Appendix A2 Detailed Action Plan for Informatics Strategy

1 Draft version 0.4

Appendix A2 – Detailed Action Plan for Informatics Strategy

Work stream / Action number

Requirement Benefits Priority Recommendations / consideration

1.01 Complete

implementation

of systems

procured in

2009

Achieve the benefits outlined in the business cases for Maternity, Pathology, Radiology, GP requesting and PICIS

These systems need to be completely implemented

Issues outstanding need to be addressed

Any final issues need regular review by the Informatics Board so they are not lost

Develop a culture of successfully and fully completing system implementation

Have a sign off process for these projects

All these projects should be reporting status to the Informatics Board until they are signed off

1.02 Single sign on Research shows that 40% of all helpdesk calls are password related. Cutting down on these calls will improve the productivity of the IT team

Encourage staff to use systems and improve data quality.

Make it easier to access multiple systems

It has been reported that the Centillion system is being implemented for single sign on in the Trust – is this the right solution?

A requirement of specification to be developed before work proceeds.

It is recommended that the following requirements are included in a specification of requirements:

o Single sign on to operating system and applications. o Alternative methods of identity confirmation such as smartcard,

biometrics etc and not be limited to typing in passwords. o Facility for resetting of passwords to be available to users o The option of NOT forcing a password change on a regular basis I.e.

sufficient information is presented to authenticate the user so it is not necessary to keep changing passwords.

o The ability to restart/continue sessions in a different location so that mobile working is facilitated (virtual desktop)

Options appraisal should be undertaken before a solution is selected

Clinicians need to understand the difference in functionality between different solutions and any trade offs.

Clinicians need to understand the impact of the rollout process i.e. might be available in the trust before remote sites. Issues in these areas might shape the rollout programme.

1.03 Clinical portal / Enables tailored view of real time information held in

Produce a specification of requirements

Review products on market and match with specification of requirements.

Version 1.0.doc 2 of 36

Safe Personal Local



EPR multiple systems.

Enables workflow to be introduced

Best of breed can still be utilised

Make it possible for staff to view patient – rather than system /departmental records on a single screen.

Consider the potential of the CfH Project - Clinical dashboard

This requirement may be merged with 1.04 as many of the products identified in 1.04 provide a clinical portal functionality

1.04 Clinical Data

Repository /

EPR Data

warehouse

Provide a richer more comprehensive data set

Reduce data entry for demographic data

Consistency in how information is presented

Access to one system

Context of information (e.g. see results in context of current drug therapy)

Reduce LOS by improving data flow

Explore the possibility of appointing a prime contractor to integrate existing systems into a single view of care. This would remove the risk and work load from Frimley for developing this key step in moving the EPR forward.

The requirement to link existing systems together has been the main objective of organisations such as Graphnet, Dbmotion; Wellogic; Medicity; Orion; Bridgeforward and others for over ten years so there are many well proven solutions.

The Trust needs to review the potential of these products

Also providing solutions are Sun Microsystems with its own open source offerings including JCAPPS (ex SeeBeyond); Tolven; Mirth; NewGate. Open Source may have a role here that is affordable and can help join all the components together. It needs to be considered before it is discounted.

A potential solution for the EPR dataware house might be a single database linking all its records to patients, enabled by Microsoft’s Active Directory system.

Once this type of solution is in place it will enable a range of possible changes to working practices.

Review the functionality in Microsoft Amalga

Consider reducing the integration burden by obtaining integrated application suites from a small number of suppliers, even if the effect is that an individual application or module is not as strong as a competing ‘best of


Safe Personal Local



breed’ standalone product. Include this as part of the clinical data repository specification.

1.05 A&E System Real time data and improved data quality

Better coding – more income for the Trust

Improve the documentation of care in A&E

Information to support clinical decisions, management and development of service

Improve adherence to Health Care commission standards

Improve junior doctor training in A&E

Facilitates Frimley becoming satellite service for London trusts providing level 1 trauma services

Produce a statement of requirement which includes o Interfacing requirements o Integration requirements – integration of information from other

systems to a common view. o CDS output o Enhanced log on capabilities (to facilitate an effective user log on

rather than group log on in the department) o Care pathway support such as stroke and thrombolosis

Survey market and identify potential solutions

Identify and list the integration issues that would need to be addressed as part of the implementation of the A&E system such as patient registration, order communications etc.

1.06 Integration

/interfacing of

existing systems

Provide a richer more comprehensive data set

Make sure that data currently available in standalone system is made available to appropriate users

Reduce data duplication /

List all standalone systems

Ensure that parameters are identified for adding new components to the informatics infrastructure / strategy development

Identify the cost and benefit of interfacing each system

Is our integration engine fit for purpose in the role of an interoperability engine?

Have the aim of creating a uniform set of patient information that is consistent, timely, and reliable using best of breed systems?


Safe Personal Local



entry of data into multiple systems

Make users more efficient

What are the resources required to support

Ongoing maintenance requirement for interfacing

All patient systems should at least be connected for demographic

Feed data from department systems into clinical warehouse

Consider a spine and bolt on type approach

Bi-directional interfaces – improve data quality?

As a priority consider systems such as Jonah /TMS where duplicate data entry is an issue

1.07 Electronic

Prescribing

Reduce LOS

Reduce drug costs

Continue to review the market

Produce a specification of requirement

Consider the recommendations in the CfH document – EPrescribing – challenges and lessons learned

Identify a clinical champion who will have a dedicated session per week to work on the implementation of e-prescribing

Develop a rollout plan now and understand the dependencies so they are all addressed before implementation

Plan and prepare for procurement so that implementation can be undertaken rapidly once enablers are in place

Progress on preparation work for ePrescribing needs to be reported to the Informatics Board so the group is continuously made aware of the status of preparations

1.08 Order

communications

Reduce LOS Need an external and internal perspective.

Produce a specification of requirements that is wider than just Pathology and Radiology (need to understand ordering across all of the patient pathway)

Identify the options including systems already in place that will provide order comms including PAS and Anglia ICE.

Order comms could make a significant contribution to CIP

Identify a clinical champion for order comms


Safe Personal Local



Develop a rollout plan now and understand the dependencies for order comms so they are all addressed before implementation not during

Plan and prepare for procurement so that implementation can be undertaken rapidly once enablers are in place

Progress on preparation work for order comms needs to be reported to the Informatics Board

1.09 Patient Safety Improve patient safety

Implement systems that help staff with positive patient identification

Identify the requirements for technology to underpin patient safety and identification

Produce an informatics patient safety plan that includes informatics initiatives like :

o NHS number o Blood transfusion. o Pharmacy o Bar coding o Wristbands

Identify the projects required to deliver the informatics patient safety strategy and especially where there are areas of commonality

1.10 PAS –“surround

and replace”

To deliver more benefit from the PAS

To have a system that meets business needs

Save costs (annual maintenance of existing PAS very expensive)

Building functionality that compliments or replaces PAS will provide the organisation with more flexibility and contingency in the event that PAS is not

Do SWOT analysis of existing Isoft PAS

Undertake options appraisal for PAS which should include the following options

o Do nothing o Plan to implement CRS o Replace with another PAS o Incrementally replace functionality

Identify options for weaker modules of PAS (already covered in this plan but need to validate)

Review maintenance costs and ensure expenditure on PAS is reported to Informatics Board


Safe Personal Local



sustainable

1.11 Electronic

scheduling for

booking and

tracking

patients

Better system for the management of patients through their pathway

Ensure that timescales for treatment such as 18 weeks are met

Ensure correct patients in clinic

Enable follow up appointments to be booked from the wards before discharge

Better resource scheduling to ensure that capacity is not wasted

Reduce LOS

The Trust needs a better system that manages capacity and demand in a more intelligent way. Currently there are lots of overbooking and annual leave issues. It is perceived that the services are constantly in crisis management. Demand and capacity information is presented but it is perceived to be too complicated. A system is needed to allow modelling and present options for configuration of capacity e.g. switch to outpatients for next few weeks to deal with capacity issues.

Produce a “to be”process map for the booking and tracking of a patient – how it should work in the ideal world.

From this map - produce a specification of requirements for booking and tracking patients i.e. what do we need to do.

Look at the role of the medical secretary and how they could become a pathway manager for patients. What tasks would they need to be freed up from in order to do this? How can technology free them up from their current tasks?

Undertake a gap analysis with PAS of the requirements for booking and tracking. Which areas can PAS/Patient Centre not do effectively?

Identify benefits of different approach and cost of current approach in terms of manpower, breaches, rework etc.

Review other solutions for booking and tracking such as enterprise wide scheduling systems e.g. Ultragenda to see if they meet requirements

Consider automating the booking-in process in clinics where patients book themselves in. Other Trusts are using these systems.

1.12 Clinical Notes Migrate from manual notes on paper to an electronic solution

Incremental step towards an electronic patient record

Understand the different requirements between specialties and all staff for clinical noting

Document these requirements and consider incorporating into EPR functionality as it is developed (some of the products in 1.04 will deliver this requirement)


Safe Personal Local



1.13 Medical

equipment

interfacing

Maximise benefit from investment in medical equipment

Provide a better service for patients

Enrich clinical information available by including medical equipment data

Understand the full requirements for medical equipment interfacing on a specialty by specialty basis

Develop or purchase a standard mechanism / or multiple options for connecting medical equipment to the network and extracting information to go into the clinical data repository.

Example of requirements – Ophthalmology want to buy a glaucoma machine for GPs in Guildford. Merge data with FPH data.

1.14 Electronic

document

management

(EDM)

Cash releasing savings of £1-6million per year per acute Trust (McIndoe 2007) coming from administration, storage, stationery and transport of paper

Process efficiencies – remove duplication and reduced time wastage

Safety improvements, inforation sharing and security, legibility, structure

Environmental benefits

Facilitate audit and research

Re reviews the requirements for electronic document management and understand its impact / role in leading to a paperless organisation.

Review solutions that have been implemented in other trusts and lessons learned. For example Portsmouth hospitals implemented IBM solution in January 2008

Understand the requirements for EDM including scanning

Understand the integration requirement (with other systems)

How to deal with bulk v on demand.

File preparation and Sign on.

Infrastructure upgrades

Process map how the new processes could work.

Data capture methods e.g. bar codes that will automate data entry

EDM will magnify the problems of historically poor records management (content and process) – it will become a blame magnet

CRS does not address the historical paper record. EDM is an additional bundle.

1.15 Patient

information

Improve services for patient

Ensure consistent information provided to patient

Investigate solutions for improving patient information services using technology

Implications of health space not being developed further – opportunity for FPH to provide value added service for patients.

Identify the trigger points for patient information in a pathway and the


Safe Personal Local



options for information provision e.g. paper, SMS text, email, internet, contact your consultant secretary, ask a question, etc

Involve patients in assessment of solution options

Patient access – see their medical record on line. Why not? A right to know.

The main source of patient information, predominantly in paper form and with limited multi-lingual content. There is limited on line patient information (except for a touch screen information kiosk in the front reception)

Enabling patients with Web 2.0 tools, if it follows other Web 2.0 trends, is likely to lead to significant challenges to current models of healthcare delivery as well as revealing significant opportunities to improve citizen health and patient outcomes.

Consider an editorial governance body /process to manage electronic patient information development.

1.16 Alerts Improve patient safety Specify the requirements for electronic alerts

Reinforcing safety / educational issues that may bypass staff in everyday work, e.g. personalised reminders to groups of doctors / nurses etc re drug errors to be avoided etc.

Look at how technology can improve alerts e.g. better bleep system may also help here

1.17 Care pathways Improve service for patient

Manage workflow

Proactive rather than reactive service

Reduce LOS

Identify requirements for a care pathway solution

Can this be incorporated into EPR solution requirement?

Look at the link between pathways and prescribing – key interface / dependency

1.18 Knowledge

management

Provide mechanisms for giving people knowledge to do their job better

Clinically focused.

Needs a clinical champion

Identify areas where knowledge management could improve clinical performance and how best to provide knowledge

New advice comes out on a regular basis. You cannot be sure that everyone


Safe Personal Local



has read it.

Trust needs to target people with the information they need to do their job

Pay for BNF subscription. St Georges have it networked. Clinical questions answered for medicine. £400 for individual licence but how much for a site licence?

Review how the intranet could become more like Amazon and be context sensitive so information that is relevant for that member of staff is presented e.g. latest NICE guidance for your speciality, prescribing problems for your speciality etc

1.19 Decision

Support

Provide functionality to support clinical decisions

Specify and understand requirements for decision support

Identify main areas where benefits could be accrued

1.20 Teaching,

training and

research

Support for better teaching and training for all clinical staff

Support for better research

By products of an electronic patient record must be functionality that provides teaching, training and research.

This requirement should be built into all specifications of requirements and considered as an integral part of all procurements where possible and appropriate

2.01 Clinical Quality

information and

outcomes

Information to meet clinical needs for service development, research and care quality

Improve the quality of service

Engage clinicians in information agenda.

Provide valuable and needed information to support service development

Manage HCC outcome

HCC outcome measures are going to represent a lot of work

Start work now to define requirements and approach

The quality agenda is creating a huge demand for good information so this links in to other actions in this plan

Consider developing clinical information analysts that work out in directorates with consultants.

Information accuracy checked daily /weekly not monthly

The information team should review and understand the Cleveland clinic solution in conjunction with some clinicians like Tom Poole and Ed Palfrey who can explain why they want it and the benefits for them.

Information team to produce an options appraisal – solution to support this requirement and present to the Informatics Board

Quality indicators that are required will include mortality and morbidity


Safe Personal Local



measures in an effective way

figures – very sensitive information. Clinicians are concerned that the information won’t be correct and will be sent to PCTs – consultants need to see it / understand it and believe it.

FOI around this area is very political – the services will be under political pressure from any information that is provided

Rather than trying to find a one size fits all solution recognise that specialties are very different in their information requirements.

Work with a single specialty to understand their key requirements. Gain agreement from the clinicians in this specialty and limit the requirements to a reasonable and useful list for development.

Link the requirements to the data quality work for this specialty so that an increased interest in information leads to improvements in data quality. Consider involving coders in project team to achieve this.

Develop a prototype solution and test with a specialty. Understand if the solution is tools to do data queries or output/reports. Use a RAPID development cycle – show output often to get feedback

Once clinical quality outcomes are available there will be a requirement to merging them together e.g. look at anaesthetic time compared to surgical complications. Look at particular drugs used across specialties. This will allow the Trust to focus into areas of concern and improve quality

Need to look at information about the patient experience and clinicians should be involved in educating patients about things like infection control and complications.

2.02 Data warehouse

for information

management

and reporting

Less reliance on PAS/Isoft information reporting solutions

Increased ability to collect information from many systems and manipulate it to improve reporting

Produce a specification of information requirements for a data warehouse – what are the objectives and requirements.

Assess the Is Ardentia warehouse - fit for purpose?

Review Ardentia -result of the review to be reviewed and signed off by the Informatics Board. Probably 3 possible outcomes - yes fit for purpose – have a development plan and report on that on a regular basis. Maybe fit for purpose but following gaps which might be resources – address these gaps


Safe Personal Local



capabilities

and report on action plan on a regular basis. Not fit for purpose – reconsider solution

The actions that have been identified for Ardentia such as build the KPIs into it. Develop a web based extract. Potential to use this for PBR and SLR etc. all need to go in the action plan for development of Ardentia/ data warehouse

2.03 PbR Data

Capture

Better income recovery

More complete data

Better understanding of the organisation of the need to capture all activity and expenses

There should be an ongoing project to look at information for income recovery

More understanding of where and why is needed by front line staff and might require an ongoing education programme.

Need to map “hot” and “cold” areas of the Trust in terms of data capture. Hot areas are where it is known there are good processes for data capture in place.

Look at technical solutions for improving data capture such as mobile computing or automated data entry using bar codes.

Regular tests of information flow to check that all activity is charged should be made. Staff should be encouraged to participate in this by providing activity information to finance which can be cross referenced with billing

2.04 Business

intelligence

function

Provide a more business savvy function for information

Flexibility to meet the changing needs of the organisation

Dedicated to the needs of managers

Performance focused information

Develop a business intelligence function with a role to develop and implement a robust and effective reporting service that is very focused on the needs of the managers in the organisation especially the GMs.

The function should deliver high quality business intelligence solutions and one of its primary functions would be to develop and maintain the data warehouse environment.

Produce management information – performance / contracts/ HR / Finance / marketing

Better presentation of information - Portal development

Dashboards on desk tops (individually designed)

Consider the use of tools like Qlikview to support this service

Look at how performance information can be improved in terms of format, regularity etc.


Safe Personal Local



Skills for this function should include: o Advanced analytical skills o Complex problem-solving skills o Good presentation skills o Excellent communication skills o Advanced Process Mapping skills. o Appropriate technical skills e.g. SQL programming and ability to

design and implement relational databases and reporting environments.

2.05 Mandatory

information

Working smarter

Release resources

Review the systems and processes currently in place to deliver mandatory and statutory information requirements

Demonstrate / Review – are they fit for purpose

If possible find better methods / automate more of the process to release resources.

2.06 Data management

To improve the organisations understanding of its data

To improve the process for system connectivity and integration

If the Trust is going to continue to pursue a best of breed approach it is critical that it has some data standards that are documented and used when procuring systems.

The onus must be put on the suppliers conforming to the Trusts data standards and not visa versa.

The data management standards need to address the following: o How do we identify our patients; people; assets? o How do we ensure consistency of data definitions across systems? o There are no consistent enforced data definitions in all the systems. o What underlying data technologies and structures do we use?

Patient attributes such as clinical conditions and allergies may be inconsistent across systems as no standard established.

Data is currently extracted from disparate systems and manipulated using information tools which is time consuming and complicated – how can this


Safe Personal Local



be improved though data standards?

2.07 Taking it on

Trust

Assure the board that the quality of information being presented is correct

Information team to provide evidence to the Informatics Board that information quality satisfies the requirements of “Taking it on Trust”.

This is needed for a wider audience than just the board

Once evidence is presented it will probably lead to further questions Going through this process will help increase understanding and address issues in perceptions around information quality some of which are wrong

Regular reporting should be undertaken (e.g. bi-annually)

2.08 PROMS

development

Engage clinicians in the development of PROMS

Support the new standard NHS contract for Acute services

Develop a plan for the implementation of PROMS

There is guidance for national standards for PROMs instruments for elective NHS patients. Adherence to the national standards will ensure comparability of data across the country. They are based on the results of comprehensive research and piloting of PROMs in the NHS.

The NHS Operating Framework for 2008/09 included a requirement for collecting Patient Reported Outcome Measures (PROMs).

The NHS NSR has highlighted the need to focus on clinical metrics that improve quality, in the context of patient safety, Patient experience and patient outcomes. The lack of a national set of clinical outcome and quality measures has slowed progress towards a culture of continuous Quality improvement. It has prevented meaningful institutional comparisons and deprived the public of essential information to underpin meaningful and informed choice.

Once initial work in this area has been undertaken it may be appropriate to merge it with project 2.02.

2.09 Information -

Education for

end users

Help users to understand what information is easily available

Help users to understand how to ask for information

Reduce requests for ad-hoc

This potentially could be a quick win and alleviate some of the pressure on the team.

Provide information over about what is available and easy to produce

Put together a list on intranet of all standard reports – where to find them

Also examples of previous queries that have been done that could be adapted if required.


Safe Personal Local



reports

Reduce time spent by information team working on ad-hoc information requests

Provide an overview for managers / directors to increase their understanding

Help users to understand what is normal and what is not when interpreting information.

2.10 Coding Increase clinicians understanding of coding

Improve quality of coding

This is a rolling programme of work that should be going on every year.

There is not a one size fits all approach for improving coding– you need specialty based projects/initiatives because each area is so different.

Pick a specialty and run a small project in that area to look at how coding can be improved. This work should include a mapping exercise to identify the best time and place to collect information e.g. surgeons might be in theatres, physicians –when?

Work with the clinicians to identify the issues for that specialty and the possible solutions.

From the stakeholder analysis undertaken to develop the strategy the current view of clinicians appears to be :

o The manual for coding is confusing o The language is not right o They over complicate things

How can these views be changed?

Will these views change once other bits of the strategy are in place i.e. better systems, access to a clinical portal etc.

2.11 Information

work plan

Visible plan showing the work plan of the information team and how resources are being utilised

Allows the organisation to understand what is in development and the timescales for delivering

All actions in workstream 2 should be included in the information work plan.

There should be progress reporting to the Informatics board on status of these projects

Where issues and obstacles occur to making progress they must be recorded in the informatics risk register and actions identified


Safe Personal Local



information products

3.01 Integrated

Business

Systems

Improve the management ability of the organisation

Specify the requirements for integrated business systems that meet the user need especially General Managers.

Combined view of finance, activity and Human resources

3.02 Solution for

improving 18

week reporting

/ tracking

Current system and processes are too labour intensive

IT need to help brainstorm a better approach

Better system for identifying and flagging breach dates

Needs to be more automatics and intuitive

Ardentia's Pathway Manager is a system which enables you to identify patient healthcare pathways and to monitor the progress of patients along those pathways. Ardentia’s Pathway Manager System includes the Referral to Treatment (RTT) module which has specifically been designed to give healthcare organisations the tools needed to manage the 18-week waits-understand the Trust has already reviewed these solutions – need to identify why not suitable to help further research.

What are other Trusts using?

3 .03 Patient Level

Costing

Look at the requirements for a system to support patient level costing.

Talk to SUHT about their use of Ardentia to support patient level costing.

Obtain from DoH the list of systems that they approve

Evaluate the functionality of Ardentia warehouse and its fit for this purpose

Not having PLC is stopping FPH participating in pilots.

Understand that PLC could become a white elephant if it does not have clinical engagement and ownership so it will need clinical champions

It will take at least a year to set up PLC. It will help CIP but if not done now it now it won’t be there to contribute to CIP when it is really needed

3.04 Internal self

service system

Reduce time taken for invoice authorisation

Improve efficiency of

Need to develop the ISS – internal self service system -electronic self authorisation of invoices.


Safe Personal Local



organisation

3.05 Rostering Exploit benefits from current system

Rostering – look at how we can do electronically.

FPH doing rostering in nursing – why not elsewhere?

The rostering system (manpower) has been purchased

Review implementation and look for other opportunities for using it

3.06 Web

development

Improve workflow and productivity of the organisation

Help make managers more efficient

More effectively manage multiple targets and objectives that they are trying to track

Web services are a valuable resource that have the ability to transform working practices

Consider having a web development group that looks at how the use of the intranet can improve working practice and save money.

Review the technology that is now available to support web development such as Adobe content management.

The group should be chaired by a General Manager.

Role of group to look at particular business issues / priorities and see how the web services could address some of those problems.

The group should be given a CIP /benefit target but also funding for investment in web development.

Examples of projects o Link up the Datex system to allow on-line reporting for incidents o Consider developing web based solution to facilitate quality such as

a matrix for falls, pressure sores. Something that is easy to use and helps the organisation to collect quality data.

o Solution for booking shifts – bank nurses to see shifts available and book themselves in instead of ringing a number.

o Talent management of staff o Ordering supplies o Look at what pathology has done - electronic ordering in path.

Consider rolling out this approach to more customers for more applications

o Support the cost improvement programme (CIP) and track savings that are identified


Safe Personal Local



o Track and manage all the multiple targets E.g. clinical / national / internal etc

o Estates – need to track income against expenditure for hotel services.

o Link tills to stock control. o Capital programme – 170million. There needs to be a better way of

tracking the spend and keeping track of project and performance manage. To be able to see % overspent – flag it up to aid decision making.

3.07 Business /

Marketing

development

support

Use informatics to develop the business

Identify the requirement for supporting marketing, communication, intelligence gathering and research.

How can informatics support this requirement?

4.01 Network

upgrade

Fit for purpose infrastructure

Future proofed

Upgrade the network to provide a fast and resilient service that has capacity for the planned developments outlined in this plan.

Provide evidence that the current infrastructure is insufficient

Provide further information for the business case

The network development and ongoing enhancement should be a centrally funded service and not require users or individual projects to make a contribution to as this approach leads to ad-hoc development that does not consider the true capacity and growth requirements.

Ensure that future proofing is considered in any investment where possible

Consider engaging a third party infrastructure specialist to provide an Authoritative and independent assessment of the Trusts current infrastructure capability and provide three levels of Investment options commensurate with the Trusts ambitions and financial capability. The scope of the assessment could include ; • Voice & Telephone systems including Internet


Safe Personal Local



Protocol solutions • The Data network • The server base and the computer centre

4.02 IT on wards More access to technology on wards will lead to more use of systems and improve data quality

Review working practices on wards and understand how specialties work on that ward, e.g. ward rounds, drug rounds. What are the technology requirements?

Should we be promoting IT input in all clinical areas as a proactive measure, e.g. attending faculty meetings to discuss electronic handovers, printer support, bleep systems etc?

What is the requirement for bedside access to the patient record and is it appropriate?

Understand current access issues for that ward/specialty.

Fit the IT solution to the requirements.

Implement one ward at a time

Review usage after implementation to understand if access issues have been resolved.

4.03 Standard desk

top PC

Faster access to system

Standard look and feel of desktop PCs

Focus on clinical areas first

Upgrade MS Office software. Make a decision to migrate to Office 2007.

Identify the change and training implications.

Do not plan to migrate to Windows 7 in the short term. Stay with XP but plan the migration to Windows 7 as part of the rolling upgrade programme.

4.04 Configuration management – remote management of infrastructure

Work smarter

Reduce support costs

Review and investigate potential solutions for that facilitate remote management of infrastructure

Prove cost benefits of these solutions

4.05 Remote site

access / WAN

No loss of productivity due to offsite working

Identify all off site working requirements by specialty

Match requirements with technology


Safe Personal Local



upgrade Supports trust strategy for moving activity off site

Improve clinical care at remote sites

Save money on voice costs

Example of areas that need to be addressed – Ophthalmology can’t access their ophthalmic system in Farnham, Aldershot, GP practices etc. It is used for monitoring glaucoma changes and comparison of data today with history.

Video link at Farnham. MDT at Surrey so that ENT clinician can link in for thyroid cases

Poor IT links with Hampshire to support screening service e.g. for diabetics. We need to be able to work with our Hampshire colleagues more easily

COIN could connect up Fleet Aldershot and Farnham – is if fit for purpose?

VOIP needs to be implemented.

Could leverage COIN to do it but is that the best solution?

Invested money into COIN but would need to pay extra for voice calls (this needs further investigation)

4.06 Wireless

networks

Support electronic discharge summary process

Support real time data entry

Allow information to follow the patient pathway

An enterprise wireless LAN is needed.

The current wireless LAN is very limited and won’t support things like RFID, order comms, Electronic prescribing etc.

A specification of requirements needs to be developed and an option appraisal.

If the Trust decides to just expand the existing wireless network the implications need to be understood

4.07 Printing strategy Standardisation of printers will reduce costs

Network printers reduce total cost of ownership

Removal of many standalone direct printers save money

Reduction in printers –

Develop printing strategy

Standardise on Network printers where possible

Look at the green issues associated with printing and address within the printing strategy

Investigate multiple function printers

Look at printing requirements from different applications – how can these requirements be addressed by a printer rather than multiple printers

Why so many comments about printers not working during the review?


Safe Personal Local



potential reduction in paper usage

Save time currently wasted walking to a printer that works –improve efficiency

Frontline staff should always have access to a working printer

Is there a need to establish better ownership of printers?

Who is responsible for maintenance (include the provision of consumables – toner cartridges and, if necessary, paper).

Who is responsible for spare printers to enable replacement of faulty printers as appropriate?

Dave Harrison has developed a monitoring system for the PAS printers. This can generate an email with an exception report detailing those printers with any kind of problem. The system can be set up to run any number of times during the day. The recommended scenario could be expanded to include all

order communications printers, all PAS printers or all printers in the Trust. Will this solution help?

Develop printer education programme for users which includes the benefits of network printers, why printers need to work in key areas, what to do when you have a printer problem

Implement remote monitoring software for printers

Actively monitor “High impact” printers on wards, A&E etc to ensure that they are working all the time.

Identify key workers in the “high impact” areas who are trained to maintain/report printers problems e.g. ward clerks, etc

4.08 Mobile data

entry devices

Consider a range of options for standard mobile devices for use within the trust including a wireless computer cart

Pharmacists may have completely different requirements from junior doctors.

Small handhelds are less likely to be used as results and x-rays very difficult to look at on such devices.

4.09 Bar coding Facilitate the implementation of electronic records

Save time on data entry/ reduce the need for

Understand how the implementation of bar coding now will benefit the trust in the future

Develop an option appraisal for bar coding that includes a benefits appraisal of how the introduction of bar coding across documentation will:

o Facilitate data entry


Safe Personal Local



information to be typed in (by staff who are largely not trained typists)

Improve the access to information that exists in

o Facilitate the scanning of information, retrieval etc when the Trust wants to move to an EDM system

Look at the inclusion of bar codes on o Patient wristbands o Labels o All patient letters o Patient documents

Look at the GS1 recommendations on bar coding and what the implications are for the Trust

Rollout more bar code readers across the Trust to support data entry

Train staff in all areas on the use of bar code readers and how it can improve their efficiency

Wireless printers to print bar codes where needed and bar code scanners for blood and pharmacy

4.10 Automation of

data entry

Increase speed of access to systems

Assist users who don’t type quickly to maximise their ability to input data.

Investigate other methods of data entry, logging on and passwords that don’t involve typing on a keyboard. Increase speed of data entry

Consider the ergonomics and usability of prospective solutions by involving end users in their selection and piloting them.

4 .11 Green Informatics initiatives

Make cost savings

Improve environment

Contribute to environmental plan for public sector organisations

The purchase of more energy efficient PCs.

Getting PCs to shut down or hibernate if they are not in use

Remove local printers and replace them with shared network printers.

Using thin client technology on the desktop where possible.

Consolidation of servers. Decommission old kit.

Promote home working to cut travel emissions for staff, also reduces traffic congestion and need for car parking spaces.

4.12 Home working Improve clinical care

Improve patient safety

Improve staff utilisation

Access at home should be equivalent to onsite working

All systems should be accessible as appropriate from home for clinicians Identify work practice of clinicians who want to undertake work from home


Safe Personal Local



and efficiency

e.g. anaesthetics and surgeons to prepare for next day e.g. check results, notes etc

Specify solutions to meet these requirements

Consider security / access but not compromise functionality.

Cost benefits appraisal of SSTREAM which is being trialled

Have a strategy for billing for services instead of presenting it as an obstacle.

Options that are presented and approved by Informatics Board.

4 .13 Rolling renewal of IT infrastructure

Service fit for purpose

Does not get so outdated that it becomes difficult to support

Stop running out of capacity

Rolling technical refresh that is planned for and resources

Servers – old and need replacing

Server rooms – need expansion

E-mail needs investment

For all IT architecture – investment every year

IT Manager to develop a plan to show what £500k of investment every year for next 3 years would be spent on. The plan must demonstrate that all areas of the Trust/services are addressed.

4.14 Security review

.

Appropriate security to safeguard patient information

The current approach to security is perceived by some users to be overly bureaucratic and a blanket approach which does not consider usability. Either it is or it has not been communicated effectively. This is an example of lack of communication between the organisation and the informatics team and visa versa. Key stakeholders across the trust are not onboard with the approach being taken.

Junior doctors want to know why the web access limits of 1 hour cannot be changed after hours when they are required to be on-call /on-site.

Security review of systems and processes in place that provide assurance for patient data.

A report on security should be undertaken and presented to the Informatics Board.

The report should include a gap analysis of strengths and weaknesses.

Explanation of encryption approach and success rate etc


Safe Personal Local



Stakeholders need to understand the reason for security measures and the approach that is being taken.

The report should clearly state where there are options to change security but the implications e.g. system timeouts changing from 10 minutes to 30 minutes.

The organisation needs to be assured that security is fit for purpose but also does not become over prohibitive in terms of limiting appropriate access.

Staff want to know why encryption and frequent passwords are necessary – it is seen as more bureaucracy – they want to know why can’t we use simple technology like thumb scans and retinal screening.

4.15 Virtual desk top Save clinical time.

Improve productivity i.e. a doctor can be working on several patients across several clinical areas but can have information relating to those patients opened in a session which is suspended when logged out and opened again in a new location.

Allows users to move around the organisation and access their data without having to go through a process of opening information in a new session.

A requirement of specification to be developed which needs to cover the desktop and the servers.

4.16 RFID tags Benefits unclear at this stage

Understand requirement for RFID across the trust.

Look at the varied requirements like estates and medical records

Can one solution meet these requirements or does the Trust need to set a standard within which RFID is implemented.

Review the study titled: “Requirements and options for Radio Frequency Identification application in healthcare,” that was conducted by RAND Europe, the Cambridge-based policy research organisation. It stresses that RFID is not unique in many of its functionalities and that other more


Safe Personal Local



consolidated auto tracking technologies, such as bar coding and Data Matrix [2-D bar coding], provide similar capabilities, often for a lesser cost

4.17 Disaster

recovery and

contingency

plans

Preparation for non system availability

Need an updated disaster recovery and contingency plan that reflects the increased reliance on electronic systems.

Power goes off regularly for generator tests.

This creates problems when a lot of people are using technology

The issues will become more acute as system usage rises

5.01 Electronic

Health Record

development

Support partnership working

Identify the requirements and solutions for delivering an incremental approach to the development of an electronic health record.

Understand what GPs want as a priority

Understand the requirements of other healthcare partners

5.02 Electronic

discharge

summary

Improve the discharge process

Provide meaningful and legible information to GPs

Reduce LOS

The priority is to get electronic information to the GPS. Is the current system suitable to do this?

Map the current process for discharge and understand the issues such as when the current discharge summaries are often re-done as they are produced too early (before consultant round in preparation for discharge)

In the catheter lab the operator does a report. This needs to be merged with drugs on TTO. Staff currently up retyping the op report and should be able to import it. A template with import facility would improve this

There is a need to be able to adapt and change easily the TCI letters. Staff have been told that it can’t be done currently – is this correct?

There are lots of TTO discharge summaries from cardiology. Patients want to have an angiogram. They have a procedure then go home. It’s pretty standard. The service needs a template discharge summary that junior docs could use.

It is perceived that getting discharge summaries out promptly so juniors can discharge promptly could shave off ½ day of LOS


Safe Personal Local



5.03 Electronic

diagnostic

results

Saving postal costs

GPs receive diagnostic results faster

Pursue the implementation of Anglia ICE to support Pathology and Radiology test results and also electronic requesting.

This action can be merged with 1.08 but is identified separately in this version to highlight it is a key part of an HER.

5.04 Electronic

advice/

interaction for

GPs

Improve patient flow

Improve relationships with GPs

Improve care

Better systems for communication with GPS about general patient care.

Capture and enable the care/interaction that happens outside of formal referral and discharge process

Possible that email advice for GPS needs to be addressed but can’t email patient details to GPs so different approach may be required

Consider giving GPs web access to EPR when implemented and shared noting?

5.05 Social services Improve links with social services.

Improve efficiency in the Trust where there are dependencies on social services e.g. discharge planning

Understand the links required with social services

Devise solutions for electronic exchange of information to improve processes.

5.06 Web

development to

support cross

boundary

working

Improve efficiency of staff whose work involves providing data for multiple services and cross boundaries e.g. children’s services

Use web services to help staff who have to complete lots of different process for the different PCTs and social services.

Very time consuming at present

Lots of scope for improving efficiency in services like children.

5.07 CRS assessment Opportunities that may arise from CRS/NPfIT

To monitor and report on an ongoing basis the status of CRS implementation in the patch in both acute and community setting.

The Foundation Trust guidance issued by regulator Monitor on NPfIT participation states that Foundation trusts require NPfIT compliant systems and must justify a business case for non-NPfIT solutions, but it does not


Safe Personal Local



mandate these solutions.

6.01 Informatics

Board

A group with a remit to manage the informatics agenda and the implementation of this strategy

Revised the terms of reference for IM&T Steering Group to an Informatics Board. This group should operate as a programme board – see OGC methodology on Managing Success Programmes (MSP).

The Informatics Board should be chaired by the Medical Director.

The Informatics Board terms of reference should cover the following areas: o Vision and clear understanding of targets o Benefits that informatics can provide for the organisation o Projects o Resources – capacity and skills to deliver o Stakeholders needs o Risks and assumptions o Timetable / Progress monitoring o Transition / business change

This group should meet monthly to ensure the informatics agenda is pursued

Membership must include a selection of Directors, all the General Managers and some clinicians representing a range of specialties.

Sub groups need to be set up to do the actual work.

All sub groups need TORs to show how they fit in and relate to each other as well as to the Informatics Board

All sub groups must report to Informatics Board

Informatics Board should report to the Trust Board

The Informatics board should be given the informatics budget and make decisions about how and where investment is targeted.

Where rolling investment programme for Informatics – regular progress report to the Informatics Board

Regular reports to IM&T Board to include o IT Operational - System availability for all key systems (e.g. PAS,


Safe Personal Local



Pathology, Radiology, PACS, Maternity etc) o Highlight reports from all informatics projects o Risk and Issue log for Informatics o Reports on change management and benefit work linked into the

informatics agenda. o External issues that have an impact such as LHC Informatics plan

development, service development outside of FPH, NPfIT/CfH update must be reported to this group.

It is suggested that any requirements for new work are debated at this group and not automatically added to the project list. A new project must identify quantifiable benefits before it can be considered.

Have a pro-forma for new projects that must be completed and be sponsored by a GM to demonstrate requirement.

Time commitment is going to be required. Agenda going to be significant. Calibre of people plus number is important.

The group must also look at handover and completion of projects which has to be improved. Sometimes project teams need to be in place longer. Operational units need to prove they are delivering the benefits. Taking responsibility for benefits. Handover must happen and the benefits must be sustained

The Informatics Board should be responsible for taking decisions about informatics and not leaving decision making to IT/Information. There has to be a robust sign off process for all decisions.

The informatics board would be responsible for making sure the strategy is well linked into the guidance from the Royal Colleges on system implementation

6.02 Roles and

responsibilities

Establish the roles and responsibilities

Give clarity to the organisation about roles

It is important that Roles and Responsibilities with respect to informatics are clear and documented.

There is usually assumption that IT/Information are taking responsibility for most things – sometimes this is not appropriate and does not provide


Safe Personal Local



and responsibilities sufficient governance/ assurance for the management of informatics.

The role of the Medical Director should be to chair the Informatics Board and focus on the benefits that Informatics can provide the organisation.

The DoF must also be a member of the informatics board. The role of the DoF is to focus on budget and time scales.

The Director/Associate director of informatics is accountable for Informatics service and responsible for delivery

GMS should own the benefits that are identified from informatics projects

GMS should own the process change that is required to deliver the benefits.

Project responsibilities should be shared between IT/Information and the end users.

6.03 Informatics sub

groups

To undertake the work on the implementation of the Informatics strategy

To allow the steering group to focus on programme management rather than the details.

Sub groups needed to implement strategy and must report into the Informatics Board :

o IT and infrastructure development group o EPR development group o Information Development group o Web Services Development group o Change and Benefits group o Business systems group (but not in year 1) o Informatics Team development group

6.04 Investment

decisions

Better planning

Better implementation

Better return on investment

Each IM&T initiative must have an associated business case which articulates the expected benefits from investment.

Benefits must be quantifiable in terms of time, resources, cash etc.

Cash releasing savings should be identified

The business change required to achieve the benefits must also be provided

The Director / Associate Director of Informatics should write the business case guidance to be used. The guidance should be signed off by the Informatics Board.


Safe Personal Local



6.05 Progressing the

informatics

strategy

• Check that the plan is on track and the benefits are being achieved

• Have gateway reviews for checking benefits • Regularly map organisational priorities to Informatics priorities – how do

these objectives meet organisational objectives? • Do this part of annual business planning activities

When new requirements are identified ensure that parameters are identified for adding new components to the informatics infrastructure / strategy development so it all joins up.

6.06 Sponsorship and

champions

Gain commitment from organisation to the informatics agenda

Work with Medical Director to resolve problems and gain his commitment to the Informatics agenda so he becomes the overall informatics clinical champion

Seek out clinical champions for next stage of system development especially EPR

Need a clinical leader for Order comms from both surgery and medicine

Need a clinical champion for e-prescribing for both surgery and medicine. Consider Tim Hoe as sponsor for medicine. These projects will not work without clinical champions to support them.

6.07 Informatics Risk

and Issue

register

Single log for informatics risks and issues

Combined IT and Information register for risks and issues

Regular review by informatics board

Owned by the Director/Associate Director of informatics

6.08 Lessons learned

approach

Identify lessons learned on projects

Ensure that mistakes are not repeated

Learning will improve implementation processes

Keep a register of lessons learned from implementations starting with those fresh in the mind e.g. PICIS, Euroking, Pathology, Radiology, GP requesting.

Informatics Board to review lessons learned and ensure that standards and policies for informatics are developed where required i.e. business as usual processes would need to be updated.


Safe Personal Local



6.09 Benefits register Formal log of informatics benefits

Set up an informatics benefits register

Formal log of benefits identified

Ensure benefits are tracked regularly

Ensure benefits are reported to informatics board

7.01 PICIS post

implementation

evaluation

Improve the booking of theatres

Reduce risk in theatres

Improve productivity in theatres

Improve data collection in theatres

Set up a working party to review if the PICIS system delivered benefits for the organisation and if not what is required to do so?

The review should include: o What benefits have been achieved and can they be quantified o Have the issues and concerns over existing theatre system been

resolved through the implementation of PICIS. o Have changes to working practice been made such as who writes

the operating list , who changes it, who knows it has been changed o Is appropriate Information now collected at pre-operative

assessment o (these work practice areas were identified as issues during the

review) o Have we got the right IT in the right places to access PICIS? o Has the need for hand held/portable devices to enter and review

data been addressed? o Has the system improved quality assurance in theatres, ITU and

anaesthetics o Can we incorporate any further change work in relation to the

implementation of PICIS with the productive operating theatre initiative (NHS institute for improvement)

Define the success criteria for full implementation

It is anticipated that PICIS will give the full costs of theatres and see spent and income –has this been delivered. Is it being reviewed every day. It’s one of the Trust’s most expensive assets

A dedicated application manager is needed for the PICIS system.


Safe Personal Local



7.02 Pathology – full

implementation

Achieve benefits that were identified would be achieved from the implementation of Clinisys

Consider the work practice changes needed to optimise the benefits from the new pathology system.

Has the length of time it takes to get blood results been reduced?

Do Juniors still have to stay on until late in the day to get the results.

Have all the issues identified been resolved through Clinisys implementation.

There were confidentiality issues with Tpath and clinicians could not view some microbiology stuff

Does Winpath still log the user out every 10 minutes?

The tracking of FBC on TPATH was really difficult – has this improved with Winpath.

TPATH required different passwords for each sub specialty. Has this changed with Winpath?

7.03 Agfa RIS review Achieve benefits that were identified from the implementation of the new RIS system

Consider the work practice changes needed to optimise the benefits from the new radiology system. Are there any?

7.04 Euroking review Achieve benefits from the implementation of Euroking

Euroking system needs to be fully implemented.

Post implementation issues need to be addressed.

System should deliver benefits such as taking away the paper work that is currently used.

7.05 GP electronic

requesting and

results

Achieve benefits from the implementation of Anglia ICE

Identify the benefits that are expected from the implementation of this system including:

o Better population of the NHS number into Path and Rad systems o Reduced duplication of records as better quality demographics

supplied in the electronic request from GPs

Have these been achieved?

7.06 Implement Real time ADT

Improve data quality particularly in relation to more accurate LOS figures

Process map the current ADT process and understand where the issues are.

Consider the role of ward clerks and medical secretaries in keeping ADT details on PAS more up to date.


Safe Personal Local



and assignment of correct consultant to activity

Improve accuracy of CHKS data

Improve clinicians perspective on information and their confidence

Make information believable

Reduce waste and inefficiencies e.g. results going to wrong consultant, complaints going to wrong consultant, producing information that is incorrect.

Prepare for Order communications and electronic prescribing

Look at work practice processes around consultant and how better IT can fix this business problem. There are different practices between specialities so don’t assume there is one solution to this problem.

In surgery the review has highlighted that patients are admitted overnight under a consultant but after review gets transferred to a different consultant e.g. urology patients that are admitted under general surgery but in the morning need to be under urology.

Sometimes the patient is previous known to another consultant so they wish to take back their care. Frimley runs an emergency admission team (EST) so the consultant for a patient changes on a 3-4 day cycle depending on the EST consultant. Also patients randomly transfer between consultants and often the junior doctors are not even aware.

Some specialities don’t work as consultants – they work as a team. This needs to be built into the approach to real time ADT.

7.08 Predicted discharge dates

Address efficiency requirements in Trust strategy

Improve management of LOS

better indicators of discharge pending

Review requirements for better discharge planning and information to support it.

Identify how the Jonah system and PAS system currently provide that information

Identify the gap between what is in place at the moment and what is required.

Understand if Jonah/PAS integration can be improved 7.09 Workforce role

redesign

Ensure that roles change in line with system implementation

HR need to develop expertise/resource to support Informatics projects where change is required to ensure that role redesign is integrated into the project.


Safe Personal Local



Increase benefits

A lead in HR should be identified who can participate in business change projects where Informatics is going to lead to a change in roles and responsibilities.

7.10 Informatics

Training for end

users

Support and facilitate staff development

Support change not just know how

Develop an informatics training strategy

Ensure that is embedded into a change and benefits approach to informatics

Does the trust have the right systems to support and facilitate staff development and training?

Are there value added applications that might help with staff retention e.g. effective information and communications services

Training needs to be more tailored to clinical staff and not just classroom based

Consider 10/15 minute sound bites in their work area

Consider super users and cascade training as per Poole model as current model cannot be sustained

Knowledge management systems need to be investigated

On-line training resources

On-line appraisals

8.01 Leadership Give Board level leadership to the informatics agenda

Ensure that the strategy is implemented

Engage with the organisation and provide a key link between the informatics service and the needs of the organisation

Provide a contact point for informatics issues and concerns for clinicians and senior management s

Recruit an Associate director or Director of Informatics

Role needs the following experience / skills o Experience of leading an informatics team (IT and information) o Experience of the implementation of challenging strategy o Programme and project management skills o Excellent communications skills o Demonstrable understanding of acute services and patient health

care o Strong negotiation skills o Able to build effective relationships with key healthcare partners

outside of the organisation o A strategist but has good technical skills. o Change management skills


Safe Personal Local



If the organisation is to have confidence in this role and its success, key stakeholders such as Directors and CDs must be involved in the recruitment process.

The GMs should also be involved in the recruitment process for this post since this post will become one of their peers. The post holder must understand the agenda of GMS and easily relate to them.

8.02 Team

reconfiguration

More joined up working

Better use of skills and staff

Reconfigure the IT and Information team into an Informatics Team

8.03 Customer focus More aligned to organisation requirements

Improve communications with organisation

One stop shop for informatics questions, problems etc

Service desk / customer service function that runs 8-6 and is gradually extended as more systems are implemented

Consult end users on how this service should be set up • Adoption of best practice and an ITIL Standard framework • The Service Desk will need an effective tool set for the logging operation,

escalation and reporting • Common links to the National Service Desks if appropriate • Will be responsible for creation and monitoring of common SLAs

Responsibility for monitoring and reporting on system availability which should be reported to the Informatics Board and HEB on a regular basis

Maintain information on intranet about service e.g. uptime stats. How to get new equipment, standards etc.

Need to further analyse where the problems in communications are at the moment. It has been summarised from this review that the organisation does not keep Information and IT informed of development and plans to make changes to services. Information and IT does not keep the organisation information of changes to services, status of problems; involve the organisation in decision making processes around “rules”, policies and procedures etc.

Consider rotating all staff who work in Informatics through the Service Desk so they get exposure to users questions, requirements and problems etc.


Safe Personal Local



8.04 Informatics

Team

development

Better skilled staff are more efficient

Increased use of IT and Information will put even more pressure on Informatics Staff

Training strategy for informatics staff needs to be developed to meet the informatics strategy requirements

Skills and training needs to be addressed that are not just technical

Consider self assessment and external assessment

Focus on working smarter and exploiting the Informatics infrastructure to improve processes and establish new ways of working

invest in staff training and in infrastructure to ensure staff in post are able to use new technology to the full, and gain the best possible value from investment

8.05 Informatics

Resources

Fit for purpose

Enough people to provide and maintain the service to required standards (e.g. uptime, response times etc) – business as usual

Enough people to support the development agenda

Ability to provide realistic and achievable timescales for delivery

Have we got the right resources?

Are we paying the right level to get the right skills

Out of hours support – needs to be resolved if system implementation is to proceed – will need a 24/7 support model to take forward most of the developments outlined in this strategy

Look at the requirement for extra people?

Resources for Projects required. A programme team needed for the implementation of the strategy which would include at least 2 permanent project managers and a project support officer for maintaining project documentation.

8.06 Implement ITIL Improve standard of IT service

Ensure service is fit for purpose as the use of IT increases

Work to national standards

ITIL is a series of documents, originally created by the Office of Government Commerce, a governmental department in United Kingdom. These are used to help implement an efficient framework for IT Service Management (ITSM).

This 'ITIL framework' essentially defines how to organize the system and network management departments within individual organizations. The concepts within ITIL support IT service providers in the planning of consistent, documented, and repeatable processes that improve service delivery to the business.

Produce a business case for implementing ITIL


Safe Personal Local



8.07 Implement the

National

infrastructure

maturity model

(NIMM)

Better IT service for the organisation

Will address many of the issues identified in this review with respect to how IT services are provided

Increase in professional reputation

High staff morale and lower staff turnover

Better protection against legal action

Attract high calibre staff

Commissioners will know that provider works to approved standards

Implications for CNST liabilities

Benchmarking and accreditation will support cases for investment

Create an understanding of NIMMS in the organisation.

All Trusts are subjective to measurement and comparison whether by SHA or monitor. Why should IT be any different since IT enabled developments like PACS underpin clinical services 24/7

What is the value in doing it – this needs to be made explicit for the organisation

Identity and access management (directory services, user provisioning, directory based authentication)

Desktop server and device management (software distribution, patch management, mobility, imaging, virtualisation)

Security and Networking (Policy, firewall, access control, network protection, quarantine)

Data protection and recovery – back up , restore, storage management

IT and Security process -Best practice guidance on cost effective solution design, development and operational support

Introduce SLAs for Informatics services into the organisation

Documents

Appendix A2 Detailed Action Plan for Informatics Strategy