Nearly the Holy Grail – Clinical Portals for faster, Better and Borderless Care

The South and East Consortium Clinical Portal Demonstrator Project 2010

Martin J EganDirector eHealth, NHS Lothian

Outline

● Project background

● The prototype

● Results

● Towards a fully-fledged portal

● Future opportunities

● Summary and conclusions

● Your questions

Background

Scotland’s NHS has been called on to harness the power of eHealth to deliver care which is:

● Safe and effective

● Timely and efficient

● Equitable and patient-centred

NHS Lothian, NHS Fife, NHS Borders and NHS Dumfries & Galloway carried out a prototype project to see if a clinical portal could help meet these objectives.

Testing the theory

Our prototype tested whether a clinical portal could provide a relatively low-cost way to provide clinicians with real-time access to all the patient data they need in a single view.

Advantages should include:

● Aggregation of data from multiple but otherwise

incompatible electronic systems

● Trusted and accurate electronic data – replacing

paper records

● Collaborative, top quality borderless care, with clinicians able to share, review and update records any place, any time

Designing and running the project

High levels of clinical involvement and leadership – testing was by members of the Cancer Managed Clinical Network

Technology provided by Carefx and Northgate Managed Services

Eight weeks of design and development and 10 days of live testing

Applications: SCI stores, Regional CIMs, TRAKcare PMS PACS and ECS

Clinical feedback

The portal delivered for clinicians, patients and the four health boards. It was described by one consultant as:

‘the nearest thing to the Holy Grail we will ever get’

What we learned

A portal had the potential to:

● Meet expectations outlined in Key Data Items Survey

● Allow continued use of legacy systems

● Speed up services through faster access to information

● Reduce the need for repeat or duplicate tests

● Promote better decisions at the point of care

● Cut administration

The technology also proved to be reliable and implementation was relatively straightforward.

Moving forward

The prototype project showed that a clinical portal could be central to realising the vision in Better Health, Better Care (2008), to:

‘… ensure that the right information is available at the right time, in the right place,

to enable staff to provide the best possible care’.

The results of the project were used to inform a business case for the procurement of a full-scale clinical portal to be deployed throughout the four boards.

Expected benefits

The prototype: video

Towards deployment

Clinical value, support and involvement are critical to its success – clinicians have been knocking at my door.

Complex work programme involving multiple projects:

● Initial deployment project● Technical infrastructure● Functional design (CAG)● Wider roll-out● Benefits analysis

Initial progress

Medical Receiving Unit (NHS Lothian)

Inpatient and outpatient workflow

All elements of functional design, technical work, UAT and training involved in deployment

Go-live: late September 2011

Initial deployment: progress

Challenges

(cameronsong.blogspot.com)

Balance between tight timescales and providing genuine clinical/patient benefit

Contract scope – allowing for discovery and additions

A foundation for future specialist workflows

Multiple stakeholders with good ideas and opinions

Managing work and priorities across four boards

The future

(Courtesy of Carefx corporation)

The portal offers flexibility for future developments in patient care.

● Additional applications

● Wider roll-out

● Layers on top of portal – context management /advanced workflows

● Business intelligence

● Patient portal

● Health and social care integration

Summary and conclusions

The prototype showed that a portal could deliver what we wanted, what clinicians asked for and what patients need.

A portal is cost-effective, flexible, easy to use, popular with clinicians, protects past investment and raises productivity.

Practical benefits will include large savings in clinician time through a reduction of 16,683 hours a year in generating patient summaries.

Greater ability to deliver care that is safe, effective and person-centred.

Questions