Prof. Fiona Macmillan,doctorChris Thorley , HIS

South Staffordshire MHF Trust

Supporting clinicians and helping to feed the beast

Supporting clinicians and helping to feed the beast

“If the rule that you followed brought you to this, then what use was the rule?”

Anton Chigurh to Carson Wells in No Country for Old Men

Supporting clinicians and helping to feed the beast

To move from IT-driven change(we in IT will put in a new system for you, and you’ll just have to change the way you do things if it’s going to give

you much benefit)

to change-driven IT

(OK, IT, we’re changing things at our end, we know what we want from an IT system, so we need to work

collaboratively and reap the benefits of our changes, so can you please go out and get it for us).

Supporting clinicians and helping to feed the beast

About 140 clinicians,

performance managers, governance , admin and assorted others

Met with

Informatics

to find out what they needed

Supporting clinicians and helping to feed the beast

About 140 clinicians,

performance managers, governance , admin and assorted others

kept on meeting with

Informatics

again and again

to find out what they needed

Supporting clinicians and helping to feed the beast

Managers view of the beast

We will be eaten unless we report on

•7 day follow up •Delayed discharges•Mixed gender settings

And reporting keeps changing

Supporting clinicians and helping to feed the beast

Clinicians view of the beast

Vague mythical creaturethat is some-one-else’s problemas we have enough problems of our own

Supporting clinicians and helping to feed the beast

New Rules

Useful stuff out , equals useful stuff in

No need for personal data-bases

Old Rules

Garbage out,

garbage in

Inaccurate data

Personal data bases

Supporting clinicians and helping to feed the beast

So, A clinically useful IT system which could tell everyone, or at least almost everyone

what's going on

If the information is there

Then so is the food for the beast

Supporting clinicians and helping to feed the beast

It was piloted with the mentally disordered offenders team, a highly complex multiagency team …linking

solicitorsprobation officers mental health professionals(debts and drugs)

They liked it so they kept on double entering until the system came on line

Supporting clinicians and helping to feed the beast

The front-end clinical system replaced the existing slow cumbersome system prone to lock out

CPA & Letters were basic,

no spell check, no formatting,

As a doctor, I didn’t use it at all.

But I had my own home made data base…

Supporting clinicians and helping to feed the beast

The Product had to marry into the national program,

The wedding was arranged

With all the usual family rows….requiring significant and successful mediation….

Supporting clinicians and helping to feed the beast

The Hybrid Journey

Step 5 – Care Plan

Referral

Allocation to

ClinicianPre-Clinic Summary

Assessment and

DiagnosisCare Plan

Intelligent care planning is highlighted by the use of collapsible blue bars. A previous paper based

form consisting of 12 sides is now available

on one screen

Support Elements - Messaging

Referral

Allocation to

ClinicianPre-Clinic Summary

Assessment and

DiagnosisCare Plan

Support Elements

Messages can be sent from one user to another but these messages stay in the patients menu tree so they can be seen by any user

Each message remains “Not

Actioned” until the recipient Actions the message in their own inbox

Performance management

Clinicians

PatientsMedical Records

Hybrid System

Feeding the beast

Governance

Supporting clinicians and helping to feed the beast

Change the rule

To change driven IT