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https://nww.stuff.nhs.uk. Or Whither NHS net. Why?. Long personal involvement Central to all the changes that surround us Knowledge is power Pretending it isn’t going to affect us is not an option. Why?. Not for coding clerks. Who don’t have a long term future. - PowerPoint PPT PresentationTRANSCRIPT
https://nww.stuff.nhs.uk
Or Whither NHS net
Why?
Long personal involvementCentral to all the changes that surround usKnowledge is powerPretending it isn’t going to affect us is not
an option
Why?
Not for coding clerks.– Who don’t have a long term future.
Not just for the IT department.
For us all, clinical workers and management workers alike.
What?
The NHS plan.Information for health.
• 1998
• Our LIS.
• Our local funding.
Building the information core.• Jan 2001.
Other bits from all over.
Strands in All This
Communications
Records
Information
Strands in All This
Maybe money?
New Ways of Working
Not bolting computers onto existing practices
About redesigning work
Redesigning care
New pathways in the jargon
NET Targets
Secondary careSecondary care
Clinical and support staff;
25% have desktop access by now– Really is 20% ‘ish
100% by 2002
Primary carePrimary care
GPs and managers95% practices
connected by now– Really is 80% ‘ish
90% desktop access by now– Really 50% ‘ish
All 100% by 2002
But but but but but !
Uses Now
EmailNet browsing Information sourceFax out (doesn’t
work!)NSTS (not that
reliable!)
Reading the stuff the NHSe no longer publishes – cures insomnia.
National address book?
GP registration links. GP IOS links – for the
brave.
Security
Lags behindCaldicott
– Awareness– Safe havens etc etc
National audit scheduled for Dec 2001 – To BS7799
NHS cryptography – Roll out spring 2002– Public key encryption
What Next? – Uses of NHS net
National priorities are pathology requests and reports.
Then xray reports and requests.Booking.Discharge information.
Jargon
EPREPRElectronic Patient
Record– ? Attainable
EHREHRElectronic health
record– ? Holy grail
Clinical Terminologies
Coding viz classifications
Read 3– Ends 2003
SNOMED – CT– Starts 2003
? Legacy coding and classifications
EPR Level 3
Integrated patient master index.• PAS.
• Departmental systems (all departments)
Electronic clinical orders and results reporting.
Prescribing software.Multi-professional care pathways.
EPR – Primary Care
RFA99 legalises electronic records.RFA99 roughly equates with levels 4-5 of
secondary care EPRs.Big problem is hospital letters.
– ? Scanning.– ? EDI.
? 90% of practices ? 90% of practices by 2003by 2003
EPR – Primary Care
Integrated nursing and medical EPRs are coming.
National framework expected in Sept 2001.
End of many Korner MDS expected in next month or two.
Local initiatives already underway.
EPR – Out of Hours
National programmeTo make summaries
of GP EPRs available 24 hours a day
First to GP out of hours services
Then to A+E departments
?? 2005
EPR – Mental Health
Separate plans for mental health EPR.
Separate funding stream. Integrated social and
health records. Shared with social
services. 25% by 2003 ? Locally ahead of the
game.
EPR – Acute Hospitals
Weird set of levels defined by the NHS
35% of acute trusts to have a level 3 EPR by 2002
100% by 2005 Plenty of words and
management speak out here – few systems!
Local Status
9 practices have full desktop NHS net connection.
All practices should be connected by end of year.
16 practices have new LANs.
6 practices “paperless.” 5 practices going
“paperless.”
Local Status
FHN has connection. FHN has too poor a LAN
for full desktop access. We have started a project
for pathology reporting and requesting.
We hope to add in radiology soon.
Networking information sources is proceeding.
Information
NICENeLHProtocolsPoliciesGuidelinesHiMPsCHiMPs
And uncle tom cobbly….
Payroll and HR
A national payroll and HR system is planned to start rolling out in 2004.
Doing away with individual organisational arrangements.
Caveats
Knowing that nurses share the same records and can rapidly communicate with doctors will allow more task sharing, profoundly changing the nature of medical work.
Caveats
A lush information landscape where information is shared with patients leaves some things unknown:
If 1% of patients join the worried well?
Sharing all records with patients?
Caveats
How much extra time to spend capturing and structuring records?[1] – 30 minutes plus per day.
– [1] Tierney et al JAMA 1993;269:379-83.
Caveats
Are we ready to share our information with patients ? – The strategy says there are irresistible
arguments for this.
Caveats
ControlGovernanceAccreditation (and Re- )Performance related payPolitics
Or just my depixol dose is late.
A Personal Hope
Clinical Needs
Not
Technology for its own sake