19/12/2015Changing Clinical Software1 Dr Colin Brown General Practitioner SCIMP Conference Dunblane 2006

19/12/2015Changing Clinical Software2 Why we are doing this? Where are we starting from? Where are we starting from? GP systems are specialist engineered products with the unique function of constructing a life-long record of unconstrained scale and content with accuracy and security – and usable in front of a patient in their precious 7.5 mins. by any users in Primary Care Team GP systems are specialist engineered products with the unique function of constructing a life-long record of unconstrained scale and content with accuracy and security – and usable in front of a patient in their precious 7.5 mins. by any users in Primary Care Team Where are we going? Where are we going? How do we get there? How do we get there?

19/12/2015Changing Clinical Software3 Clinical System Changes Versions referenced: Ascribe to Vision Ascribe to Vision EMIS PCS to Vision from GPASS, Vision, EMIS LV EMIS PCS to Vision from GPASS, Vision, EMIS LV GPASS to EMIS PCS, GPass Clinical, Vision from Torex HMC GPASS to EMIS PCS, GPass Clinical, Vision from Torex HMC iSoft Synergy from Meditel, Premiere iSoft Synergy from Meditel, Premiere Torex HMC to GPASS Torex HMC to GPASS TPP from EMIS LV TPP from EMIS LV Vision to GPASS from GPASS 4x, 5x, Seetec, Microtest, Vision to GPASS from GPASS 4x, 5x, Seetec, Microtest, EMIS LV, VAMP Medical

19/12/2015Changing Clinical Software4 Overall Plan Pre-migration practice development status Pre-migration data quality issues Data migration issues Data freeze period Go Live Day New-system learning New-system design issues 3rd-party issues General incl. Lessons Learned

19/12/2015Changing Clinical Software5 Practice development status Practice development status Software Software Hardware and system Hardware and system Business processes Business processes Training - what are the training needs? IT training Specific new-system training Training - what are the training needs? IT training Specific new-system training

19/12/2015Changing Clinical Software6 Pre-migration data quality Pre-migration data quality Codes – Read versions, other, SNOMed Codes – Read versions, other, SNOMed System admin data - Non-standard Priorities Recalls ADRs System admin data - Non-standard Priorities Recalls ADRs Drug dictionary - a dictionary migration also? Issues - “OP”, ADRs, BAN/RINN, old scripts Drug dictionary - a dictionary migration also? Issues - “OP”, ADRs, BAN/RINN, old scripts Metadata: [PRIORITY = LOW] Metadata: [PRIORITY = LOW]

19/12/2015Changing Clinical Software7 Pre-migration Planning: phone a friend phone a friend ask the audience 1 - access the UG 2 - the patients - involve them 3 - check with occasional team users ask the audience 1 - access the UG 2 - the patients - involve them 3 - check with occasional team users E-working? E-working?

19/12/2015Changing Clinical Software8 Data Migration Data Migration Extraction of data from old database Conversion of the extracted data to new database Extraction of data from old database Conversion of the extracted data to new database format, and of old to new data types. Quality Assurance. format, and of old to new data types. Quality Assurance. Conversion accuracy? Conversion accuracy? Coded and Uncoded data Coded and Uncoded data InPS - 2 utilities provided InPS - 2 utilities provided EMIS - these functions built in to the main software EMIS - these functions built in to the main software

19/12/2015Changing Clinical Software9

19/12/2015Changing Clinical Software10

19/12/2015Changing Clinical Software11 Data Freeze Data Freeze Computer Downtime Is there any need for this?

19/12/2015Changing Clinical Software12 Go Live Day Hints and Tips from Supplier Go Live Day Hints and Tips from Supplier Business Continuity Plan – as if paperless Business Continuity Plan – as if paperless No routine surgeries, clinics No routine surgeries, clinics Print-offs for the actual downtime Print-offs for the actual downtime Hardware and system configuration on site Hardware and system configuration on site Data Melt You've got to do this? - not necessarily so… Data Melt You've got to do this? - not necessarily so… Data Melt Data Melt Clinical value is max. if sooner not later. Clinical value is max. if sooner not later.

19/12/2015Changing Clinical Software13 New System Learning 1 New System Learning 1 Function re-modelling Function re-modelling - Predict the functions to be changed…. to anticipate how your new system will work differently and re-model your business processes - Original s/w method of delivering a function may not be the only way - Version-specific not brand-names

19/12/2015Changing Clinical Software14 New System Learning 2 New System Learning 2 Design issues Design issues on-the-fly coding on-the-fly coding Keyboard use Keyboard use Appointments Appointments Better Display > Data Quality issues Better Display > Data Quality issues

19/12/2015Changing Clinical Software15 3rd Party Issues 3rd Party Issues Docman Labeltrace SCI Gateway / 2nd Opinion Managed Server 3rd Party Issues

19/12/2015Changing Clinical Software16 General Clinical - specific benefits? Detailed Pros/Cons – per user? Detailed Pros/Cons – per user? Practice Management - similar challenges? Summarising for training status Summarising for training status Lloyd George to A4 Lloyd George to A4 Going paperlight Going paperlight Changing premises Changing premises Changing partners Changing partners New job New job Combine some of these? Combine some of these?

19/12/2015Changing Clinical Software17 DO - LIST #1 - for Suppliers online connectivity on Go Live Day online connectivity on Go Live Day share the Drug Dix / coding migrations share the Drug Dix / coding migrations bulk prioritising functions bulk prioritising functions improve handling of non-coded data improve handling of non-coded data consider appointments migrations consider appointments migrations customise migration advice for “donor” system customise migration advice for “donor” system custom-configure the initial setup of new system custom-configure the initial setup of new system guarantee access to archive data + audit trails guarantee access to archive data + audit trails

19/12/2015Changing Clinical Software18 DO - LIST #2 - for NHS Board IT Depts keep original s/w live. keep original s/w live. test s/w on hardware platform before Go- Live. test s/w on hardware platform before Go- Live. contract with suppliers to retain legibility of archive data + audit trails. contract with suppliers to retain legibility of archive data + audit trails. support GMS IT Facilitators in custom data quality fixes pre-migration. support GMS IT Facilitators in custom data quality fixes pre-migration. share local expertise in new business processes. share local expertise in new business processes.

19/12/2015Changing Clinical Software19 DO - LIST #3 - for Users create custom benefit lists for each team member. create custom benefit lists for each team member. prepare … then prepare some more prepare … then prepare some more engage your local friendly new-system user to check out your test data. engage your local friendly new-system user to check out your test data. engage your patients - they can sympathise about computer problems! engage your patients - they can sympathise about computer problems! access all UG support access all UG support

19/12/2015Changing Clinical Software20 DON'T ( = specific "errors of commission“) Suppliers Suppliers Change the GoLiveDay Change the GoLiveDay Use non-standard codes Use non-standard codes PCOs Strip kit from the site if needed for original s/w to run. PCOs Strip kit from the site if needed for original s/w to run. Users Leave it all to the leader Go on Holiday! Users Leave it all to the leader Go on Holiday!

19/12/2015Changing Clinical Software21

19/12/2015Changing Clinical Software22 THE END ……………………. is just the beginning