Sue Bracey

Head of software development & Integration

Benefits of Spine Mini Services

Agenda

•Plymouth ICT Shared Service (PICTS)

•Spine Mini Services

•PICTS SMS implementation

•Benefits and caveats

•Where to next

•Conclusion

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

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

StoreFilter

Transform RouteSend

ENSEMBLEIntegration Engine

ICNARC Renal

Stoma Care

OLE/ODBC

Cancer Registry

CACHEDATABASE

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

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

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.

PICTS, SMS Implementation

Worked with InterSystems and CFH through Common Assurance Process (CAP)

YouThe Trust

Your Patients

Are Patients Safe?

Is Data Safe?

Is It Secure?

Is the Solution

Resilient?

Can we Audit the

Requests?

Trust Operating Model

Spine Services – Work flow

iPM(PAS)

AE SALUS

Other System

MaternitySpine

SMSP

ADT Flow

TIE(Ensemble)

Spine CheckerA31

A31

A31 A31

A31A31

Refer to data Quality Team

A01

A01A01

A01

A0

1

Queries to DQ Team

Spine Mini Services live May 2012

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

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.

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.

What next

SpineRefer to data Quality Team

iPM(PAS)

SMSP

ADT Flow

TIE(Ensemble)

Spine Checker

A31

A31

A31A01

A01

Message Flow

Trust A

ITK Federated messaging

service

Other System

Work Flow

GP System

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.

Questions?