The Go-Between Issue 112 June 2013 Information for Information Users
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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). ____________________________________________________ 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 ______________________________________________ _______________________________________________ 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 ______________________________________________ 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 ______________________________________________ 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 ______________________________________________ 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] ______________________________________________ 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 ______________________________________________ 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 ______________________________________________ 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. ___________________________________________________ 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) __________________________________________________________ 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