The Go-Between Issue 112 June 2013 Information for Information Users

http://www.bcs.org/server.php?show=ConWebDoc.13667
The Go-Between
Information for Information Users
The Go-Between would like to hear from potential
contributors. Articles should be on health informatics
related matters and around 250-400 words in length. Copy
deadline for Issue 113 is 20 July 2013.
For contributions etc. please write to the Editor
(address on back page).
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In This Issue
Diary
Interoperability Toolkit (ITK)
News in Brief
NHS Comparators
NHS eReferral Service
NHS iView
Personal Development
Technology Fund
Issue 112 June 2013
care. Sharing information between providers of care will
enable patients to experience a more seamless NHS and
make their journey through different parts of the NHS
much safer because their records can follow them
electronically wherever they go.
The money will enable local NHS providers to choose the
best systems for them. However, all electronic patient
records systems adopted by providers must enable secure
sharing of data and comply with NHS England’s
requirement for modern, safe standards of record-keeping
by 2014/15.
Over the coming months, additional
information highlighting best practice and examples of
organisations already making significant progress will be
made available.
The Technology Fund will become operational from the
start of July 2013. It is understood that Initial “Expressions
of Interest” are expected to be submitted by the end of
July 2013. .
More information:
http://www.england.nhs.uk/wpcontent/uploads/2013/06/tech-fund-faq.pdf
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Technology Fund
In May 2013, the Secretary of State for Health and
Professor Sir Bruce Keogh, Medical Director of NHS
England, launched a £260 million Technology Fund. The
Department of Health is making the fund available to NHS
providers from public dividend capital and it will be
managed by NHS England on behalf of the Secretary of
State.
The fund will be available to NHS providers to support the
move from paper-based systems for patient notes and
prescriptions to integrated electronic care records and the
development of e-prescribing and e-referral systems.
This will help stop the situation where patients find
themselves having to repeat their medical history over and
over again – sometimes in the same hospital – because
the hospital does not have access to their records. Studies
show electronic prescribing can cut prescription errors –
which can be present in as many as 8% of hospital
prescriptions – by up to 50%.
Management of the fund will be coordinated by the crossorganisational Informatics Services Commissioning Group
(ISCG), tasked with the effective commissioning of all
national information and technology services in health,
healthcare and social care.
The money will be used to create electronic systems,
linked to patient records that connect across providers and
move the NHS towards the routine use of high quality data
at the point of care. This will enable doctors and nurses to
get better information about patients and to provide safer
NHS iView: keeping an eye on data – see page 2
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Interoperability
Toolkit (ITK)
The Go-Between has reported before on the work
associated with the Interoperability Toolkit. This article
provides an update on this important initiative.
System interoperability within the NHS has been a difficult
target to hit. In some areas, there is a good level of
similarity in business process, data requirements and
technical alignment. In others there are competing and /
or incompatible solutions.
Continued on page 2.
Continued from page 1.
It is important, however, that local solutions meet local
business requirements; but equally they need to be able to
integrate with other systems to meet that business need.
The aim of the ITK (IT Toolkit) is to provide a number of
standards, specifications and technologies which are
consistent and applicable across a wide range of domains
and localities.
The Interoperability Toolkit (ITK) is a set of common
specifications, frameworks and implementation guides to
support interoperability within local organisations and
across local health and social care communities.
The NHS is faced with a situation where attempting to
integrate applications is overly complex and increasingly
expensive. The ITK is targeted at reducing this complexity
and therefore expenditure by introducing a unified
specification for system interoperability within the English
NHS.
Some of the specifications Release 2 of the IT Toolkit are
now available for download (see link below; registration is
required). Below is a summary of the recently available
specifications.
Clinical Correspondence
Specifications for the exchange of variety of clinical
documents including discharge summaries and outpatient
letters.
The specification details how HL7 Clinical
Document Architecture (CDA) is constructed, together with
the templates and code sets expected within the document.
Telehealth Personal Health Monitoring
This specification supports the exchange of summary
monitoring data between a Telehealth remote monitoring
management system and a clinical record.
The BCS PDP has settings that enable the creation of
fields of information and a choice of the priority of the
fields so only the information pertinent to the individual is
recorded in an easy and intuitive way.
As the BCS PDP is owned by the individual it is not tied
into any employer, so can be taken from workplace to
workplace. It is a cloud-based solution, so can be
accessed anywhere on any compatible device with an
Internet connection.
A significant challenge to CPD recording is being able to
record achievements close to the point of delivery, so
being able to record what has been learnt on a
smartphone on the train, on a tablet device at home or at
the event, or back in the office on a PC ensures the
maximum opportunity to record your achievements.
Registering with the BCS Personal Development Plan also
enables the BCS to support individual career pathways
with updates regarding relevant new learning
opportunities, such as new books, upcoming events and
potential certifications. It therefore provides information
about useful opportunities to further build skills and grow
knowledge.
Anyone can register to use the BCS Personal
Development Plan, and most IT professionals can benefit
from using the BCS Personal Development Plan.
Recording professional development activities in an early
stage of a career or for students can help build a useful
weight of CPD evidence that can be used to help secure
prime placements and employment opportunities.
Admission, Discharge and Transfer (ADT HL7v2)
These specifications cover the implementation and
accreditation of the ITK 2 specifications for the transfer of
admission, discharge
and
transfer administrative
information. Traditionally found in PAS to departmental
system interfaces.
For those continuing to grow their career, the BCS
Personal Development Plan enables the easy recording
and tracking of their Development Goals and Activities, in
addition to allowing the sharing of their successes with
peers using the social network sharing tools. This both reaffirms their commitment to CPD and adds an edge of
constructive competitiveness.
For the seasoned
professional sharing information and success is a valuable
benefit that all experienced IT professionals can engage
with – giving back to the IT profession.
In development are several specifications including the
following:
More information: http://www.bcs.org/category/16876
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Health and Social Care Integration
The specification of personalised assessment and care and
support planning process, supported by information sharing
between NHS and social care IT systems. Includes:Assessment with Care and Support Planning, Hospital
Discharge Notifications to Social Care and NHS Continuing
Healthcare
NHS iView
Clinical dashboards
These specifications support of the transmission of
commissioning
/
performance
data
including
measurements of: quality of patient care, performance
monitoring, operational effectiveness, clinical outcomes
and patient experience.
The Government is committed to using information to
improve the performance and effectiveness of the NHS
and making it more easily available to clinicians and
managers. This is a key theme in the national strategy for
the NHS The Power of Information.
NHS iView is an online service that provides aggregated
health and social care data to authorised users within the
NHS. It has been designed for professionals working with
health and social care data on a regular basis to give
flexible and timely access to secure data.
Personal Development
Essentially NHS iView is a dashboard system that uses
data submitted on central returns.
On NHS iView
information can be accessed and extracted to meet
individual requirements. The system enables selections to
be made, comparisons viewed, with the ability to create
tables and generate graphs. The service is free to use but
there is a registration process.
BCS The Chartered Institute for IT has launched a
Personal Development Plan (PDP) for its members and
non-members. It is a free-to-use, cloud-based solution that
enables the recording of CPD (Continuous Professional
Development).
In overview NHS iView the user can:

access information: choose to view a variety of
different data

build reports: cross reference, benchmark and make
comparisons
More information:
http://systems.hscic.gov.uk/interop/background/specs
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


generate charts: customised reports in tables and
graphs
export data: copy to Excel to manipulate data your way
save reports: store your favourite reports, views and
graphs for future presentations and meetings.
The service currently includes data on the following areas:

Workforce Annual Census

Workforce Monthly data

Estates & Facilities

Social Care (NASCIS)

PCT prescribing

Dental Activity data

National Kidney Care Audit (NKCA) - Patient transport

Head & Neck Cancer Audit

National Bowel Cancer Audit

Population, Statistics and Demography
An on-line demo system is available.
More information: www.iview.ic.nhs.uk
Contact: [email protected]
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NHS eReferral Service
In 2012 the Secretary of State for Health set a target for the
NHS to be paperless by 2018. Paperless working will
improve communication between clinicians and carers,
within providers and between different provider
organisations.
To help deliver the challenge, NHS England has launched
a vision and consultation for a new NHS e-Referral
Service. The new NHS e-Referral Service will build upon
the benefits and successes of the current Choose and
Book system. Using lessons learned, the new service will
evolve to meet the needs of the NHS while improving
patient outcomes and experiences.
Since 2004 over 40 million referrals from GP to first
outpatient appointments have been made using Choose
and Book and the service is used to refer around 40,000
patients every day.
To date the NHS e-Referral Service programme team has
focused on examining options for a new solution. The
team have talked to a range of stakeholders, including
Clinical Commissioning Groups (CCGs), referrers (GPs),
service provider organisations and patients.
This
stakeholder engagement has resulted in a number of
patient journeys in various formats (digital scenarios and
storyboards) have been developed to demonstrate how an
NHS e-Referral service of the future might enhance patient
journeys.
The patient journeys include:

Self-referral

Advice & Guidance

Redirection and Follow-up

Arranging Aftercare

Tertiary Referral to a Named Consultant

Diagnostic referral

Referral Management

Linked Appointment
The team is currently inviting and collecting feedback,
ideas and suggestions. There are online surveys for
reviews of each of the patient journeys.
More information: http://systems.hscic.gov.uk/ers
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NHS Comparators
Comparing
data
between
organisations
using
benchmarking and key performance indicators in health
services can be traced back to Florence Nightingale. NHS
Comparators is a contemporary tool in this respect.
NHS Comparators is an analytical service for
commissioners and providers. It helps improve the quality
of care delivered by benchmarking and comparing activity
and costs on a local, regional and national level.
NHS Comparators pulls together:

activity and costed data through the Payment by
Results (PbR) tariff from the Secondary Uses Service
(SUS)

information from The Quality and Outcomes
Framework (QOF)

GP practice demographic population profile data
There are around 200 comparators, many of which can be
broken down by programme budget category or grouped
speciality. There are specific comparators relating to:

accident and emergency

maternity

mental health

long-term conditions

prescribing

GP survey

QOF
NHS Comparators is intended to be easy to access and
understand, the service is a valuable resource to all health
professionals, not just information specialists.
They
enable the Investigation of comparative access rates and
performance at aggregate level by GP practice, PCT level,
provider level or above view suggestions for interpretation
of high or low values for each comparator access support
via the on-line demos and knowledge base.
Although local knowledge is needed for interpretation, the
data in NHS Comparators may indicate areas where
activity or clinical practice is out of line with peers highlighting possible quality of care concerns or areas
where there are potential cost savings to be made. NHS
Comparators looks at a whole range of activity: in-patient,
outpatient and disease-specific:, so commissioners can
use the service to identify and investigate differences in
referral and access rates to secondary care in terms of
costs, and activity providers can use the service to
benchmark their performance on a range of local and
national comparators.
In addition, the Payment by Results indicators allow the
identification of areas where the improvement of coding
could increase income.
Registration is necessary to use the system. An on-line
demo of the NHS Comparators systems is available.
More information:
Demo system
http://www.nhscomparators.nhs.uk/NHSComparators/Scre
encasts.aspx
Registration:
http://www.nhscomparators.nhs.uk/NHSComparators/Logi
n.aspx
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News in Brief
Mobile Connectivity in England
The Government recently undertook a consultation on
proposals to boost the roll-out of mobile and mobile
broadband, which is essential to business growth and jobs.
Demand for mobile broadband including 4G - among
consumers and business is high and growing all the time.
But planning regulations are slowing down the roll-out of
mobile services in many parts of the country.
The
proposed changes will speed up the regulatory process for
mobile and mobile broadband infrastructure, while ensuring
strong safeguards are in place. The proposed changes
maximise the use of existing sites and the sharing of
infrastructure
between
operators.
See:
https://www.gov.uk/government/consultations/mobileconnectivity-in-england
National Technology Strategy
The Go-Between understands that a national technology
strategy for the English NHS is expected for release in the
Autumn.
CARE Measure
The Consultation and Relational Empathy (CARE)
Measure is a person-centred process measure that was
developed and researched at the Departments of General
Practice in Glasgow University and Edinburgh University.
The CARE Measure consists of 10 questions completed by
patients. It measures empathy in the context of the
therapeutic relationship during a one-on-one consultation
between a clinician and a patient. Originally developed for
use by GPs, it has since been successfully used by other
medical staff, allied health professionals (AHPs) and
nurses. The CARE measure can be used free of charge.
The Intellectual Property rights rest with the Scottish
Government. See: http://www.caremeasure.org/index.php.
ASSIST Annual Conference
On 15 November 2013 BCS ASSIST is holding its Annual
Conference in London at the BCS offices in Southampton
Street, London on the theme of “Delivering the Paperless
NHS.” Details and booking arrangements will be available
in the forthcoming weeks.
New GP Payments System
A new system for GP payments went live in June – an
improved service for calculating payments for GP practices
across England after successful Early Adopter testing in
four areas. The Calculating Quality Reporting Service
(CQRS) replaces the existing QMAS system for the
2013/14 financial year. CQRS will assess GP practice
achievement against the Quality & Outcomes Framework
(QOF)2, Directed Enhanced Services3 and other clinical
services.
Mental Health MDS & HES
The Health and Social Care Information Centre (HSCIC) is
for the first time linking the Mental Health Minimum Data
Set (MHMDS) to Hospital Episode Statistics (HES).
Linking MHMDS to HES enables the analysis of acute
patient pathways for mental health service users in
England. Patient identifiers are removed from the data
sets and the bridging file and replaced with a pseudonym
that protects the identity of individual patients but allows
the
records
to
be
linked.
See:
www.hscic.gov.uk/HESMHMDS.
Technology Entrepreneurs
NHS England is encouraging innovation by holding an
event specifically for health technology start-up companies
and Small to Medium Enterprises (SMEs).
The Threat from Cyberspace
BBC Radio 4 is airing a three part series programme
entitled Under Attack: The Threat from Cyberspace: the
first at 20:00 on Monday 1 July 2013 (and on BBC
iPlayer). The episodes cover the virtual world where they
steal, spy and wage war. The British Government recently
declared that one of the greatest threats to national
security emanates from cyberspace.
How Safe Is Your Information?
Recent research shows that Small & Medium Enterprises
are now experiencing incident levels previously only seen
in larger organisations, with 87% of small businesses
experiencing a security breach in the last year.
Information has become a form of currency in today’s
society - so having the right skills and knowledge to keep it
safe is vital. However, the idea that security is only the
responsibility of the IT department is a myth; every
employee is responsible for the organisation’s security.
BCS has recently published a book Information Security
Management Principles (Second Edition), which gives
business and IT managers the skills to identify threats and
protect against them. This second edition includes the
evolving area of security of cloud-based resources, and
covers the principles on which to build the necessary
security for personal and/or organisational use. See:
http://www.bcs.org/content/conWebDoc/50823.
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Diary
10 Jul 13
Data Linkage Stakeholder Forum, Leeds
(http://www.hscic.gov.uk/dlsforum)
12 Jul 13
Conference: Health & Social Care Info
Governance & Sharing, London
(http://www.capitaconferences.co.uk/publicsector-conferences/health-social-care )
15 Nov 13
BCS ASSIST Annual Conference:
“Delivering the Paperless NHS”,
BCS Offices, London WC2
(booking available soon at www.bcs.org)
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Address for correspondence:
The Go-Between,
c/o David Green, Director of IM&T,
SW London & St George’s MH NHS Trust,
Springfield University Hospital, Tooting,
LONDON SW17 7DJ.
[email protected]
London & South East