1. Healthcare Change in the NHS Practical considerations of VistA Dr. Tony Shannon

2. Tony Shannon M.B. B.Ch. B.A.O. Ireland Fellow of College of Emergency Medicine England Fellowship in InformaticsUSA MSc in IT ManagementEngland Consultant in Emergency Medicine, Leeds Teaching Hospitals Chief Clinical Information Officer, Leeds Teaching Hospitals (Clinical Lead, NHS Connecting for Health – National Programme for IT) (Chair, Clinical Review Board, openEHR Foundation) Honorary Research Fellow, University College London

3. Key points Healthcare Change – People, Process & Technology VA & Vista International Leaders Challenges in the NHS – Integration – Code & Community – UI & Usability Next Steps – Towards Gold Standard

7. NHS Model Communities: People + Process + Technology Thinking in silosClash between process and IT

8. Archetypes Templates ‏ Standards & Interoperability Generic Specific

9. Test Requirement BuildDesign AoMRC Generic Medical Documentation

12. eHealth Ecosystem International Standards LocalInnovators eHealth Bodies & Vendors

13. International Leaders

14. NHS Innovation- from Bottom Up Leeds, England 4 Hospital Site 14,000 employees £800m annual budget £7m annual IT spend Clinically Led Process Improvement Agile OS development

15. 200+ System X CUI Clinical Portal TIE A BC 1234512345 PAS Scheduling Orders Results ePrescribing Clinical Docs Primary Care Informatics Strategy

16. Clinical Portal: Patient Oriented & User Centred

17. Leeds TH 200+ VA Vista Enterprise Wide Common Web UI Integration Engine ESB ABC 1234512345 Core Process Modular SOA Enterprise wide System X Cache Gt.M PPM SQL

18. Challenge # 1: Integration

19. Challenge 2: Code & Community

20. Challenge 3: UI & Usability

22. LeedsTH NHS: Steps towards VistA User Centred Design – Clinically Led Agile Development – 10 Days Technology – ExtJS4 – EWD – Mumps – Gt.M/Cache NoSQL

23. North- User Context West Navigation (Via Accordion +/- Tree) Inc external sources Eg Meds Allergies Diagnosis Clinical Docs Centre Data Group in focus Via Chart/Grid/Table +/- data source to explain data context (eg Leeds/ Washington) East Data in Detail Create Data Update/Delete Data Create/Update/Delete Data Data Entry done in popup NB may be external component Save Clinical UI Patterns

24. High level- Aggregate Patient Data ClinUiP.wordpress.com

25. Mid level- Patient Group Data

26. Low level- Patient Detail Data

27. Patient Detail Data- Data Entry

28. ClinUiP on Vista

29. ClinUiP Benefits Intro to OS EHR development Intro to ExtJS/EWD/GtM Introduction to Mumps & Vista Align towards Vista/Vista Integration

30. Next Steps Knowledge Transfer in the NHS Gold Standard for NHS – Standards- CUI & AoMRC – Admission, Handover & Discharge – Integration with a.n.other Explore Integration with Vista & Others – EWD & NodeJS- XML, Mumps/Javascript – NoSQL & SQL

31. ...towards evolving ecosystem…. International Standards LocalFrontline Innovators NationaleHealth Bodies & Vendors Regional

32. Key points Healthcare Change – People, Process & Technology VA & Vista International Leaders Challenges in the NHS – Integration – Code & Community – UI & Usability Next Steps – Towards Gold Standard

33. Thank you tony.shannon@frectal.com www.frectal.com