1. NHSScotland eHealth/ IM&T Strategy

2. Outpatients/ ACAD Outpatients/ ACAD GP/PHCT Inpatients Dentist Pharmacist MH National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) Pt admin Labs XRay Clinical Me at home Social Care Education NHSScotland LA What’s the vision? From many care settings, fragments of information assembled, accessed securely online, at point of patient care, respecting patient consent. ‘virtual’ care

3. Outpatients/ ACAD Outpatients/ ACAD GP/PHCT Inpatients Dentist Pharmacist MH National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) Pt admin Labs XRay Clinical Me at home Social Care Education NHSScotland LA What’s the problem? Services still largely paper driven          IT, where it exists, is often disparate obstacle to modernisation pace of change limited by resource ‘virtual’ care

4. Outpatients/ ACAD Outpatients/ ACAD GP/PHCT Inpatients Dentist Pharmacist MH National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) Pt admin Labs XRay Clinical Me at home Social Care Education NHSScotland LA          ‘virtual’ care What are we doing to achieve the vision? 1.Striving for ‘integrated consistency’

5. Outpatients/ ACAD Outpatients/ ACAD GP/PHCT Inpatients Dentist Pharmacist MH National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) Pt admin Labs XRay Clinical Me at home Social Care Education NHSScotland LA          ‘virtual’ care Corporate telecomms and email national contracts, central funding element all hospitals and GP practices linked programme to extend to pharmacies dentists under consideration

6. Outpatients/ ACAD Outpatients/ ACAD GP/PHCT Inpatients Dentist Pharmacist MH National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) Pt admin Labs XRay Clinical Me at home Social Care Education NHSScotland LA          ‘virtual’ care CHI Index all GP registered patients single national definitive index unique number per patient name address # xx xxxxx xx CHI Index

7. Outpatients/ ACAD Outpatients/ ACAD GP/PHCT Inpatients Dentist Pharmacist MH National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) Pt admin Labs XRay Clinical Me at home Social Care Education NHSScotland LA          ‘virtual’ care SCI Store Local Integrated Care Record + acts as a ‘services hub’ for other systems various stages of implementation in all NHS Board areas 99.9% GP practices with online access similar concept planned for NHS - L.A. eCare Store name address # xx xxxxx xx CHI Index Id Lab XRay Letters Summ xx SCI Store OK3.2  

8. Outpatients/ ACAD Outpatients/ ACAD GP/PHCT Inpatients Dentist Pharmacist MH National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) Pt admin Labs XRay Clinical Me at home Social Care Education NHSScotland LA          ‘virtual’ care eCare Store name address # xx xxxxx xx CHI Index Id Lab XRay Letters Summ xx SCI Store OK3.2   SCI Gateway web-based clinical communication fully encrypted aiming at all inter-organisation communication SCI Gateway

9. Outpatients/ ACAD Outpatients/ ACAD GP/PHCT Inpatients Dentist Pharmacist MH National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) Pt admin Labs XRay Clinical Me at home Social Care Education NHSScotland LA          ‘virtual’ care eCare Store name address # xx xxxxx xx CHI Index Id Lab XRay Letters Summ xx SCI Store OK3.2   Emergency Care Summary access to key GP information out-of- hours embryonic National Summary Record SCI Gateway Id Drugs Alerts xxx xxx xx xx xx   Emergency Care Summary

10. Outpatients/ ACAD Outpatients/ ACAD GP/PHCT Inpatients Dentist Pharmacist MH National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) Pt admin Labs XRay Clinical Me at home Social Care Education NHSScotland LA          ‘virtual’ care eCare Store name address # xx xxxxx xx CHI Index Id Lab XRay Letters Summ xx SCI Store OK3.2   Online Information Services SHOW as umbrella for 120 websites HEBSWEB, e-Library SCI Gateway Id Drugs Alerts xxx xxx xx xx xx   Emergency Care Summary SHOW, e-Library etc

11. Outpatients/ ACAD Outpatients/ ACAD GP/PHCT Inpatients Dentist Pharmacist MH National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) Pt admin Labs XRay Clinical Me at home Social Care Education NHSScotland LA          ‘virtual’ care eCare Store name address # xx xxxxx xx CHI Index Id Lab XRay Letters Summ xx SCI Store OK3.2   SCI Gateway Id Drugs Alerts xxx xxx xx xx xx   Emergency Care Summary SHOW, e-Library etc What else are we doing to achieve the vision? 2. Filling gaps

12. Outpatients/ ACAD Outpatients/ ACAD GP/PHCT Inpatients Dentist Pharmacist MH National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) Pt admin Labs XRay Clinical Me at home Social Care Education NHSScotland LA          ‘virtual’ care eCare Store name address # xx xxxxx xx CHI Index Id Lab XRay Letters Summ xx SCI Store OK3.2   SCI Gateway Id Drugs Alerts xxx xxx xx xx xx   Emergency Care Summary GCS SHOW, e-Library etc Secondary + Managed Clinical Care A&E system procurement complete PACS procurement nearly complete Generic Clinical System just underway - SCI Diabetes as inspiration ? GCS for anaesthetic record A&EPACSGCS

13. Outpatients/ ACAD Outpatients/ ACAD GP/PHCT Inpatients Dentist Pharmacist MH National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) Pt admin Labs XRay Clinical Me at home Social Care Education NHSScotland LA          ‘virtual’ care eCare Store name address # xx xxxxx xx CHI Index Id Lab XRay Letters Summ xx SCI Store OK3.2   SCI Gateway Id Drugs Alerts xxx xxx xx xx xx   Emergency Care Summary SHOW, e-Library etc GCSA&EPACSGCS So that’s all fine then?

14. Outpatients/ ACAD Outpatients/ ACAD GP/PHCT Inpatients Dentist Pharmacist MH National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) Pt admin Labs XRay Clinical Me at home Social Care Education NHSScotland LA          ‘virtual’ care eCare Store name address # xx xxxxx xx CHI Index Id Lab XRay Letters Summ xx SCI Store OK3.2   SCI Gateway Id Drugs Alerts xxx xxx xx xx xx   Emergency Care Summary A&EPACSGCS SHOW, e-Library etc Ageing, expensive mainframe Need more links to local indexes Pilot stage in two Boards only Roll-out before access to patients ‘Only’ 30% referrals so far Minimal discharge letters Child Health Systems fragmented and ‘too national’ GPASS + 4 commercials Need to establish less and better Slow pace in extending content Most wards still not linked Still issues, alas Doesn’t meet range of public needs NHS 24 Online in planning

15. Outpatients/ ACAD Outpatients/ ACAD GP/PHCT Inpatients Dentist Pharmacist MH National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) Pt admin Labs XRay Clinical Me at home Social Care Education NHSScotland LA          ‘virtual’ care eCare Store name address # xx xxxxx xx CHI Index Id Lab XRay Letters Summ xx SCI Store OK3.2   SCI Gateway Id Drugs Alerts xxx xxx xx xx xx   Emergency Care Summary SHOW, e-Library etc GCSA&EPACSGCS Particular issues in hospitals (apart from gaps and plethora of stand-alone systems) eg. - 8 different PAS systems - 41 Outpatient systems - A&E uptake - revenue and support pressures Still issues, alas

16. Outpatients/ ACAD Outpatients/ ACAD GP/PHCT Inpatients Dentist Pharmacist MH National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) National Services (NHS24, screening, jags, CHI, ISD, SBR, SAS) Pt admin Labs XRay Clinical Me at home Social Care Education NHSScotland LA          ‘virtual’ care eCare Store name address # xx xxxxx xx CHI Index Id Lab XRay Letters Summ xx SCI Store OK3.2   SCI Gateway Id Drugs Alerts xxx xxx xx xx xx   Emergency Care Summary SHOW, e-Library etc GCSA&EPACSGCS and then there’s NHS England … funding hike post Wanless report like us, were spending c. 2% on IT looking to increase to nearer 4% embarked on an ambitious and radical programme what to do when in bed with an elephant?

17. 1.Current direction and approach is right … 2.… but rate of progress isn’t 3.Over next three years, use any funding boost to support local progress – but based on nationally- agreed priorities and systems. 4.Consider for adoption NPfIT (or alternative) elements if appropriate for NHSScotland …. 5.… but defer consideration of wholesale adoption for c. two years. Conclusions