EMIS in Scotland delivering the aims of the

eHealth strategy 2011-17 in the primary and community setting.

Mark MulhollandRegional Director – Scotland & NI

• EMIS team in Scotland• Current regional landscape• Working towards the eHealth strategy 2011-

2017• Health & Social care integration• Future development – products + services

– PCS development roadmap– EMIS Web GP

EMIS Team in Scotland

• Scotland previously part of NE & Yorkshire region

• Scotland & Northern Ireland amalgamated as a region in April

EMIS Team in Scotland

• Move away from ‘The Field’• Towards defined functions (field and internal

structures)– Sales / Account Management– Training– Service– Commercial development

Sales / Account Management

Mark Mulholland (RD) – cross functional-----------------------------------Tom McCluskey (SAM/CAM) – EMIS Web projectsFiona Leishman (SAM/CAM)Diane Henderson (CAM)

– On maternity

Claire McNeil (acting CAM)– NHS GG&C

Training

Lynn Tomlinson (CTM) – Scotland, NI, NE&Y

Jenni Lockhart (STC)Colette Jackson (TC)Claire Watt (TC)

– Full time secondment to GG&C

Andrew Burton (TE)– Full time focus on EMIS Web community

Claire McNeil (TE)– Acting CAM

Service Relationship Exec

• Will Christie– Covering all 14 Scottish Health Boards + National

Service forums– Remit solely focussed on service delivery in

Scotland

Commercial Development

• New function headed by Matt Murphy• Debra Renwick representing Scotland• Link between field and development

– Facilitating turn around of field ‘opportunities’ to ‘delivery’

EMIS in Scotland

• Regional offices – Development presence

• 2009 – 1 member of staff (me)• 2012 – 12… and growing!

GP Estate

• EMIS PCS installed in 528 of 1006 practices– Across all 14 Health Boards

• 52.5% market share– EMIS PCS practices in all Health Boards– 3 Health Boards exclusively EMIS PCS

• Forth Valley• Borders• Shetland

– Due to become 4 exclusive Health Boards • Possibly 5

eHealth strategy 2011-2017eHealth strategy 2011-2017• Build on the achievements delivered and foundations

set in 2008 strategy• Quality outcomes

– Everyone gets the best start in life, and is able to live a longer, healthier life

– People are able to live well at home or in the community– Healthcare is safe for every person, every time– Everyone has a positive experience of healthcare– Staff feel supported and engaged– The best use is made of available resources

eHealth strategy 2011-2017

Continuing towards….

Better Health - Better Care

eHealth strategy 2011-2017

• Safer patient care through availability of accurate up to date information– Building on ECS / KIS / ePCS– Anticipatory care approach

• Accurate, informed diagnosis and collaborative delivery of care– Decision support tools

• Efficient working across settings– Faster availability of newly recorded information

eHealth strategy 2011-2017

• Patients as responsible partners in the care they receive– Informed, engaged

• Improved referral processes– Reduction in times from referral to receipt of care– Seamless transaction across multiple systems

eHealth strategy 2011-2017

Integrating IT systems and data sharing

Mobilising primary care dataSupporting a single shared record

eHealth strategy 2011-2017

The best use of existing technology…

…the technology already exists

Local strategies

• Individual board strategies to deliver aims of eHealth strategy and care integration agenda

NHS Greater Glasgow & Clyde

• 250 EMIS PCS – 9 InPS Vision• EMIS Web Children’s Services Community

system project underway and resourced• Single Organisation approach

– No immediate plan for integration with GP record• No sites streaming…yet

• 600+ users• Every child 0-18 years

NHS Greater Glasgow & Clyde

• Instructed development work– SCI Store patient demographic feed

• MPI integration – Nov 2012

– Bi-directional SCI-Gateway referrals • Jan 2013

NHS Greater Glasgow & Clyde

• Clinical Portal– Orion portal integration– GP data feed via EMIS Web

• Continence Service– Early adopter of EMIS Web as clinical system– No SEF requirement

NHS Ayrshire & Arran

• EMIS Web Community System project underway and resourced– Working towards Virtual Wards go-live in

November

• Girvan Community Hospital project– Small working project – Three Girvan GP sites sharing services at

community hospital

Other potential Web opportunities

• NHS Western Isles– Vodafone digital pen integration

• NHS Forth Valley• Dumfries & Galloway • Borders• Shetland• Grampian

Clinical Portal

• Clinical Portal Integration• Individual board strategies

– Orion– CareFx (Northgate)

RIO

Cerner Milleniu

m

Ascribe

Pharmacy

Order Comms

Inpatient Services

Minor Surgery

Physiotherapy

Learning Disabilities

Child Health

District Nurses

Health Visitors

CareLogic

OtherServices

GP

Integration tool

EMISWeb

Speech and Language Therapy

Interoperability

Healthcare Gateway• 50:50 joint venture between EMIS and InPS• Medical Interoperability Gateway (MIG)

– Exchange real-time data between any third party system and EMIS or INPS clinical systems

– 100% of patient records in Scotland are now held on EMIS PCS or InPS Vision

• Not limited by one to one interoperability standards between distinct systems– Ensemble?

• Live primary care data available in Clinical Portal, OOH, Community, Acute, etc…

• Patient care information captured in community, acute etc available in General Practice in real time– Single care record

Patient centric eHealth

• Interest in Patient Access as patient portal– Best use of available resources

• eHealth Policy & Strategy– Possible development

• Links to PIL in MR viewer• Bi-directional messaging• Capturing patient specific clinical data online• Integration with secondary care appointment systems

• Online repeat ordering TBC!

Health & Social Care Integration

• Integration of Adult Health & Social Care Bill currently in consultation

• EMIS exhibiting at Scottish Executive conference in Edinburgh on 19th September

Health & Social Care Integration• Aims

– lay the foundations for an integrated model of care in Scotland – CHPs disbanded– Replaced with Health and Social Care Partnerships (HSCPs)– Local council authorities and NHS boards jointly responsible– Efficiency savings remain dominating factor in policy discourse– Initial focus on integration of budgets for older people services– Emphasis on improving care in patients home as opposed to care

home or hospital– New focus on funding of community systems / decrease in

institutional budgets

Future developments

• GP IT Contract & Services Management Group– Level of engagement

• Working relationship with Kevin Boylan (NISG Service Manager)

• CAB / RFC / Service Management• Regular contact + monthly NISG meeting• Quarterly GPITC&SM meeting• New Quarterly Service Review

– All boards represented

New patch release process

• Following recent discussions with NISG and subsequent ratification from GP IT CAB we will shortly be moving to a new process for releasing PCS updates to our estate of practices

• Move from 4 week patching cycle• Move to 8 week patching cycle

New patch release process

• A sequence of phases of release, with an initial clinical witness phase, followed by an extended (3 weeks) pilot phase with testing on PCS application as well as interactions with national and 3rd party systems.

• A period of stability where no releases are made to the estate.

• A quick release process for issues of clinical risk or to meet national timescales (e.g. QOF rules, read codes, drug releases)

Future development• Release 10 (November 2011)

– Prescribing performance release 2– Independent Nurse Prescribing– CMS post pilot development work

• Release A (Jan 2013)– Instalment dispensing text for non GPs– AMS messaging for Stored scripts

• Release B (late Feb 2013)– GP2GP phase 1

• Release C (early Apr 2013)– AMS messaging for dispensing scripts– Prescribing alerts stop

GP2GP

• Transfer of structured GP record between practices• Bi-directional cross border transfer• Establishment of lifelong UK GP record with minimal

degradation • MIG ?

• Working in partnership with PSD• Minimal disruption to Docman / eLinks transfer process

EMIS Web GP

• EMIS Web requires SEF development for use in GP estate– Development resource committed

• No current timescale– Original SEF group disbanded– Not all tranches of development relevant to

hosted technology – Practice / HB appetite varied

• Mature user base ready• HBs not ready to support roll-out (e.g. GG&C)

EMIS Web GP

• GPITC&SM Group remain fully committed to EMIS PCS – Under framework contract

• Specific areas of discontent in EMIS PCS would be addressed– S&R, Prescribing, App Book, QOF Recall, PSD

transactions, decision support tools

What are we doing next?• Remainder of 2012

– Move A&A and GG&C Web community projects towards implementation

– Move all other Web opportunities to planning / pre-implementation

– Drive local marketing message– Increase awareness of EMIS products and services in

secondary domain– Continue to seek opportunities in community / extended /

acute settings• Interoperability opportunities (TRAK, Midas, Adastra, etc)

– Continue to support NHS Scotland efficiency agenda

2013 and beyond

• Established flag ship community project for Scotland (a la Cumbria, Liverpool)

• SEF accredited EMIS Web GP– Enthusiastic EMIS Web user base

• EMIS products and services established in secondary / community care domain– Primary care interoperability

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