: Meeting: Trust Board Public Meeting. 20 April Title of Paper: Quarterly Informatics Strategy Report. Key Issues:

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1 Meeting: Trust Board Public Meeting D: 20 April 2015 Title of Paper: Quarterly Informatics Strgy Report Key Issues: The quarterly Informatics Strgy Report is attached. The delivery of the Informatics Strgy is generally on plan. Links to Strgic Goals: Provide services that are safe, person centred, delivered in appropri environments and sensitive to the needs of the individual Retain the confidence of patients, carers and commissioners by upholding the principles of the NHS Ensure a firm financial foundation underpins the delivery of our vision Through the use of evidence based practice, provide high quality services to establish a reputation for exceptional standards of care Provide and develop services that are efficient, cost effective and responsive to the needs of the people who use them Risk Issues: The efficiency saving identified based on the implementation of mobile working are not achieved due central and local funding not being available to implement the solutions. The strgy is not focused around clinical services due to the Trust not recruiting a clinical chief information officer (CCIO) and clinical information officers (CIOs) to ensure the strgy is clinical focused and lead A slowdown in the delivery of system improvement due to the exit of the national contract in FY15/16 impacts the Trust ability to provide care to patients. Recommendations: The Board is asked to note the progress made in the delivery of the informatics strgy. Author of Report: Adrian Snarr, Director of Finance Infrastructure and Informatics 1 P a g e

2 Quarterly Informatics Strgy Report April 2015 The informatics strgy will support the Trust s values by; Collecting information once and using across the Trust systems many times. Electronic information should be shared securely with patients, carers and other providers to ensure the best quality of care can be received by the patient. To cre business intelligence from the data entered into the Trust systems to improve our decision making. To use outcomes measures as the standard way of measuring success in the treatment of our patients. To have the right infrastructure and support to provide safe services. The Informatics Strgy Board (ISB) has met once in The ISB has provided direction and management of the programme, resources, risk and assurance. This paper provides an upd on the progress to d. Programme upd The programme plan is general on plan, with the following highlights: ID04 Migr from our local system to NHSmail The Trust migrd from the local Humber system to NHSmail on the 2 April The main focus is to support staff in the NHSmail transition process. This involved the migration of 3,000 accounts by IT services. It has been a smooth transition for a majority of the Trust staff, with most support activity helping staff to complete the registration process for their NHSmail account. There were some initial problems with the use of generic mailboxes which had been resolved within the first week of the transfer. With the migration we can now use the increased security provided by NHSmail with our partner organisations. We will also receive the enhanced service provided by NHSmail 2, lr in the year. ID11 Move from a static to a mobile work force using information technology The design stage for total mobile being used with Lorenzo has been completed. The three team using SystmOne Mobile Working have completed their test and the Trust is ready to deploy it across all SystmOne teams. ID15 Implement e-transcribing The proof of concept has been completed with 26 trust staff and the business case is being completed. The tasks which are behind plan are; ID02 - Appoint a Chief Clinical Information officer 2 P a g e

3 Roles are now part of the care groups re-structure process. ID05 - Deliver a paper-lite electronic patient record for Lorenzo Progress has been made to recover this piece of work. Two mental health teams are now using clinical notes. This functionality will be rolled out to all teams during the next six months. ID06 - Standardise the use of SystmOne We have not been able to retain the specialist resources required for this work. Recruitment of a new person is taking place and we will have further slippage as a new specialist picks up the work and when they start in the position. ID20 - To implement the new patient electronic booking system The electronic referral service (ers) has slipped nationally to the 15 June 2015, plans are being re-scheduled to support the new d. Resources The resources profile (shown below) does not include the resources to implement a new Trust-wide system. Once we have agreed the procurement approach for the replacement clinical systems, the resource profile can be updd. We have 6 wte informatics resources at April 2015, these needs to significantly increase in May and June to support the roll out of mobile working. A further expansion of resources would be required in FY15/16 to support the transition from national to local contract and the implementation of mobile working. The e-technology capital budget has been linked to the cost improvement business case for mobility. 3 P a g e

4 Risk The risk profile for the Informatics Strgy is shown below on the likelihood/consequence table. The risks are shows by the prefix R and the risk number. Likelihood of Recurrence Rare (1) Unlikely (2) Possible (3) Likely (4) Almost Certain (5) Insignificant (1) Minor (2) Consequences Moder (3) Major (4) Catastrophic (5) [R4] 4 5 [R1] [R2, R8, R10] 10 [R9] [R7] 12 [R3,R5] [R6] A majority of the risks are current rd significant impact; the three highest risks are; R3 - The efficiency saving identified based on the implementation of mobile working are not achieved due central and local funding not being available to implement the solutions. R5 - The strgy is not focused around clinical services due to the Trust not recruiting a clinical chief information officer (CCIO) and clinical information officers (CIOs) to ensure the strgy is clinical focused and led. R6 - A slowdown in the delivery of system improvement due to the exit of the national contract in FY15/16 impact the Trust s ability to provide care to patients. The full risk log is shown in appendix B. Assurance To assure the Trust that the Strgy is being delivered, Deloitte s have been contracted to provide external assurance. The terms of reference for the assurance has been drafted and has been circuld for comment, prior to the work commencing. Conclusions The delivery of the Informatics Strgy is broadly on plan, but FY15/16 will require significant investment to ensure it is successful. A failure to increase the investment in FY15/16 will make it very difficult to deliver the strgy. Lee Rickles Head of Programmes and Informatics 20 April P a g e

5 Appendix A Informatics Strgy Plan 5 P a g e

6 6 P a g e

7 Appendix B Risk log for the Informatics Strgy No Success Criteria Risk/Description 1 2 The Trust will not have a clinical system at the end of the national contract on the 7 July 2016 Risk Rating (1-25) 5 Mitigating Action Owner Target D for Resolut ion Target Risk Level The Trust is engaged with the Health and Social Care Information A Snarr Jul-16 Low Centre to be aware of the assistance and support that can be provided from the centre. The Trust will procure via OJEU or framework contracts the strgic systems to replace SystmOne and Lorenzo. Deloitte's are providing a critical friend roll as part of the process. Fall back plan - Lorenzo has a perpetual licence which would be transferred to the Trust and can be used to provide the core clinical system. 2 11,17,14,15 The efficiency saving identified based on the implementation of mobile working are not achieved due to it being tred as an IT project. 8 High level of clinical engagement in the local nurse technology fund workshop. The lead for the digital pens and tablet based systems are clinical staff, supported by informatics and the PMO. Proof of concept is being undertaken with digital pens fourth quarter FY14/15. SystmOne mobile worker has received good feedback from clinical staff, a wider roll out is being planned for Current SystmOne and Lorenzo user group to be expanded into clinical systems forum to ensure engagement on all technology is continued. A Snarr Jun-15 Moder 3 11,17,14,15 The efficiency saving identified based on the implementation of mobile working are not achieved due central and local funding not being available 12 A CIP business case has been drafted (based on the nurse tech fund 2 bids) and circuld for comment. Central funding has been provided to the Trust to buy the capital of the total mobile product. Local funding identified in the business case is required to roll out the technology and carry out the business change. A Snarr Jun-15 Moder 7 P a g e

8 No Success Criteria Risk/Description 4 4 The Trust do not move onto to NHSmail and fund the upgraded of the local system Risk Rating (1-25) 3 Mitigating Action Owner Target D for Resolut ion The Trust has migrd to NHSmail. A Snarr Jul-15 Low Target Risk Level 5 2 The strgy is not focused around clinical services due to the Trust not recruiting a clinical chief information officer (CCIO) and clinical information officers (CIOs) to ensure the strgy is clinical focused and lead 12 Cre funded CCIO and CIO rolls. Recruit to the positions and the CIO and CIOs to lead informatics change as part of the new care group structure. T Cope Jul-15 Low 6 5, 6,7 A slowdown in the delivery of system improvement due to the exit of the national contract in FY15/16 impact the Trust ability to provide care to patients 12 Use alternative systems and total where possible (e.g. digital pens, data warehouse, local software house for applications). Where changes are made within systems this is transferable to the new strgic system. T Cope Oct-15 Moder 7 9,12 The Trust does not improvement the way it uses its data because the Information management and performance teams do not have the skills to provide a robust data warehouse and business intelligence service 9 Carry out a gap analysis of the current services and technologies used to support business intelligence. Decide to outsource, shared service or internal investment for business intelligence. Implement change programme in Information management and performance. Implement change programme across the Trust for business intelligence. S Hunter Nov-15 Moder 8 P a g e

9 No Success Criteria Risk/Description 8 26 The Trust is not able to provide patient access to their record by 2018 Risk Rating (1-25) 8 Mitigating Action Owner Target D for Resolut ion Target Risk Level The current Trust systems and key market systems have this D Hill May-18 Low capability built into their future road maps. Procure a system that has this capability The Trust does not achieve level 9 of the clinical digital maturity index (CDMI) and oper as a paperless organisation by The OJEU notice specification required level 9 to achieve by The Informatics Strgy Board to continue to direct the implementation of the Informatics Strgy. The Informatics programme to be resourced to the required level. To use the informatics strgy as a key technology enabler to organisational transformational change. D Hill Mar-18 Low The Trust is not able to achieve its single clinical system strgy due to the worsening financial position. 8 The Trust review the value for money assumptions for a single system strgy vs a multi system strgy. This will be revised based on the current financial position of the Trust. The strgy will be revised to reflect the best value for money, based upon the funding available to the Trust. A Snarr Mar-18 Moder 9 P a g e