Benefits of Spine Mini Services Sue Bracey Head of software development & Integration 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 Sending Systems iPM (PAS) TCP A&E Maternity iCM-Orders iCE-GP Orders Labs Receiving Systems ENSEMBLE Integration Engine FTP FS TCP WEB Web SQL Email Labs CRIS Maternity Neonatal Innovian Viewpoint Radiotherapy Infection Control Radiance Sonicaid CACHE DATABASE ESR OLE/ODBC Spine Update iCE-GP Results Trauma Board Text Radiology A&E iCM-Results Apply Business Rules Store Filter Transform Route Send iPM ICNARC Renal Stoma Care Cancer Registry Chlamydia screening Torbay/Treliske Labs Occ Health Speech recognition Process > 250,000 messages / day Local solutions Others -departmental Spine Mini Services 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 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. 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) Are Patients Safe? Is the Solution Resilient? Can we Audit the Requests? Is It Secure? You The Trust Your Patients Trust Operating Model Is Data Safe? Spine Services – Work flow TIE (Ensemble) AE SALUS iPM (PAS) A01 ADT Flow A31 Spine Checker Other System SMSP Maternity Refer to data Quality Team Spine 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. Anecdotally similar reduction in the number of letters sent to the wrong address. Patient safety – documented incident where a patient was linked to the wrong (deceased) patient. – DQ alerted in real time. 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 Patient safety - documented incident where a long term regular patient was found to have the wrong NHS number recorded against them. Patient safety - documented incident where a patient was linked to the wrong patient on iPM and the details adjusted to match. Its quick and saves time - DQ team. They update iPM and the NHS number appears checked and verified in seconds. Reduction in calls to DQ team. 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 TIE Other System (Ensemble) ITK Federated messaging service ADT Flow iPM (PAS) GP System A31 Spine Checker SMSP Work Flow Refer to data Quality Team Spine Trust A Message Flow Summary • Spine mini services improves patient care, saves time and is one of the key enablers to the safe sharing of information across healthcare organisations. • 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. • Supported by HSCIC we should look to standardise on workflow elements to support spine mini services. Questions?