DRAFT eHealth Strategy 2015-2017

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Chief Executive Foreword

NHS Lanarkshire is fully committed to improving the care we provide. Patient safety is our number one priority. We aim to deliver the highest standards of safety whilst delivering services that are person centred and effective. It is important that our patients are confident in the services we provide, no matter where and when they access our services. Meeting this vision requires a well-trained and highly motivated

workforce that is supported with modern, adaptive and sustainable clinical information and digital technologies. The NHS Board recognises the growing impact that eHealth is bringing to the delivery of healthcare around the world today. Information and Clinical Technology is making healthcare systems more efficient and more responsive to changing healthcare needs and expectations. We aim to deliver a single electronic patient record that is accessible by all appropriate clinical staff, operating in multiple clinical settings, to support the delivery of timely, high quality treatment and care. This is particularly important as we reshape services to meet the changing needs of our patients and staff, especially around increasing demand, 24*7 services, more care away from the larger hospitals and patients having access to key information to help them better manage their own care. eHealth will continue to work closely with our clinical leaders to prioritise our work over the next few years as detailed in our delivery plan. We will continue to use our resources to ensure the service and the patient can make the best use of technology around safety, quality, efficiency and effectiveness. Without making the best use of eHealth solutions we will not maintain the pace of improvement needed to meet the challenges ahead. I ask all staff to embrace and support this strategy. Calum Campbell Chief Executive

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Contents Chief Executive Foreword .......................................................................................................... 2

Executive Summary .................................................................................................................... 4

1. Introduction ........................................................................................................................ 6

1.1 Background .................................................................................................................. 6

1.2 Purpose........................................................................................................................ 6

2. Delivering the Strategy ....................................................................................................... 7

2.1 Developing the Strategy .............................................................................................. 7

3. Our Vision ........................................................................................................................... 9

3.1 NHS Lanarkshire Vision ............................................................................................... 9

3.2 What will the service look like in 2018? .................................................................... 10

4. Leadership ........................................................................................................................ 10

4.1 Patient and Clinical Expectations .............................................................................. 11

4.2 Meeting Expectations................................................................................................ 11

4.3 Leading Changes and Developments ........................................................................ 12

5. Progress Challenges and Priorities ................................................................................... 13

5.1 Building on Strong Foundations ................................................................................ 13

5.2 Challenges ................................................................................................................. 13

5.3 Priorities .................................................................................................................... 14

5.4 Key Enablers .............................................................................................................. 14

5.5 Key Barriers ............................................................................................................... 15

6. Finance .............................................................................................................................. 17

6.1 Current Budget .......................................................................................................... 17

6.2 eHealth Workforce (WTE) ......................................................................................... 18

6.3 Future Resource Model ............................................................................................ 19

6.4 Independent Review ................................................................................................. 19

7. Strategic Roadmap ........................................................................................................... 19

7.1 NHSL Roadmap............................................................................................................... 20

8. Delivery Plan ..................................................................................................................... 21

GLOSSARY ................................................................................................................................. 23

Appendix A – Review of Current Delivery Plan ........................................................................ 24

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Executive Summary This strategy is intended to be brief, non-technical and progressive. It is the key document for setting out the current situation for eHealth and provides the future strategic direction for electronic health services across NHS Lanarkshire. It is the vehicle for promoting agreement and setting the priorities across a wide range of clinical and operational services to help us to deliver our strategic aims in this next reporting period 2015-17. NHSL remains a highly innovative health board at the leading edge of most national projects, and has an excellent record of delivering projects locally. In the previous period (2011-14) NHSL initiated and implemented a wide range of eHealth projects including;

• The electronic case-note • Widespread adoption of clinical portal • Management /Clinical Dashboards • Electronic Whiteboards (WardView) • HePMA for electronic Prescribing (PILOT) • CareView • Vision 360 work in the community • Tele-Conference and eMDT (Multi-Disciplinary Team) • Order Communications for Radiology • TrakCare PMS (Patient Management System) • Virtual Desktops and SSO (Single Sign On) • LIMS (Laboratory Information Management System)

There will be on-going development work on these systems in the next three years including;

• Expanding services within clinical portal • eCasenote to Wishaw General Hospital and Monklands Hospital • Infection Control Surveillance • Electronic sign off for results • HePMA development • Supporting Community and replacing MiDIS • Order Communications for Laboratory • Patient Portal • Clinical Messaging

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This strategy seeks to;

• Summarise the current situation • Set the future strategic direction • Set the priorities for 2015-17 • Establish a common vision • Ensure there is adequate leadership and engagement • Ensure governance is appropriate and effective • Highlight key challenges for eHealth/and options for resolving • Support the development of the workforce • Support the transition process linked to improved service integration through Health

and Social Care Partnerships

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1. Introduction

1.1 Background NHSL has been a leader in eHealth across Scotland over the last 10 years, and remains one of Scotland’s most innovative Health Boards, often leading on national projects. Demands remain high in continuing to meet the day-to-day needs of the service whilst also responding to new requirements, increased expectations, service changes and keeping pace with resourcing and implementing new technologies. This strategy will provide a framework to enable NHS Lanarkshire and its community planning partners to continue to deliver the highest standards of service on an increasingly integrated basis as we seek to support more people to live longer lives at home or in a homely setting.

1.2 Purpose The strategy is about balancing priorities to deliver improved service outcomes around the 7 AIMS in Scottish Government eHealth Strategy 2014-2017. The 7 aims are;

1. Enhance the availability of appropriate information for healthcare workers and the tools to use and communicate that information effectively to improve quality.

2. To support people to communicate with NHS Scotland, manage their own health and wellbeing, and to become more active participants in the care and services they receive.

3. To contribute to care integration and to support people with long term conditions 4. To improve the safety of people taking medicines and their effective use 5. To provide clinical and other managers across the health and social care spectrum with

the timely management information they need to inform decisions on service quality, performance, and delivery.

6. To maximise efficient working practices, minimise wasteful variation, bring about measurable savings and ensure value for money.

7. To contribute to innovation occurring through the health innovation partnerships, the research community and suppliers, including the small and medium enterprise (SME) sector.

Table 1 - eHealth Strategic AIMS

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The key purpose of the strategy is to; 1. Set out the current position 2. Establish priority areas for action for the next reporting period 3. Identify challenges and opportunities 4. Improve stakeholder management 5. Improve the management of resources including staff and equipment

2. Delivering the Strategy

2.1 Developing the Strategy The eHealth Strategy is developed using a balance of national, regional and local strategies and plans (see Figure 1). Implementation of the strategy is monitored using a set of nationally agreed common progress measures. These are approved and managed via local governance arrangements, and are subject to an annual review, and a mid-year review by the Scottish Government.

O

Figure 1 - The Relationship between National and Local Strategy and Delivery Plans

Once the Strategy has been approved by the NHS Board implementation will be managed through the structure set out in Figure 2 (overleaf). A fully costed and timetabled delivery plan will be prepared covering the three year period of the Strategy. This will include a fully detailed annual work-plan to ensure clarity about what will be delivered and to what effect in each year of the Programme. NHSL cannot deliver these improvements in isolation. We intend to continue making the best use of our current and evolving West of Scotland sourcing strategy and continue working at all levels as most appropriate including;

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• National Level (Shared Services) – making best use of the national systems to

ensure we get best VFM, exploit integration opportunities, support common look and feel for clinical systems, working across organisations and services, and traditional boundaries, including services provided local benefits by national agents like NSS, SWAN, DHI, Pan Scotland including making use of national standards.

• Regional (WoS) – exploiting the developing WoS sourcing strategy where we can continue similar groundwork with national but making more use of ‘what works well’ across a number of geographical close boards, using similar services like clinical portal, applications, and work closely together making the best use of contractual arrangements that support VFM, speedy adoption and clear improvement of service.

• Local – all delivery remains ‘at local level’ to best support patients and staff. Most

innovation is also locally developed, trusted relationships developed, and a well established and highly resourced ‘business as usual’ annual programme of work is all delivered at the local level.

We also need to continue to collaborate with our community planning partners and with the territorial and special Health Boards across Scotland. Efficient and effective delivery of our strategic aims will require more regional working, wider partnerships with Local Government and third and independent sector partners with a strong focus on what our service users and front line staff need to improve clinical services and deliver better healthcare outcomes.

Figure 2 - eHealth Governance1

1 Information Assurance includes all aspects of Information Security

eHealth Strategy Group

Delivery Plan Applications Strategy

Information Assurance Strategy

Infrastructure Strategy

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3. Our Vision

3.1 NHS Lanarkshire Vision Our vision is that by 2020 everyone is able to live longer healthier lives at home, or in a homely setting. We will have a healthcare system where we have integrated health and social care, a focus on prevention, anticipation and supported self-management. When hospital treatment is required, and cannot be provided in a community setting, day case treatment will be the norm. Whatever the setting, care will be provided to the highest standards of quality and safety, with the person at the centre of all decisions. There will be a focus on ensuring that people get back into their home or community environment as soon as appropriate, with minimal risk of re-admission. Meeting this vision requires a well-trained and highly motivated workforce that is supported with modern, adaptive and sustainable clinical information and digital technologies. Changing factors across Scotland makes a single record even more important because;

• Increase in demand (circa 22%) due to increased life expectancy, long-term conditions, more complexity of conditions like dementia, and the need to reduce inequality and enable self-care by patients having direct access to their own information.

• More integrated care and revised models of care means more services will be delivered in the community with an increase in virtual clinics with or without the patient. This means the information to underpin this new model of care needs to be available to support timely and effective decision making.

• A single record is needed to break down the divisions between care, where a hospital admission can also view a primary care record, and vice versa, especially with the increasing number of people with multi-morbidities and complex needs.

• Traditional approaches have been to provide a primary (GP) system or an acute (Hospital) system, we do not intend removing systems but we will build a comprehensive patient record summary from multiple systems – that appears like a ‘single record’.

• This takes the TRAK/Clinical Portal/GP/Applications a step closer towards the appearance of a single record for the user and the patient.

Note: The stated vision for NHSL continues to meet the principles of AIM 1. The clinical portal provides a route to build a single virtual record from many systems that can be accessed from multiple settings, the addition of viewing legacy case-notes and scan forward documents will also help in the longer term. Progress is planned to evolve towards ‘directly inputting’ and an electronic sign off for results that will help reduce the forward scanning elements.

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The single record provides an opportunity to;

• Enable information sharing to facilitate integrated health and social care from the home/hospital/GP/mobile clinic

• Increase the use of information to enable health and social care professionals to improve the quality and safety of care based upon the intelligence derived from our information.

• Support people to manage their own health and wellbeing, live longer, healthier lives at home or in a community setting

• Provide Information that can better support the research and development agenda in delivering improved technology enabled care.

3.2 What will the service look like in 2018?

• Person centred information across sectors and boundaries of care will be available. • Digitization of patient information will proceed to completion, with minimal resort to

paper then scanned and added to the digital record. • The balance of structuring this data without delaying clinical workflows needs to be

considered with the benefits of more valuable data to patients, analysis and research. • This digital information will provide the basis for our vision of a single digital record

both for sharing across the health/social care and with patients as their personal health record allowing opportunity to have active communications with their care professionals

• The ability to use structured digital data to enable clinical decision support for staff, especially for less experienced staff

• Options for significant redesign opportunities for some care processes based on better health intelligence, allowing the more experienced clinicians to deal with the most complex of cases, and providing a speedy service for patients requiring less complex needs.

• This will mean more home monitoring and earlier interventions based on clinical judgement with access to digital health information.

4. Leadership Leadership is fundamental for adoption, ownership and getting the benefits from using current and new systems. Without better and wider use of technology closer to the point of care, the challenges for health will be overwhelming and the vision for 2020 will not be delivered.

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This is recognised across NHS Scotland and formal leadership options are being reviewed at a national level. This will need to complement the success of groups like Clinical Change Leadership Groups (CCLG) recent NMAHP network. NHSL has good leadership models. The Clinical Steering Group for Clinical Portal and eCaseNote is an excellent example. There are plans for an expanded group within NHSL to include all 3 major sites with local implementation teams. A central steering group to be closely linked with the existing eHealth Clinical Advisory Group. It is the local leadership that remains critical to building success and for determining the priorities, design, implementation, adoption and success of this strategy – clinical leadership should drive improvements.

4.1 Patient and Clinical Expectations Clinicians across Scotland have set out in their survey of 2014 some simple messages for eHealth; • Make information more comprehensive • Make systems easier and faster to use • Make systems mobile

If patients were also able to access their own records ONLINE, it is likely they would be asking to do much the same (as above). So this strategy has taken these messages as the primary subjective direction of travel, in collaboration with the more objective plans and targets (outlined in the aims/delivery plan) this should provide a good balance of subjective/objective goals in which to set the direction and provide measures for the next period. Providing on-line access to patients to enable: • Update demographic details • Manage appointments • Order repeat prescription • View results • View summary record

4.2 Meeting Expectations

In the aviation industry it is the most experienced pilots that design safe systems for flying. Modern aircraft are not designed by technicians and flown by pilots so why should the critical business of healthcare be any different?

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Electronic systems are now fundamental to supporting front line care. GP systems have been fully electronic for a number of years and digital information in secondary care (Hospitals) have also been using patient management systems (PMS) for a similar period of time. Acute care still lags behind the primary care providers, as much of acute information has been around the administration and reporting, rather than directly supporting clinical pathways. We (collectively) have built a plethora of different clinical applications that are extensively used across hospital care. These tend to be specialist related (Renal, Endoscopy, Cardio etc) and traditionally not widely available beyond the specific specialist purpose. The implementation of PMS, Clinical Portal, eCaseNote has allowed the incremental development of bringing together these systems to build a single record.

This should continue to include the specialist systems and the ability to directly input information into the clinical portal in the next stages of development.

Progress has moved eHealth from being a supporting service to a critical HIGH RISK service requiring 24*7 speedy support, and without access to electronic systems the ability for clinical staff to function safely and efficiently is seriously reduced. This is particularly acute when the paper record has been removed (scanned), despite it’s many, and well documented, limitations.

4.3 Leading Changes and Developments

Strong clinical leadership is required across NHSL to support this strategy. The current Clinical Leads in eHealth and the Clinical Steering Group have provided excellent leadership with major contributions helping us progress over the last few years. This will need to be expanded across all major locations and be geared towards ALL the operational aspects of eHealth and not restricted to single projects. This goes beyond getting the ‘views’ of clinicians but senior clinicians as the principle stakeholders with operational staff including active roles to;

• Develop strategic priorities • Promote widespread clinical engagement and ownership • Lead on functional design of solutions • Deliver clinical workflow solutions • Improve efficiency of systems administration including reducing the number of

systems and access passwords • Setting the response criteria for supporting critical clinical systems • Define how clinicians should be trained

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5. Progress Challenges and Priorities

5.1 Building on Strong Foundations The implementation of the National eHealth Strategy 2011-2017 has progressed well within NHSL. The Bi-Annual review from SG and the regular reviews with CMT shows NHSL remains a leading board to meet targets as one of the most progressive eHealth Boards across NHS Scotland. We have now progressed to providing a richer and wider clinical service that is beginning to provide the benefits of better information but increasing the risk in other areas.

Note: Progress is measured against the approved NHSL eHealth Delivery Plan of September 2013 (Appendix A)

Progress Highlights in this period include;

• TrakCare PMS • Information assurance strategy delivered Feb 2013 • Fairwarning service implemented across NHSL Dec 2013 • Single Sign-On partially rolled out in 2014 • Virtual desktop deployed across NHSL • Electronic ordering for Radiology across NHSL in 2013 • LIMS (with the exception of Blood Transfusion) is operational but requires significant

improvements • eCasenote implemented in Hairmyres, requiring improvements prior to Wishaw and

Monklands, improvement plan agreed • MIDIS deployed across Community • Digital Dictation working across all major sites • Clinical Portal deployed in all acute settings • Optometry referrals are electronic in some areas • EDT deployed across NHSL to send documents back to GP • OPERA implemented • WARDVIEW implemented • KIS deployed for GP • DASHBOARDS deployed to support service • HEPMA pilot in operation • CAREVIEW Operational

5.2 Challenges Despite good progress there remain major challenges and multiple opportunities to make better use of technology. As ever the pace of change and development will be governed by the level of resources that are made available. Key challenges are well recognised and have been discussed openly in multiple forums. These are summarised but not expanded here;

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• Improved single view/but still many information SILOS • Infrastructure costs/speed of development/mobile working • Numbers of systems/support/and resources • Engagement and ownership Issues • Resources, skill sets/needs analysis • System adoption/Ownership/Care • Skills Development/flexibility/adaptiveness • Sustained technology performance and resilience • Support and training needs/modern system requirements • Benefits realisation/measuring/converting

5.3 Priorities Clinicians have clearly stated that information systems should;

• Provide a more complete view of patient information • Capture information electronically at the point of care • Faster and easier use of systems • Provide mobile access • Ensure systems are highly available

5.4 Key Enablers The key enablers for eHealth remain focused around; 1 People and Skills People remain at the heart of the services

provided by eHealth. Continued development of staff, new skills, wider clinical engagement, and new models of care offer continued need for this enabler to continue, including strong management and clinical support for eHealth supporting clinical transformation.

2 Funding The mix of local and national funding has allowed eHealth to progress significantly since 2007 in Scotland, on-going investment needs to continue to increase if services are to meet growing clinical and patient demands.

3 Technology/Integration Technology is becoming better, faster and cheaper and the opportunity for integration and interoperability grows helping get more ‘bang for buck’ and we seek to continue to exploit this key enabler in the next period and

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beyond 4 Suppliers The majority of our technology across NHSL is

delivered by a mix of national and local suppliers, this continues to be both an enabler and barrier that needs to be constantly and carefully managed. Wider recognition is required that many of our systems are not controlled directly by NHSL staff but by this range of suppliers. This reflects a major proportion of our funding provided annually to suppliers who MUST be future critical enablers for delivery of strategy, reducing the blockers effects in key areas like extensive delays, poor integration, and over excessive costs.

5 Innovation Health needs to grasp opportunities for innovation. This may require bringing new entrants to the market place, replacing national services with more local service providers, and needs to be balanced with the themes of the national strategy and a wider sourcing strategy.

6 Demand The biggest enabler in eHealth continues from growing demands from clinical, operational services and patients. This is likely to continue to grow exponentially between now and 2020.

5.5 Key Barriers The key barriers for eHealth remain focused largely around; 1 Culture There are many cultural aspect to eHealth that

prevent acceptance; support, implementation including lack of perceived benefits, paper is often faster and easier, and fears around system integrity, availability and security.

2 Clinical Engagement Much closer engagement and understanding between the clinician and ehealth staff is needed in this modern era, this includes clinicians making /taking the best opportunity of the systems they have/new systems and for eHealth staff to understand better the clinical work flows and challenges – the bringing together would convert from barrier to major enabler.

3 Resources/Skills Technology is moving very quickly, the way we train, learn, and use systems is changing radically but many of our staff resources are

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dedicated at delivering BAU services and only a small amount are geared at delivering new projects/innovation/mobile working as examples. NHSL are geared to delivering BAU and support needs for new systems (from existing resources) with major transformational impact is poorly resourced and a significant barrier to rolling out major new systems .

4 Suppliers Suppliers require lengthy periods to support making system changes, have excessive cost, limited resources and work largely in silo’s – this becomes an increasing barrier when systems needs today is round working via more interoperability with other supplier systems, and all that entails.

5 Change Process Often new systems are trying to replicate a well established paper process, there is only gradual change from the old process so new systems are trying to mimic old paper based systems, only when this is established and there is better ways of working, do the process changes to take advantage of the most obvious change, this causes delays, not the best use of resources and delayed benefits of the new system.

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6. Finance Since the adoption of the National eHealth Finance Strategy in 2012 funding remains a balance of investment between NHSL and SG funding across Capital and Revenue areas. This was underpinned by a set of common progress measures that determined the progress and measurement subsequently accepted by all health boards in 2013 and reported quarterly. These remain the primarily the means of measurement for boards annual reviews and progress milestones.

6.1 Current Budget The following graphs show the 2014/15 eHealth budget split across; Pay, Non Pay and Capital investment.

Figure 2: Overview of Annual Budget

The pace and success of this strategy is determined by the level of investment within eHealth. This affects not only the initial implementation on new projects (at 17% compared to 83% for BAU) but highly dependent on;

• People and Skills • Technology and Systems • Information Management • Programme Management and Support • Application Management • Business and Clinical Intelligence • Training and Support

£9,190,052 , 46%

£9,265,490 , 46%

£1,685,000, 8%

eHealth Budget 2015/16

Pay

Non Pay

Capital

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Budget Allocations The following graphs shows the eHealth budget distribution for 2014/15 across key functional areas.

Figure 3: Annual Budget and Breakdown (2015/16)

6.2 eHealth Workforce (WTE) The workforce within eHealth is split across the key functional areas. The increasing demand for services across all functional areas will require consideration of additional resources to support the on-going introduction of new technology and innovation and supporting the ever increasing Business As Usual (BAU).

£11,418,626.00, 62%

£3,453,567.00, 19%

£2,366,603.00, 13% £1,037,594.00, 5% £179,152.00, 1%

eHealth Budget 2015/16

BAU

Applications

Strategy

Infrastructure

Non-Recurring

Health Records Staff, 219.44

Central eHealth, 6.39

Information, 19.53

Programme, 15.8

Infrastructure, 28.96

Applications, 27.99

Strategic Delivery, 8.5

Workforce Numbers (WTE)

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6.3 Future Resource Model The investment model under the revised eHealth finance strategy is built upon delivering improved and measurable outcomes improvements for patients, staff, NHSS and the public in general, either as patients or citizens accessing health and social services. Financial pressure rightly determines that any investment must deliver clinical and operational efficiencies that best meet the demand of NHSL and NHSS. The model within NHSL would also require that any investment should satisfy both the outcomes criteria and the merits of a business case. The Information Technology Industry is shifting towards a revenue based model where systems and services will be provided “Off Premise” as a service this will have an impact on future funding requirement for the provision of eHealth Services. This is often referred to as Cloud Computing; Software as a Service (SAAS) and/or Infrastructure as a Service (IAAS). This will result in a commercial model based on consumption/usage so future services are likely to be provided on a per user/month basis.

6.4 Independent Review We will seek to regularly test our services are delivering value for money by conducting regular comparator reviews and seek independent advice on our progress of projects and programmes by independent experts to help add value and progress the roadmap to 2020.

7. Strategic Roadmap The 2015-17 key targets for delivery by NHS boards to support the 2020 Vision including;

All appropriate staff will have access in all locations where they work to an effective and resilient electronic clinical system that supports them in their daily work caring for patients, including accessing and recording patient information, accessing clinical advice and decision support guidance, and initiating and managing care processes by themselves and colleagues All appropriate staff have access to a view of each patient’s comprehensive Electronic Patient Record which will provide them with an overview of the key information recorded by any colleagues in health and social care, and, where applicable, by the patient or their carer(s). This will comprise of a view of summary information from the major clinical systems, including general practice, community care, secondary care and others, and, ideally, will provide the capability to ‘drill down’ to an appropriate degree of further detail Patient care processes will be supported as these systems will enable staff to refer to colleagues, triage referrals, request investigations and receive results, generate clinical correspondence, and track care and receive prompts and alerts; Information can follow patients irrespective of departmental and organizational boundaries, facilitating the work of the clinician, including mobile access where required.

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7.1 NHSL Roadmap The roadmap provides key projects to develop between 2015-2020 required to deliver the outcomes laid out in the 2015-17 strategy.

Figure 4 – NHSL – eHealth Roadmap

2015-2017 eCasenote Develop Clinical Portal Electronic Ordering (Labs) Results Sign Off VISION 360 Optometry Referrals eMDT Patient Portal Appoint/Prescriptions LIMS-BT Single Sign On Business Case • Community System • HEPMA • eFORMS • NHSmail migration

2017-2019

Document Editor for eForms Expand Clinical Portal to Social Care Patient Portal to support Letters/Results/ECS KIS to social care staff Access for Health /Social Care Community Devices including mobile New GP Contract Portal to include primary care and community systems across boards

2020

Patient Portal Self Record/Key Results/Consultation/ KIS to social care Decision Support

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8. Delivery Plan The following delivery plan outlines the key projects within the eHealth Programme and the actual/planned implementation timeframe. Project Description STATUS 2015/16 2016/17 2017/18 eCaseNote Complete the implementation of eCaseNote at Wishaw

General Hospital and Monklands Hospital. STARTED

Clinical Portal Further develop the clinical portal in line with clinical/service priorities. Extend access to the Clinical Portal across Acute and Primary Care.

STARTED

Admissions View Implement AdmissionsView across the three Acute Hospitals STARTED PharmacyView Implement PharmacyView across the three Acute Hospitals STARTED Vision 360 Complete VISION 360 Implementation and provide GP

Summary in Clinical Portal STARTED

Optometry Referrals Complete the implementation of eReferrals for Optometry STARTED SSO Complete Implementation of electronic Single Sign On for all

key systems across NHSL. STARTED

HEPMA Develop the Business Case for electronic prescribing system. STARTED Dashboards Continue to extend the use of real time information

dashboards in line with the needs of the organisation. STARTED

REGIONAL Support the implementation of the WoS Infrastructure Strategy

STARTED

VDI Complete the Implementation of Virtual Desktop Infrastructure.

STARTED

TEC Support the implementation of the Technology Enabled Care Programme

STARTED

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LIMS BT Deliver LIMS BT Solution ON-HOLD

UNDER REVIEW

Order Comms Implement Laboratory Order Communications ON-HOLD

UNDER REVIEW

Results Sign Off Resolve issues relating to sign off for Radiology Results ON-HOLD

NHSmail Develop the Business Case for migration on to NHSmail TBA Maternity Support the development of a Business Case for Maternity

Systems. TBA

Community Support the development of a Business Case for Community Systems (MIDIS Replacement).

TBA

Infection control Support the development of a business case for a surveillance system,

STARTED

Infection control Implementation of infection control surveillance system. TBA Patient eServices Provide Vision-On Line Services across NHSL TBA eFORMS Develop the Business Case for eFORMS. TBA H&SCI Contribute to the development of Business Cases to support

eHealth requirements in relation to Health and Social Care Integration.

TBA UNKNOWN

Patient Portal Develop Business Case to support the creation of a Patient Portal.

TBA UNKNOWN

HEMPA IMP Implementation of HEPMA across NHSL TBA MATERNITY IMP Implementation of Maternity System TBA NHSMail Migration Migration from local email to NHSmail TBA Community IMP Migration from MIDIS to Community System TBA

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GLOSSARY A&E Accident and Emergency CCLG Clinical Change and Leadership Group CMT Corporate Management Team CHI Community Health Index Cloud Computing The delivery of applications off premise CP Clinical Portal CAG Clinical Advisory Group DHI Digital Health Institute ECS Emergency Care Summary EDT Electronic Document Transfer EPR Electronic Patient Record eForms Electronic Forms eVetting Electronic Vetting Fairwarning Electronic Monitoring of Access to Clinical

Systems GP General Practitioner HEPMA Hospital Electonic Prescribing and Medicine

Administration IDL Immediate Discharge Letter IA Information Assurance IAAS Infrastructure as a Service KIS Key Information Summary MPI Master Patient Index MiDIS Community Information System Microstrategy Provider of dashboard systems NSS National Shared Services Order Comms Electronic ordering and receipt of results OPERA Theatre System PACS Picture Archiving and Communication System PMS Patient Management System RIS Radiology Information System SAAS Software as a Service SG Scottish Government SLA Service Level Agreement SSO Single Sign On SWAN Scottish Wide Area Network (and services) TEC Technology Enabled Care TTG Treatment Time Guarantee VFM Value for Money Winscribe Digital Dictation Provider WoS West of Scotland WTE Whole Time Equivalent

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Appendix A – Review of Current Delivery Plan Review of the Delivery Plan (Approved in April 2013) Planned in 2013 Status (May 2015) Actions for Strategy

Assurance Strategy Approved/Implemented Feb 2013 Monitor Progress

Fairwarning/Privacy Operational across NHSL Dec 2013 Monitor Progress

Single Sign On Fully Rolled out across NHSL during 2015 including primary care

Review Progress

Virtual Desktop Fully Rolled out across NHSL during 2015 Review Progress

OCS Radiology Complete. Fully Rolled out across NHSL Review Results Sign Off

OCS Labs Delayed until 2015/16 due to LIMS issues Review Options

MiDIS Business Case to be produced to support MIDIS replacement.

Action Options

VISIO 360 Extend current service to support community Review

Laboratory BT Delivery issues with Blood Transfusion Module.

Monitor

FIRSTPORT – public website and development of NHSL

Complete. Review

Review

OP and Remind Complete.

Optometry Referrals On-going, issues with GP History, will be resolved by vision 360.

Review

Optometry Payments As above. Review

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Digital Dictation Fully Deployed Review Benefits and Innovation

Video Conference Developing and supporting Virtual MDT

Review benefits and Innovation

Check In- Kiosks POC unsuccessful. Review

Electronic Document Transfer

Review progress and benefits/innovation

Extended to include OOH and hospital prescribing

Clinical Portal Operational across all sites extend to Primary Care including GP.

Review/GP

eCasenote Operational at HMH, issues to be resolved prior to future roll-out

Being Reviewed

Review Plans

Ensemble

This is a national integration engine that supports the integration of data from multiple systems

OPERA Operational Review Badgernet (neonatal) Operational Review

Maternity Reviewing systems/Business Case Review

HEPMA Limited implementation – for review Review

REAL TIME INFO

Some dashboards available/to be further developed in phases in line with Data Quality Workplan

Review

Data Quality On-going workplan Review

Wardview Rolled out across Acute Hospitals

Review benefits and operational effectiveness

V1.6 FINAL DRAFT (14/08/2015) 26

eFEWS (Patientrack) Pilot unsuccessful. Closed.

Patient Portal Proof of concept complete. Closed.

KIS Operational Review Palliative care Planned Review