Th Royal Wolvrhampton NS Trust Trust Board Rport Mting Dat: 28 th July 2014 Titl: Excutiv Summary: Action Rqustd: Rport of: Author: Contact Dtails: Rsourc Implications: Public or Privat: (with rasons if privat) Rfrncs: (g from/to othr committs) Appndics/ Rfrncs/ Background Rading NS Constitution: (ow it impacts on any dcisionmaking) ICT Stratgy Updat Rport To provid an updat on progrss moving th Trust towards th dsird stratgic objctivs for ICT. Assuranc Only Nick Bruc Acting Divisional Managr ICT Srvics Nick Bruc Tl: 01902 695902 Email nick.bruc@nhs.nt Rsourcing planning accommodatd Public Sssion ICT 5 yar Stratgy Approvd Trust Board 22 nd July 2013 ICT 5 Yar Stratgy Approvd Trust Board 22 nd July 2013 http://www.royalwolvrhamptonhospitals.nhs.uk/pdf/9.3_ic T%20Stratgy.pdf In dtrmining this mattr, th Board should hav rgard to th Cor principls containd in th Constitution of: Equality of tratmnt and accss to srvics igh standards of xcllnc and profssionalism Srvic usr prfrncs Cross community working Bst Valu Accountability through local influnc and scrutiny 1
BACKGROUND DETAILS 1. Introduction This rport is to provid an updat on th currnt progrss for th agrd ICT Stratgy. Plas not that whilst th ICT Stratgy will accommodat and flx to adopt th changing tchnology landscap for Cannock acquisition, this rport dos not updat on th Cannock aspct which is dtaild sparatly as part of th IM&T work stram rporting structur. Currntly th RWT ICT Division is on track with progrssion of th Stratgy and vision for IT solutions across th Trust whr all nw projcts dlivring chang and transformation ar mappd back to th Trust stratgic thms, intrnal and xtrnal considrations. Ovrall IT solutions introducd ar alignd to th ICT Stratgy whr dviations from silod solutions in favour of mor stratgic, rusabl and gnric solutions ar bing applid. Th focus of th ICT roadmap is to quip th Trust with viabl and clinically saf solutions that will nabl improvd patint car at th point of car. Usability, rliability and robustnss of th IT solution and infrastructur platforms ar ssntial to this, as ar choics in softwar / systms to nabl th dirction of travl which is moving th Trust from currnt, to dsird futur stat. Th importanc of nsuring that transformational IT projcts ar not just drivn from IT, but ar don in collaboration with clinical srvics and usrs is rcognisd. Through ky stakholdr ngagmnt groups ovrall lvls of support and working rlationships hav bn improvd and joint agrmnt on IT Projct prioritisation achivd. 2
2. Dirction of Travl Foundation Progrss As with any nabling platform th undrlying foundation is critical to th succss and stability of th ovrall solution. Significant progrss and ffort is bing xpndd to nsur th foundation is fficint, robust and prformant. Th following progrss has bing mad on th ovrall foundation aspcts of th ICT solution to nabl th dsird stratgic outcoms. Currntly Windows XP oprating support from Microsoft has concludd. A sparatly ngotiatd agrmnt btwn cntral govrnmnt and Microsoft has allowd an xtnsion of th Microsoft agrmnt nationally for th NS until Jun 2015. Th Trust is thrfor progrssing as a priority upgrads to th nwly supportd Microsoft oprating systm Windows 7 on PC s across th stat. Windows 7 rollout progrss as of th nd of Jun 14 on th Acut sid was 48% complt and community rollout 35% complt. Ongoing monitoring of th rollout continus with an aim to complt th stat by April 15. Ovrall consolidation of all databass & Documnts into a rsilint IT storag solution (SQL Clustr / DFS) has takn plac. This ffctivly rmovs rlianc on oldr infrastructur platforms for th storag of th Trusts data / documnts. Considrabl invstmnt has bn mad in th SQL Clustr (A robust and rsilint bank of storag) to nsur data storag for th liks of th Trusts EPR (Clinical Wb Portal) is consolidatd, instad of prviously whr storag was fragmntd, difficult to manag and subjct to failur. All ntwork main cor and ntwork switchs hav bn upgradd, this nsurd th switching from a usr s PC in th wall sockt to srvrs hosting th Trusts systms ar rplatformd to th nwst quipmnt and monitoring softwar. Work is du to shortly commnc on upgrad of th main tlphony switch which is ovr 10 yars old. This will improv th ovrall platform for tlphony across th Trust srving both IP and analogu phons connctd to th Trusts switchboard. Th businss cas is du to b submittd to Trust CRG in August. A full audit of licncing across th Trust for Oracl databass has bn conductd and ICT Tchnical Srvics is currntly in th procss of auditing all Microsoft licncs across th ICT Estat, this compriss of PC, Srvrs, additional softwar i.. Offic and MS Databas licncing. To nsur w gt this corrct, th ICT Division is working in partnrship with a fully qualifid MS Licncing xtrnal company. Following continud rports of ntwork and clinical wb portal spd prformanc, th ICT Division has commissiond xtrnal support to conduct Prformanc alth Chcks of th ntwork, databass and commissiond Softwar. Two provn and xprincd companis who hav prviously workd with NS Trusts hav bn schduld to assist in th procss to look at locations across th Trust (such as art and Lung) whr systm / ntwork prformanc has bn rportd as bing dgradd. Work on th alth chcks is du to start this month and span into th month of August. It s rcognisd as rlianc on IT incrass across th Trust that sufficint lvls of IT accss bcoms a priority. Th ICT Division is adopting a smartr approach within currnt lvls of availabl invstmnt to nsur adquat lvls of PC s ar in plac for our usrs and for 3
patint car. Targt dploymnt informd from clinicians, othr ky stakholdrs and aras with known high dmand is bing applid across th Trust for nw quipmnt. Ovrall cultur shift within ICT Division is bing strongly ncouragd, th focus on customr cntric approach, improvmnts to our support procsss and tams, i.. IT lpdsk to focus and incras th fficincy of th srvic is now constantly undr rviw. Bttr communication with our usrs and ky stakholdrs is bing facilitatd through a numbr of diffrnt ngagmnt groups and improvd communication across th ICT Srvic in gnral is bing applid. Th rcognition to support vr volving ways of working by our usrs is moving th focus towards mobil computing. It s plannd that mony scurd for ICT Stratgy will b utilisd to trial a numbr of mobil dvics. Th ICT Division acknowldgs that a spcific mobil dvic of choic is unlikly and that mobil dvics will b drivn prdominatly by Usr Rol and Arna. Thrfor it s likly that a numbr of mobil dvics of choic will b chosn dpndant on this critria and th usr s way of working. Trial dvics ar plannd for build and dploymnt to usrs across a spctrum of working arnas to inform th ICT Division on th usability of ths trial dvics. Th ICT Division plans to invst furthr ffort into this mobil platform in rcognition of th importanc of changing ways of working for th futur. In som cass th Division is working with xprt xtrnal supplirs such as BT whr ngagmnt on pilot rollouts is alrady in progrss. 3. Stratgy Outcom Progrss Intgratd Elctronic Patint Rcord Elctronic Documnt Managmnt Srvic / Trust Transformation Intgratd Businss Intllignc Commrcial Opportunitis Th ovrall Stratgic outcoms ar in ffct th front facing aspct of th work that th ICT Division is undrtaking. To a crtain xtnt whilst lmnts of th foundation work will rmain transparnt to th nd usr, th outcom work that is nabld will b dirctly visibl and thrfor at th Coalfac of patint car. Th main Trust wid EPR systm, th in-hous dvlopd Clinical Wb Portal continuously nds to volv in trms of ovrall prformanc, rliability, usability and clinical functions. Portal improvmnts occur somtims on a daily basis but largr volvmnt of this systm will always nd to b plannd. Currnt vrsion 4 is du for rplacmnt and th IEPR tam will b planning on th dvlopmnt of Vrsion 4.5 to b rlasd first quartr of nxt calndar yar with vrsion 5 first quartr of nxt FY. In th mantim major volvmnt of vrsion 4 will continu ranging from ovrall improvmnts to th prsntation layr, prformanc of th systm and additional nw functions rquird for improvd clinical car. Functions such as accss to Wolvrhampton GP rcord information and Pathology rqusting for ordr comms has rcntly bn introducd last month (Jun 14). Rlass to 4
vrsion 4 will continu and improvd / nw functions to support IEPR Phas 3, CQUIN and ovrall Mandatory improvmnts ar plannd. Stratgic Trust wid Ordr Comms is acknowldgd as a priority whr th Trust is currntly using TD Wb for ovrall pathology rqusting across th Acut and GP practic locations. Th trial of a nw product prviously known as PlumTr but now calld Dart OCM is undrway for Pathology & Radiology ordr comms rqusting. Currntly th Pathology trial of this product is limitd to a numbr of GP practics in th surrounding aras and th Radiology trial will b rstrictd to a srvic in th Acut. Th implmntation to progrss th trial of Dart OCM across GP rqusting is alrady in flight and Radiology pilot for an Acut srvic is in fasibility stags. Should ths trials prov succssful thn stratgically th Trust would nd to valuat th bst solution and look to consolidat ovrall Ordr Comms with intgration through th Clinical Wb Portal. IEPR phass of Inpatint scanning ar nar compltion with only thr aras rmaining A9, Gynacology D7 and Padiatrics. Th IEPR Programm Group continus to progrss this procss for th captur of papr cas nots lctronically working with th clinical srvics and stakholdrs to nsur th procss is fit for purpos, robust and bnficial. Ovrall Safhands Systm dploymnt which is th largst of its typ in th world has provn succssful and only rcntly th Saf ands programm tam wr rcognisd for thir fforts winning a SJ Award at th Patint Safty and Car Awards 2014. This provids Patint Tracking, Equipmnt / Asst Tracking, Ral Tim Alarms and patint status information along with and ygin / Bd tracking functionality. Plans ar working towards cntralisd logistics and bd control using this systm to provid a tru LIVE bdstat for th Trust with nhanc capability managmnt. Th ICT Division rcntly won 582k from th NS Tchnology Fund and coupld with Trust contribution of an additional 200k this has rsultd in 782k invstmnt to upgrad and rvamp of th Trusts currnt rfrral databas, documnt Managmnt and Elctronic corrspondnc snding systms. Currnt systms wr old and whilst at th tim fit for purpos for th job at hand will now no longr cop with th incrasd rlianc on IT. This bid was targts at points in th patint journy whr IT solutions ar critical to support patint car, spanning rfrral, bulk of car and discharg. Th implmntation of solutions supporting th patint journy is in progrss with th nw rfrrals databas and lctronic snding du for rlas in Octobr 14. Furthr dlivry of th Tchnology fund solutions for ovrall documnt managmnt (andling and prsntation of ALL lctronic documntation, spcially that within th Portal) is du for compltion by January 2015. 5
4. ICT Projct Dlivry 14/15 Th bulk of transformation dlivry for ICT is supportd through ICT nw projcts fundd from businss cas allocation both Capital and Rvnu. In othr cass ICT Projcts ar dmd as cost nutral whr projcts such as th xpansion of -Discharg, dlivry of Endoscopy Diaris, art Failur, and althy Lifstyls tc ar dlivrd utilising cor ICT rsourcs from th in-hous tams. Th currnt Projct invstmnt from Capital for this FY is as blow. Plas not that rassignmnt of this allocation within th total fiscal nvlop may occur as projct costs flx or prioritisation on th dlivris chang. Whr Projct invstmnt has not bn availabl thn th impact of this undrgos assssmnt and if rquird scalation to th ICT Stratgy Board will occur. An xampl of this is as blow whr funding to support an lctronic rmindr systm for DNA rduction has not bn allocatd. In that sns scalation to r-valuat th projcts priority may dtrmin that this invstmnt is ssntial as it will dlivr fficincy savings, an improvd patint xprinc and ovrall incras th Trusts prcption in th public arna. ICT Capital Funding March 2014 Allocation Carry Ovr from prior yars Rnal IT Businss Cas (Proton) 7,500 Tlphon Switch Upgrad 150,000 Matrnity IT Systm 332,572 Pathology GP Dirct Accss 122,320 UPS Cntralisation 51,293 Windows 7 Upgrad 119,335 Nw Schms -prscribing Chmothrapy 242,824 -prscribing Trust wid 0 Documnt Managmnt 781,420 Discharg Day Cas / Phas 3 0 R&D TBC DNA Rduction 0 IEPR Phas 3 155,000 PC rplacmnt 10,486 Emrgncy Portal Nw Build TBC Total 1,972,750 *Th capital dlivris ar support by Rvnu allocation for ICT Division of 467k rcurring with 694k non-rcurring 6
( ( ) ) Community Rcords Managmnt - Phas 2 Digitisd Documntation - District Nurss Building Works - Emrgncy Portal Digitisd Documntation - Rollout iepr Phas 2 iepr Phas 3 Matrnity IT Systm Databas Normalisation Safands Discharg Compltion - phas 2 & phas 3 Emrgncy Assssmnt Systms EAU D3 Podiatry art Failur IPP PAS Spin Complianc Pathology GP Dirct Accss Strok ypr Acut Documnt Rtntion & Scanning 5. Projct Prioritisation & Status (Plas s Appndix 2 ICT Projct prioritisation Chart) Th prioritisation of ICT Projcts is a collaborativ approach btwn th ICT Division and our ky stak holdrs through th various stak holdr managmnt groups and ultimatly th ICT Stratgy Board. Prioritisation of projcts is compltd through a numbr of various masurs which th ICT Division has mappd back to Trust objctivs and bnfits. An xampl of masurs can bn sn blow, but in summary ths produc a Priority Ranking for th ICT Projcts dpictd in Appndix 2. Not that th lowst scoring projct is th highst priority. (Mtrics and scoring mchanisms will continu to volv as w continu to look at fin tuning our procss). PORTFOLIO PRIORITISATIO N MODEL W i g h t i n g # W i g h t i n g % Roadmap PROJECT PRIORITISATION RANKING 1 2 3 5 6 6 9 10 12 15 19 21 22 23 24 25 26 27 Currnt Staus: Piplin Activ Scop Piplin Activ Piplin Activ Activ Activ Activ Activ Activ Activ Activ Activ Activ Piplin STRATEGIC ALIGNMENT 0.68 68% 6.5 6.3 5.8 6.3 6.5 6.5 6.3 6.0 5.8 5.8 5.4 4.2 5.2 5.2 4.6 5.0 4.9 5.5 Piplin Improvs Patint Safty 0.12 12% 10 10 10 10 10 10 10 10 10 10 10 10 10 6 2 6 6 6 Improvs Patint Exprinc 0.12 12% 10 10 10 10 10 10 10 10 10 10 10 6 10 10 6 6 6 10 Mandatory NS Rquirmnt 0.12 12% 10 10 6 10 10 10 10 6 6 10 6 2 6 6 10 6 6 10 Mandatory IT Rquirmnt 0.04 4% 10 2 2 2 2 2 6 6 2 2 2 2 2 2 2 2 2 2 Dlivrs Trust Stratgic Srvic Dvlopmnt Objctivs 0.04 4% 10 6 10 6 10 10 10 10 10 6 10 10 6 10 6 10 10 10 Crucial Enablr Projct 0.04 4% 10 10 10 10 10 10 10 10 10 6 10 6 6 10 10 10 10 10 Pan trust Implications 0.04 4% 10 10 10 10 10 10 6 10 10 10 6 2 6 10 10 10 10 10 Scurs xisting rfrral/ customr bas Incrass xisting rfrral/ customr bas 0.04 4% 6 10 10 10 10 10 10 10 10 10 10 10 10 10 6 10 10 6 0.04 4% 6 10 10 10 10 10 10 6 10 10 2 6 6 10 6 10 10 2 Dlivrs improvd fficincy 0.04 4% 10 10 10 10 10 10 10 10 10 6 10 10 10 10 10 10 10 10 Alignd to ICT Stratgy 0.04 4% 10 10 6 10 10 10 6 10 6 6 6 6 6 2 10 10 6 10 DIRECT FINANCIAL VALUE 0.08 8% 0.3 0.2 0.0 0.2 0.3 0.3 0.1 0.3 0.1 0.2 0.2 0.2 0.3 0.2 0.4 0.3 0.6 0.0 Projct Cost 0.03 3% 10 2 2 2 2 2 1 10 1 2 2 2 10 2 10 2 2 2 Financial Rturn on Invstmnt 0.05 5% - 1 2-1 2 5 5 2-1 2 2 2 2-1 2 2 5 10-1 DIRECT NON-FINANCIAL VALUE 0.15 15% 1.9 1.5 2.3 1.5 1.1 1.1 1.1 1.5 1.1 0.8 1.1 1.9 1.1 1.1 1.5 1.1 1.1 0.6 Patint Satisfaction 0.10 10% 15 7 15 7 7 7 7 7 7 7 7 15 7 7 7 7 7 2 Staff Engagmnt 0.05 5% 7 15 15 15 7 7 7 15 7 2 7 7 7 7 15 7 7 7 Risk 0.09 9% - 0.1-0.3-0.4-0.4-0.5-0.5-0.5-0.8-0.3-0.4-0.4-0.1-0.4-0.4-0.4-0.4-0.5-0.2 Dlivry 0.02 2% - 1-4 - 6-6 - 6-6 - 6-15 - 4-6 - 6-1 - 6-4 - 6-6 - 4-1 Bnfits 0.02 2% - 1-6 - 6-6 - 6-6 - 6-7 - 6-4 - 4-1 - 4-4 - 4-4 - 4-4 Currnt Oprations 0.05 5% - 1-1 - 4-4 - 6-6 - 6-7 - 1-4 - 4-1 - 4-4 - 4-4 - 7-1 TOTAL 1.00 100% 8.5 7.7 7.7 7.5 7.3 7.3 7.0 6.9 6.8 6.4 6.2 6.2 6.1 6.1 6.0 6.0 6.0 5.9 Stratgic Alignmnt Dirct Financial Valu igh 10 Undr 100,000 10 Mdium 6 100,000 to 500,000 2 Low 2 Ovr 500,000 1 7
Projcts showing as RED on ICT Dlivry programm:- -Prscrib Chmothrapy: - Thr ar assuranc issus with th currnt supplir Ascrib who provid th Pharmacy systm as to whthr thir -Prscrib systm is fit for purpos to support -Prscribing Chmothrapy. Currntly a viability rviw is in progrss and visits arrangd to s th systm oprating ffctivly at othr Trusts providd as rfrnc sits. Supplir commitmnt around providing th rquird assurancs ndd has bn poor, with xcutiv lvl scalation rquird at th supplir lvl. In prvious dlivris with Ascrib rsourcing issus on thir sid hamprd timframs, it s flt that an lmnt of this along with lack of commrcial incntiv is contributing to th poor lvls of ngagmnt bing xprincd. Work to look at altrnativ solutions i. Chmo Car with othr supplirs is undrway but it should b notd that supplir slction would dlay timframs furthr. Ovrall -Prscribing has bn put on hold whilst a supplir dirction is agrd. Th bnfits of pursuing Ascrib as a solution would allow a consolidatd systm across Pharmacy, Chmothrapy Prscribing and Trust wid -Prscrib. Adoption of a sparat solution from anothr supplir for any of ths lmnts would rquir implmntation through th us of intgration. This mayb th only altrnativ as commrcial commitmnt from th Trust cannot occur until rassurancs on th Ascrib systm is providd in trms of this bing fit for purpos. GP Dirct Accss: - Whilst th projct is showing as RED this is against original baslind milstons. Rcntly good progrss has bn mad whr cross organisational challngs, tchnical issus with th GP systm supplir EMIS hav bn rsolvd. Pilot sits ar du to go liv starting w/c 21 st July and providing ths ar succssful thn th solution will b signd off rady for furthr scal out (Considration to WCCCG practics and Cannock GP Dirct Accss). Th following practics and rollout dats ar as blow for th GP Dirct Accss pilot 22 nd July 14 Laksid 28 th July 14 - Russlls all 30 th July 14 - Clavrly 06 th August 14 - Gravl ill 07 th August 14 - Planks Lan Endoscopy Diaris: - Initial complxitis mapping srvic rquirmnts against tchnical solution has contributd to slippag to th original dlivry dats. Th ICT tam hav bn working closly with th srvic to rsolv any issus. Th systm was rlasd in Jun with an lmnt of dual srvic running btwn th prvious systm and th nw systm. Good progrss has bn mad and dual running of systms has now casd with th systm fully liv. Th ICT and Patint Accss tam continu to work closly with th srvic to rsolv minor issus and look at systm nhancmnts which will bnfit th srvic. UPS Cntralisation: - Th nd for building works to support this projct has addd to dlays. Two of th thr rooms ar now bing progrssd and ICT Tchnical Srvics ar working closly with Estats collagus to look at lctrical issus surrounding th third room to bring this back into scop of dlivry for th projct. 8
Appndix 1 Elctronic Patint Rcord Dsign Principl -
Cannock Discharg - phas 2 Building Works - Emrgncy Portal Documnt Managmnt Prscribing - Chmothrapy iepr Phas 2 iepr Phas 3 Prscribing Trust wid Discharg - Day Cas phas 3 Digitisd Documntation - Rollout Matrnity IT Systm Pathology GP Dirct Accss Outsourcing Pharmacy OP (Boots) Safands Frinds & Family Survys PAS Stratgy Emrgncy Assssmnt Systms AMU D3 Podiatry IPP PAS Spin Complianc Glustats PMP CQUIN Endoscopy Diaris Singl Sign -On POC R&D Wirlss Expansion Pharmacy Upgrad Radiology CQUIN Pathology - Prompting & Alrting Windows 7 Upgrad UPS Cntralisation Tlphon Switch Upgrad Edg Ntwork - phas 2 District Nurs Casload Managmnt Pathology - Cytlogy art Failur PLICS Rollout Acut Kidny Injury IT Solution Rnal Rplacmnt Coniston ous Mov althy Lifstyls Carbon Rduction IT Softwar R Absnc Systm Rank Appndix 2 50 45 40 35 30 25 20 Lgnd Main ICT Projcts in priority ordr Lowst ranking = highst priority Projct Complt Projct in Flight Projct at Risk (Known dlay) Projct placd on old ICT Projct Prioritisation 15 10 5 0
Appndix 3 Ovrall igh Lvl ICT Stratgic Roadmap - - - - - Notlss OPD In Patint Scanning Rollout Mobil Dvics / Smartr Tlphony Community Rollout -Discharg Complianc E-Discharg Expansion Pathology Expansion of Srvics Intgratd Ordr Comms Safands Elctronic Doc Mgmt Prscribing Implmntation PAS Spin Complianc PAS Consolidation / Rviw Shard Data Solutions / Data Warhous Stratgic PAS Ongoing Evolution of Clinical Wb Portal EPR Solution Entrpris Wid althcar EPR Solution or Continuation of In-ous EPR Rnal Cannock Acquisition Day 1 to Yar 3 Transitional Matrnity Thatr Systms Rviw Frinds & Family Tsts Patint Rmindrs