1. Sue Bracey Head of software development & Integration Benefits of Spine Mini Services

2. Agenda Plymouth ICT Shared Service (PICTS) Spine Mini Services PICTS SMS implementation Benefits and caveats Where to next Conclusion

3. Plymouth ICT Shared Service (PICTS)  Provides IT services and support for the local healthcare community -12,000 + users across multiple sites -Plymouth Hospitals NHS Trust (PHNT) - largest single site acute hospital in UK -Community Interest companies /GP’s/PMS/Others  Local population of over 500,000  Tertiary services for 1.5m people

4. Integration at PICTS TCP Web Email Text SQL Labs iCM-Orders Radiology Radiance ESR iPM (PAS) Sending Systems A&E Maternity Spine Update Sonicaid iCE-GP Orders iPM Labs Innovian Infection Control A&E Maternity Local solutions Others -departmental Receiving Systems Apply Business Rules Store Filter Transform Route Send ENSEMBLE Integration Engine ICNARC Renal Stoma Care OLE/ODBC Cancer Registry CACHE DATABASE CACHE DATABASE iCM-Results iCE-GP Results Radiotherapy Viewpoint Chlamydia screening Neonatal Trauma Board Torbay/Treliske Labs Occ Health CRIS TCP FTP FS WEB Speech recognition Process > 250,000 messages / day

5. Spine Mini Services  Why Mini?  Reduced options - we can’t update the spine - something we need to take forward with cfh - hcic  Having retrieved the data we get to decide what to do with it.  What are Spine Mini Services?  Services that allow you to retrieve information direct from the spine - in real time.  SMS options:  Verify NHS number  Get NHS number  Get patient’s demographic details

6. Why introduce spine mini services Interested in ITK Technology partners of intersystems To improve our data quality –Non spine compliant PAS –No real time access to up to date demographic information –Few NHS numbers for newly registered patients, reducing our ability to communicate with other healthcare providers in a timely fashion.

7. PICTS, SMS Implementation  Worked with InterSystems and CFH through Common Assurance Process (CAP) You The Trust Your Patients Are Patients Safe? Is Data Safe? Is It Secure? Is the Solution Resilient? Can we Audit the Requests? Trust Operating Model

8. Spine Services – Work flow iPM (PAS) AE SALUS Other System Maternity Spine SMSP ADT Flow TIE (Ensemble) Spine Checker A31 Refer to data Quality Team A01

9. Queries to DQ Team  Spine Mini Services live May 2012

10. Benefits  Patient safety - Large reduction in the number of discharge summaries and other correspondence being sent to the wrong GP.  Patient safety – documented incident where a patient was linked to the wrong (deceased) patient. – DQ alerted in real time.  Anecdotally similar reduction in the number of letters sent to the wrong address.  Patient safety – documented incident where a patient was linked to the correct (deceased) patient. – patient had been incorrectly recorded as deceased on the spine – DQ alerted in real time, GP informed, spine corrected

11. Benefits  Its quick and saves time - DQ team. They update iPM and the NHS number appears checked and verified in seconds.  Patient safety - documented incident where a long term regular patient was found to have the wrong NHS number recorded against them.  Reduction in calls to DQ team.  Patient safety - documented incident where a patient was linked to the wrong patient on iPM and the details adjusted to match.

12. Caveats The spine is a good source of data – but it is not perfect Humans exist on both sides of the primary secondary care divide. – and humans make mistakes. Bad practice - Documented incident(s) where patient’s address fields have been used for other purposes, overwriting their actual address and delaying treatments.

13. What next Spine Refer to data Quality Team iPM (PAS) SMSP ADT Flow TIE (Ensemble) Spine Checker A31 A01 Message Flow Trust A ITK Federated messaging service Other System Work Flow GP System

14. Summary Spine mini services, in conjunction with business rules improves data quality at the trust, at the GP practice and on the spine and helps to identify mistakes early. Supported by HSCIC we should look to standardise on business rules to support spine mini services. Spine mini services improves patient care, saves time and is one of the key enablers to the safe sharing of information across healthcare organisations. Supported by HSCIC we should look to standardise on workflow elements to support spine mini services.

15. Questions?