Update on the eHealth Programme Paul Rhodes eHealth Programme Director

Contents Policy and Investment Partnership and Governance Progress and Continuity Performance and Value

eHealth is about enabling better care through the use of information… “Better health better care” takes us forward from “Delivering for Health” eHealth is a recognised enabler for both eHealth helps deliver key areas of the BHBC vision “NHS Scotland should be known for continuous improvement and its relentless pursuit of quality…..In our discussions we need to look at…..developing a new strategy for eHealth by Spring 2008, exploiting new technologies to everyone’s benefit.” Nicola Sturgeon (Sept 07)

Planned Policy Activity to Spring 2008 Discussions with Boards, Clinical Leads etc about the future direction of eHealth. Development of eHealth Financial Strategy December Strategy Board Further Stakeholder discussion Launch of new Strategy

The updated eHealth strategy will provide a clear direction for all eHealth initiatives… Aiming for a practical, deliverable strategy building on existing work Currently engaging with stakeholders to ensure strategy delivers for Boards Some early consensus but different groups have different priorities Lots of calls on funding Updated strategy in Spring 2008

Investment: What was the spend in ? Revenue –Nat:£50.166m –Local:£81.689m Total:£ m Capital –Nat:£29.573m –Local:£34.819m Total:£64.932m

Investment and the Spending Review

Partnership and Governance More open dialogue Wider engagement in development More involvement from Boards in direction setting and management of national initiatives

The eHealth governance structure will support NHS Scotland to deliver… Clinical Change Leadership Group SGHD Departmental Board eHealth Strategy Board National eHealth Programme Board National Clinical Reference Group Local Project Board National Project Team Local eHealth Implementation Board NHS Board LocalNational eHealth Leads (NHS Boards) Chief Executives Group Minister National Project Board National Project Board National Project Board National Project Team National Project Team National Project Team Local Project Team Local Project Team Local Project Team Local Project Board Local Project Board National Project Board National Project Board National project board NSS National Project Board National programme board National project board Improved governance Clinical leadership Local/ national balance

This overall structure will be supported by the eHealth Directorate… StrategyProgrammesChange, benefits & comms Strategy Architecture and design Change, benefits and communications Programmes Architecture and design Alan Hyslop Jonathan Meddes Elaine Heslop Angela Mitchell Paul Rhodes

Providing a clear way of integrating clinical, business and technical decisions will reduce risk… Information governance Architecture Design authority Standards and specialist working groups

Progress and continuity ConceptEarly implementationIn use CHI PACS ECS SCI Gateway SCI Store A&E (EDIS) Improve patient experience Secure best value PMS IPACC Single sign-on Sexual health GCS applications ECS 2

Emergency Care Summary over 5.1 million records, 1015 patient opt outs (representing 0.02%) total number of access since launch: 338,752 consideration of including child protection alerts Business Case being developed for extending content and access (including patients) Primary Care – national projects

Telecommunications all practices now migrated to new minimum standard 512 kbit/s (apart from 22 remote sites with ADSL issues) c. £4M p.a. spent on GP telecomms Primary Care – national projects SCI Gateway c. 60K referrals transmitted per month… … but only 1500 discharges Department of Work & Pensions claims now live

NHSmail target of use of NHSmail – encrypted – for all clinical currently 60% practice staff registered with NHSmail Service migrating to new platform – when in place then 9 month target to move over all GPs and other NHS clinical staff Primary Care – national projects

Lab test results reporting (electronic into GP patient record) a key target for practices … and SGHD recovery plan nearing completion new GPASS software in testing commercial systems …. needs NHS Board SCI Stores at latest version big push anticipated over 2008 (+ Link between Cervical Cancer Screening and GP systems: development complete, in testing) Primary Care – national projects

Docman: 345 practices live NSS PSD projecting 567 live by December… … and complete roll out by March/April 2008 GP2GP Electronic transfer of GP clinical data from any to any GP system Vision/EMIS currently working in England Business Case for Scotland’s options, completion end December/Early January (NSS PSD) Primary Care – national projects

Consultation on the idea – findings show… concerns around access control not # 1 priority for all NHS Boards Community Nursing Review may suggest different models for best IT approach Outline Business Case completed Integrated Primary and Community Care (IPACC) Pre-procurement requirements definition and other preparatory work underway, with extensive involvement of all stakeholders

Performance and Value Project Delivery Benefits Delivery Delivery of Value

Focusing on people and processes will maximise the chance of benefits being realised… Identifying the opportunities for improved care using existing systems Developing and rolling out a benefits management approach to all eHealth projects Recognising the “people” aspect of the change, initially focusing on establishing two-way communications

We are taking a structured approach to identifying opportunities from existing systems Map generic pathways to applications and targets/ standards Identify specific opportunities from existing key systems Take a specific pathway on one Board and identify opportunities

Programme Management for improved delivery… Governance and skills key to improving outcomes Supporting new projects through lifecycle Providing a “delivery blueprint” Accountability “Professionalising” IT

Summary Focus on outcomes and benefits Not just about new systems Focus on improved performance Focus on getting relationships right and broader partnership

Current numbers of practices per system: Ascribe 11 EMIS 57 Gpass 744 INPS (Vision) 190 iSoft 16 Integrated Primary and Community Care (IPACC)