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#78

Oct & Nov2015

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Dr. Paul Johnson, GP at Cricketfield Surgery and the GP lead for the Newton Abbot Frailty Service.

Over two thirds of the country’s population.

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5 MINUTES WITH... SYSTMONE REACHES 40 MILLION UNIQUE PATIENT RECORDS!

EPRS IN REAL-TIME, AT THE POINT OF CARE

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Electronic Patient Records (EPRs) for more than 85% of patients in the country can now be accessed in real-time at the point of care across health and care. This marks a

significant step forward in the delivery of patient care at no cost to the NHS.

See what TPP is up to in 140 characters or fewer and send direct messages to us online.

Find our profile at www.twitter.com/TPP_SystmOne

We’re tweeting every week and continuing to follow the main health and IT profiles to guarantee we’re instantly informed. Make sure you let us know if your unit is also online so we can follow you and your updates.

FOLLOW US ON TWITTER FOR LIVE UPDATES

R ich, detailed EPRs contain vital clinical information which can often be life saving – especially important when caring for those

in emergency care or at the end of life. Instant access to the EPR means that clinicians can focus on treating patients, removing the administrative burden.

Sharing EPRs also enhances the patient experience. Patients do not need to repeat information and are reassured that the treating clinician has the latest information about their care. A patient from West Yorkshire recently told TPP, “I think record sharing is life saving. Knowing my record is shared is very reassuring and gives me more independence”.

This momentous development has been

facilitated by a direct integration between the clinical systems of the two major GP systems, SystmOne and EMIS Web. The two suppliers host EPRs for the majority of the country.

The scheme went live in a rapid response team in central London. This important team, who use the SystmOne Community module, can now view data in real-time from GP practices using EMIS Web.The pilot will then be extended to Waltham Forest in London to share records between a SystmOne GP practice and an extended hours service using EMIS Web.

The development aligns with government strategy and is especially significant for trusts using SystmOne EPR Core (a record viewer available licence free to all hospitals). This allows clinicians to access the EPR of almost all patients in the country. TPP will be informing all hospital trusts.

“My goal when I started the company was to make sure that

patient records are shared wherever the patient needs. Data sharing is crucial. It is a key enabler to help the NHS achieve some of its key priorities – creating

efficiencies, reducing costs and improving patient safety.”

– FRANK HESTER, FOUNDER & CEO, TPP

EPRS IN REAL-TIMEAT THE POIN T OF C A R E

| TPP News Stories |

2 TPP Times Issue 78 - October & November 2015

TPP’S CLINICAL DIRECTOR VISITS VIRGINIA MASON IN SEATTLE

DR. JOHN PARRY, CLINICAL DIRECTOR, TPP

Unavoidably ‘yes’ when you consider the seven wastes of overproduction, transport, motion, waiting, processing, inventory and defect. So what can Virginia Mason (VM) bring to the NHS? Lean, Toyota Production System, Just in time, VM Production System – do they work here? These are well established techniques already embedded in many acute trusts.

What’s the difference in Seattle? The enemy is the same – time and those wastes. The likely differences are scale and investment. VM has had 13 years with a long term CEO and a truly patient centric commitment. They started their journey with financial challenges (deficit), and proved that turnaround was possible.

Some of the improvements described should never have been needed. Poor supply logistics meant staff wasted time hunting for supplies, sometimes buying them in themselves. They are painfully honest about bad patient care. But no system can be insulated from improvement and every organisation can learn from the stories told by VM.

On the recent visit to VM I was joined by a group of senior NHS staff. We spent a few hours in the VM Institute and toured the hospital. Some changes seemed so simple - dual bin stock technique with kanban control has reduced overstocking, but more importantly ensured adequate stock in the right place. Strict time analysis of all care

components has driven second by second time saving and subsequent building redesign. Investment in dedicated kaizen teams to create and deliver change created the engine to sustain improvement. A standardised care protocol delivered by small efficient teams has ensured optimal outcomes for all. All resonated with my experience in general practice.

But the most challenging change was including the waste for patients – waiting for appointments, waiting for investigations, waiting for results. When the payer is a multinational (Starbucks) and demands better and cheaper care, the organisation has to change. Sounds familiar.

IS THE NHS INHERENTLY WASTEFUL?

Above: Image courtesy of

http://virginiamasonblog.org/

In July this year, the Trust Development Authority

announced a ground-breaking programme with Virginia

Mason hospitals to mentor five NHS trusts.


3Visit us at www.tpp-uk.com

T he initiative will involve partnerships with: University Hospitals Coventry

and Warwickshire NHS Trust; The Shrewsbury and Telford Hospital NHS Trust; Barking, Havering and Redbridge University Hospitals NHS Trust; The Leeds Teaching Hospitals NHS Trust and Surrey and Sussex Healthcare NHS Trust.

TPP’s Clinical Director Dr John Parry accompanied the King’s Fund Leadership Team

on a study tour to Seattle in early September – read his thoughts below on visiting the Virginia Mason Institute.

JohnsonPaul5minutes with...

Q Why did you move to SystmOne?

A Our then PCT had SystmOne licenses available, so we had a demo of the system and found it

had lots of the innovative functionality available that we were looking for, which would enable us to streamline our work processes. So we made the change.

Q A lot of services in your area have moved to SystmOne recently. Are you planning to share

information and working across services?

A Six practices in our locality have moved to SystmOne, with community services having

access to patient notes. It’s revolutionised the way we work, greatly improving efficiency across services.Group protocols and templates mean that care across the locality is standardised, with each GP having access to both clinical and administrative information across all six practices. This allows us to share working at weekends.

Having joined-up services also enables us to have better co-working across the locality, with one specialist individual providing care to all six practices through shared clinics. We are currently exploring lots of ways to share services using specialist individuals.

Dr.

Dr Paul Johnson is a GP at Cricketfield Surgery. He is also the GP lead for the Newton Abbot Frailty Service, which provides services for the top 2% of high risk patients, supporting them to live and age well. He presented at this year’s National Frailty Conference, speaking about the Screening Tool of Older People’s potentially inappropriate Prescriptions (STOPP) protocol he has created for the frail elderly


| Interview |

JohnsonPaul

Q You attended the national frailty conference in June to discuss the STOPP protocol you developed for the frail elderly. Can

you tell us more about this?

A Often, frail elderly patients who have multiple conditions can potentially end up taking too many, unnecessary

prescriptions. The STOPP protocol is a tool to help ensure that this does not happen, making sure that the medicines a patient is taking are appropriate and will work well in combination.

The protocol assesses over 70 criteria to analyse whether any medications that a patient is taking may be inappropriate.

I published the protocol within an open organisation group in SystmOne, so it was accessible to all. I have since received a lot of interest from other SystmOne users keen to use the protocol.

Q What inspired you to create the STOPP protocol?

A Originally, I trained in General Medicine, and planned to be a geriatrician. However, I soon realised that staying in

hospital medicines was not where I wanted to be, so I moved over to become a GP around nine years ago. I’ve maintained my passion for geriatrics, and wanted to bring my interest and skills to primary care.

As such, I’m now the GP lead at the Newton Abbot Frailty Service, leading a multidisciplinary team looking after patients from all six local GP practices.

Q Why did you choose to attend the national frailty conference?

A It is so important to identify frail patients to ensure that they are receiving the right multidisciplinary team to

appropriately manage the patient’s care and means that crises can be pre-empted.

The frailty conference was fantastic as it brought these issues to the forefront, bringing together a range of experts in order to discuss and shape the future of the care of frail people in the community. I’m already looking forward to next year’s conference!

FIND OUT MORE

You can read more about the STOPP protocol in this month’s HSJ Technology Supplement, available at http://www.hsj.co.uk/resource-centre/supplements/


| Interview |

O n the week beginning 12th October billing software Medibooks began piloting in five SystmOne GP practices.

Medibooks offers fully customisable, easy to use billing software that is designed to help GP practices and federations manage their non-NHS and private income.

The Health and Social Care Information Centre (HSCIC) provides the GPSoC contract framework to guide GP practices in procuring IT systems. The framework requires clinical system suppliers to provide interface mechanisms for third party suppliers. These integrations encourage compe-tition and help smaller suppliers to bring innovative developments to the market quicker.

To procure SystmOne under GPSoC, please follow the steps outlined on the GPSoC section of the HSCIC website. For more information about SystmOne GP visit the TPP website.

TPP AND MEDIBOOKS COMPLETE FIRST EVER GPSOC INTEGRATION

O n average a new record is created on SystmOne every nine seconds. The 40 millionth record was created at 00:05:36 on Friday 9th October, as part of the data migration of over 15,000 patient records for Solent

NHS Trust’s move to SystmOne Mental Health.More than 6,000 organisations use SystmOne across 24

different health settings, spanning primary care, secondary care, social care and mental health. As SystmOne is built on a “one patient, one record” model of care, these patients benefit from having a rich, detailed patient record that is securely available at the point of care.

Wellington Health Centre in Westminster was the first practice to register a patient on Friday 9th.

Anthony Mukoro, IT Manager, Wellington Health Centre, said: “We’re delighted that the first patient after SystmOne reached 40 million records has been registered at our practice. We’ve been on SystmOne for nearly two years now, and we’ve found that it allows us to develop a detailed electronic patient record, which helps our clinicians to deliver the highest quality of care.”

TPP now host more than 40 million unique patient records – over two thirds of the country’s population.

SYSTMONE REACHES 40 MILLION UNIQUE PATIENT RECORDS!

TPP’s SystmOne has become the first system to integrate with a third party supplier under the GP Systems of Choice (GPSoC) framework.

“This is a huge milestone. We now host one of the largest real-time healthcare databases in

the world. With another 100 services going live before Christmas, and with our database able to scale up to holding a record for everyone in the

country, this growth is only set to continue.”

– FRANK HESTER, FOUNDER & CEO, TPP



TPP NOW ITK ACCREDITEDFOR CLINICAL CORRESPONDENCE MESSAGES

“Our health community has been identified as one of the three national

accelerator sites for the delivery of one of the first fully integrated digital health and social care records which we have achieved through working with our technical provider TPP. Our

aim is to improve patient care and enable new ways of working that ultimately improve

the experience of patients using services within Airedale Hospital and across the wider

care community.”

– DAVID WORTH, PROGRAM MANAGER, DIGITAL CARE AT AIREDALE NHS FOUNDATION TRUST



A iredale NHS Foundation Trust is rolling out the SystmOne e-Prescribing (including medicines administration) and

e-Discharge modules across further wards at Airedale Hospital. This is through the addition of the medication to each patient’s singular record, which spans multiple care sectors.

The aims of the project are to improve accuracy and reduce prescribing errors, as well as to improve patient safety and ensure greater efficiency for clinicians.

Since the trust went live with SystmOne e-Prescribing and e-Discharge earlier this year, the following benefits have been realised:

® Sharing of the electronic patient record in real time – between primary and secondary care (subject to patient consent). This allows the appropriate clinicians to see what has been prescribed.

® Instant discharge notifications – 85% of patients admitted to Airedale Hospital have a discharge notification sent to their GP practice within seconds.

® Easy access to drug charts – from any location within the hospital.

® Clear and easy to read prescriptions – removal of the risk of illegible handwriting and manual movement of paper charts.

® Reduction in the need to transcribe drug charts.

The additional information provided by the combined drug history and content of discharge letters into the integrated record is enabling timelier, more informed care. Other providers in the area also use SystmOne such as community nurses, care homes and palliative care. Through SystmOne these care professionals are now easily able to view the medication prescribed during a patient’s admission.

T PP has received Interoperability Toolkit (ITK) accreditation to send and receive clinical correspondence messages.

SystmOne GP services can now receive these messages (e.g. discharge letters, ambulance messages) from other healthcare services such as urgent care.

The ITK is a Health and Social Care Information Centre (HSCIC) initiative. It’s a set of national standards, frameworks and implementation guides to support interoperability within local organisations, across local health communities. ITK uses international standards and is aligned with HL7 and Integrating the Healthcare Enterprise (IHE).

This accreditation will enable SystmOne users to receive more messages electroni-cally, ensuring timely and accurate receipt of information. As TPP has been working on a nationally recognised message, this will help to standardise clinical corre-spondence messages - allowing an increasing amount of services to send and receive relevant messages.

Accreditation is the first step in HSCIC’s Clinical Document Architecture (CDA) assurance process. This functionality is expected to be rolled out in November. TPP is already ITK accredited for sending and receiving 111 cases.

SYSTMONE E-PRESCRIBING TAKES OFF AT AIREDALE HOSPITAL

HEALTH AND CAREINNOVATION EXPO

2015



TPP attended the Health and Care Innovation Expo held on the 2nd and 3rd September in Manchester, along with 10,000 delegates.

D uring TPP’s time exhibiting and networking at the event, it was clear that there is a great appetite for innovation and the adoption

of technology in the healthcare sector.The key theme of the Expo was the Five

Year Forward View, specifically the 37 vanguards chosen to trial new models of care. All the vanguards were at the event in a dedicated area to talk with delegates about how they have redesigned services and improved the delivery of care. We were pleased to see some of these areas using SystmOne, specifically around enhanced health in care homes and integrated primary and acute care settings.

The event introduced the public into the conversation about supporting the delivery and adoption of innovation in health and care. This approach was summed up by Chief Executive of NHS England, Simon Stevens, who emphasised how ‘the NHS is not an island’ and is embedded in every part of the community.

One of the main NHS England announcements focused on the drive to put people in control of their own health and care. By next year, all patients should be able to access their full GP record online. By 2018, this will also include information from all health and care interactions. Over

the past year, the NHS has made big strides in ensuring that GP services offer their patients online transactional services with 97% of SystmOne GPs switching on the SystmOnline patient facing service.

However, one constraint and area for

development mentioned throughout the event was to make sure the public is confident that their personal medical data is held securely and is being used for the right purpose. Getting this right will encourage patients to consent to their information being shared and encourage further integration across health and care.

There was also more attention given to mental health, especially ensuring parity of esteem between physical and mental health alongside service improvement. One of the major areas of attention was the huge response to the Mental Health Taskforce survey, which has had more than 20,000 responses. Although themes are still emerging, four main issues have been highlighted so far; prevention and early intervention; access that is quick, high

quality and effective; integration across clinical systems to ensure whole-person care; attitudes.

There are areas of the country that are making huge strides towards addressing these issues, specifically those using the SystmOne Mental Health module to work closely with other health and care providers. It is great to see so many contributing to the survey and we look forward to seeing the final Mental Health Taskforce report.

It is clear that innovation and technology is one of the key enablers of many of the NHS England goals over the next few years. The Expo was a great opportunity to not just promote SystmOne, but also share best practice and speak to our new and existing contacts about how they see technology helping their service evolve and deliver more holistic person-centred care.

Thank you to everyone who came to see us over the two days of Expo, we look forward to next year’s event.

You can read more about Expo on the NHS England blog site - http://www.england.nhs.uk/expo/news-and-blogs/blog-posts/ or continue the conversation on Twitter using #Expo15NHS

“One of the main NHS England announcements focused on the drive to put people in control of

their own health and care.”

T wo Practices in Barnsley have been working together to develop and implement an e-consultation scheme.

Royston Group Practice and The Kakoty Practice have developed a method for diabetes patients to converse with a health professional via email, freeing up capacity and empowering patients to manage their health more effectively.

The system works very efficiently; all e-consultation requests are sent to a ‘task box’, which is picked up by a health professional at the practice. The GP or Nurse can then respond with general advice or signposting to other services. The patient’s e-consul-tation form has a text box with a set number of characters to keep requests concise; they can then be notified by a text message when they receive a response from the health professional.

Angela Adams, Practice manager at Royston Group Practice said:

“The service is showing real promise in these early stages. The solution we have found offers great potential to be a real hit with patients and helping to

reduce the number of non-urgent appointments, providing reassurance and freeing up clinic time for those who need it most.

We’ve used the established SystmOne ‘task box’ so that requests from patients cannot be missed or overlooked and these are actioned to the patient record for full audit trail. We respond to patients as quickly as we can. We have begun with diabetes patients to test the system, who send queries and from which we form the most appropriate ways to advise. We use the query request template to signpost them towards self supporting tools, such as Sound Doctor.

We’ve been working collaboratively with our system suppliers and other practices to get the best out of this initiative, and it’s something we hope can really make a difference for patients and GP practices in Barnsley.”

Watch this space! The project has started with a focus on diabetes patients, with a view to expanding to all types of long term conditions if the project continues to improve the timeliness of available appointments for those who need it most.

If you have a story you would like to share about how you are using SystmOne in your area, please get in touch with us at [email protected] or call the marketing and communications team on 0113 20 500 93.



It is always great to see how people are using SystmOne in innovative ways and how they are sharing these innovations with the local and wider community. The following article is taken from NHS Barnsley CCG’s newsletter, Closer. It illustrates how two practices have been using SystmOne to provide an e-consultation service for diabetic patients.

SHOW ING E A RLY PROMISE

E-CONSULTATIONPROJECT

INNOVATIVE

Congratulations to our very own TPP employees who successfully completed the Great North Run, which took place Sunday 13th September.

17th & 18th May 2016

SNUG Conference 2016BirminghamMore information coming soon!

SAVE DATETHE


H ere at TPP we would like to thank the five employees who took part in the Great North Run and managed to raise

over £2,000. This amount was doubled and then rounded up to £5,000 by Frank Hester, Founder & CEO, TPP.

This impressive total will be distributed among a selection of charities, specifically dedicated to improving the level of care and wellbeing of citizens both UK and worldwide.

Approximately £1,300 will go towards the International charity Save the Children, who work in over 200 countries to save

children’s lives and fight for their rights. £500 will go towards the national charity Great Ormond Street Hospital, and finally the remaining £300 will go to a local charity St Gemma’s Hospice. As the largest hospice in Yorkshire, they deliver specialist medical and nursing care for people with life threatening illnesses, predominantly cancer patients.

Frank’s contribution will be donated to Great Ormond Street Hospital, enabling them to provide world class care for children through the development of new innovative treatments.


TPP EMPLOYEES RAISE £5000COMPLETING THE GREAT NORTH RUN

PUZZLE

Send your answers to [email protected] to be in with a chance of winning a label printer courtesy of Brother.

Congratulations to Pam Hill at Sandwell and West Birmingham Hospitals NHS Trust who won the last competition!

Can you fill the 15 SystmOne words into the grid and unscramble the bold boxes to reveal the mystery word?

1. SystmOne

2. Eprescribing

3. General Practice

4. Patients

5. Mental Health

6. Palliative

7. Community

8. Management

9. Pharmacy

10. Mobile Working

11. TPP

12. NHS

13. Reliability

14. Integrated

15. Reports

EVENTS CALENDAROCTOBER

1 2 3 4 5 6 7

8 9 10 11 12 13 14

15 16 17 18 19 20 21

22 23 24 25 26 27 28

29 30 31

NOVEMBER

1 2 3 5 7

8 9 10 11 13 14

15 16 17 18 19 20 21

22 23 24 25 26 27 28

29 30

4

12

6


| Calendar | Puzzle |

EHI Live 3rd & 4thNEC - Birmingham

HSJ Summit 5th - 6thSopwell House - St Albans

Third Health & Justice Conference 6th30 Euston Square - London

Acute & General Medicine and Patient First 12th & 13thExCel - London

The King’s Fund Annual Conference 19thThe King’s Fund - London

Commissioning Live Manchester 24thManchester Central Convention Complex

International Medical Travel Exhibition and Conference (IMTEC)7th & 8thDubai International Convention and Exhibition Centre

The King’s Fund Integrated Care Summit 13thThe King’s Fund - London

HSJ Modernising Healthcare Summit 15th & 16thThe Holiday Inn - Stratford-Upon-Avon

© TPP 2015

SYSTMONE FUNCTIONALITY

TOP TIP GOT A TIP?Register patients for Online Services (SystmOnline) and send registration details using their preferred contact method via Organisation Preferences > Online Services > Messaging.

Let us know your tips for using SystmOne

Do you use a shortcut or little known functionality you think more people should hear about? Tweet us at twitter.com/TPP_SystmOne or email [email protected] to see your tip in the next edition of the TPP Times.

IMPROVEMENTS TO INSTANT MESSAGING

BOOKMARKSDATES ON TABBED JOURNAL

Users suggested a number of improvement to make the instant messaging functionality more intuitive:

® Instant Messages now appear at the bottom right hand corner of the screen so are much less distracting. You can continue what you are working with and address them when it is convenient.

® If you receive multiple instant messages, they will stack in the bottom right hand corner of your screen.

® In your user settings, you can stipulate your postpone options. You can either

In the appointments ledger or overview, you can now select multiple staff members and set these as a group via a bookmark. This allows you to just view rotas for a specific subset of your staff without having to select the individuals each time. You can set up as many bookmarks as you like and give

each a name to make it easy to manage your groups. You can edit your bookmarks if there are subsequent changes, e.g. a team change their name or a new member of staff joins. This development was suggested to make it much easier to manage staff rotas and appointments, and have visibility of workloads across teams.

do this by setting a standard postpone time of your choosing (e.g. 30 minutes) that will be applied to all postponed messages. Alternatively, you can get the message to prompt you for a postpone time on a case by case basis, so you can specify an urgent message to pop back up in 10 minutes, then choose for a less urgent message to come back in a few hours.

® When replying to a message, the last message will be displayed at the top of your reply. Previously you would just have an empty free text box and the

last message would disappear. This was inconvenient if there were specific details in the message you wanted to respond to that you had not noted down.

® If you log off with instant messages still on your screen that you have not actioned, when you next log in your messages will still be there. Previously, if you logged off the messages would disappear, and again, could only be viewed via audit.

We have changed the date format on the tabbed journal to match that used on the new journal (e.g. 18 Aug 2015). This makes entries clearer and improves consistency across the system.

The following developments were the top three voted for by users at the 2015 SNUG Conference Development ChatRoom Live session. A big thank you to everyone who participated, and watch this space for future SNUG Conference developments.


| Did you know | Top tips | New functionality |

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