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TRANSCRIPT
IInnffoorrmmaattiioonn MMaannaaggeemmeenntt &&
TTeecchhnnoollooggyy SSttrraatteeggyy
2014 to 2019
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Document Name
Information Management & Technology Strategy 2014/19
File Name
IMT Strategy New Version October 0.7
Author / Contributors
Tim Rycroft / Stuart Shaw / Ben Jackson / Martin Fisher / Andrew Leng
Version
0.7
Change Control
Version Date Record of Change Authority
December 2013 N/A Trust Board
27/01/14 CEG
11/02/14 EDG Strategy
25/03/14 EDG Strategy
23/04/14 Patient Thread / Vision EDG Strategy
13/04/14 5 Year Plan EDG Strategy
10/10/14 IM&T Steering Group
Distribution List
Name / Group Title
Andrew Copley Director of Finance
Stuart Shaw Head of Planning & Performance
Martin Fisher Head of Information
Andrew Leng Senior IT Architect
Dr Justin Tuggey Caldicott Guardian
David Worth Programme Director Digital Care
IM&T Strategic Steering Group
Clinical Executive Group
Executive Directors Group
Approvals
Sponsor Name Signature Date
IM&T Strategic Steering Group Andrew Copley October 2014
CEG
EDG Bridget Fletcher September 2014
Trust Board Chairman October 2014
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Contents
1 Introduction 7
2 National Strategic Context 8
3 Direction of Travel 10
4 Strategic Context for IM&T Services 12
Transforming Clinical Service Delivery (Applications) 16
Developing the Information Platform 17
Enabling Technology – Infrastructure & Supporting Services 23
5 Investment 26
6 Benefits Management 27
7 IM&T Governance 28
8 IM&T Strategic Principles 30
9 Digital Roadmap 31
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This updated Information Management & Technology strategy is designed to support the
Foundation Trusts response to the current challenges in the health and care sector and to
further address additional areas of development in relation to our own specific information
and technology requirements that support the delivery of the Right Care vision and
operational objectives of the Trust.
The previous Foundation Trust’s IM&T Strategy focused in particular on the design, delivery
and implementation of information systems and the supporting infrastructure that have, to
date, enabled progression towards the Foundation Trusts key strategic objectives. In
particular, the focus placed over the past couple of years was on developing the clinical
systems in line with the established roadmap outlined previously in the National Programme
for IT (i.e. developing the Clinical 5; PAS, Bed Management, e-discharge, e-prescribing and
Order Communications).
This IM&T strategy will aim to set out how the technology platform needs to be further
developed to build on the current position whilst meeting the priorities and challenges
ahead, in particular how the approach supports the digital care programme enabling service
transformation, improving quality and greater efficiency.
Importantly, this updated strategy will also expand on delivering the requirements of both
the national and local information agenda, by further identifying the key challenges and
putting in place a set of supporting strategies that allow the Foundation Trust to respond
effectively to both through a particular focus on information optimisation.
The approach taken shall set out how we plan to respond to the increasing levels of
openness and transparency required at individual, service, organisation and sector level in
support of the national information requirements, whilst also improving the way in which we
produce data and information.
The themes detailed in this strategy are high level only and will be further developed in
conjunction with all stakeholders and as part of the annual and 2-5 year planning process.
The identified themes also support the Trust Right Care Programme. The IM&T strategy will
act as both a driver in inspiring group and overall Trust level plans and the delivery of
associated benefits.
In line with other current strategic requirements, the strategy will contain a roadmap for the
next two years as part of a wider five year strategic outlook.
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Information is at the heart of the NHS agenda as described in The Power of Information
Strategy produced by the Department of Health (2012). The big data agenda, although not
yet mandatory, is a clear indication that the information we store and manage will play a
significant part in the development and enhancement of healthcare in the future.
The publication of a national information strategy establishes the strategic approach to be
taken towards the delivery of information led services. One of the key national policy aims is
to modernise health services and improve health outcomes, by putting patients first in every
decision that the NHS makes. As set out in the NHS England guidance Everyone Counts:
Planning For Patients 2014/2015 to 2018/2019, a number of key strategies are outlined such
as the requirement for greater transparency and participation, putting patients and
citizens in control and better outcomes for patents.
Underpinning this vision is the need for high quality information so that everyone can make
the right decision at the right time. To support this, a modern data service is being
developed for the NHS that will provide NHS organisations, citizens and researchers with
accurate, timely information which will radically transform the way we care for and treat
people and continuously improve the services we offer.
In addition, key recommendations from national inquiries, such as those included in the
Francis Report, are highlighting the requirement for a greater level of transparency in the
information being made available by organisations;
“All healthcare provider organisations should develop and publish real time
information on the performance of their consultants and specialist teams in relation to
mortality, morbidity, outcome and patient satisfaction, and on the performance of each
team and their services against the fundamental standards”.
The core principles outlined above build on the strategic direction set out in the published
guidance liberating the NHS: Equity and Excellence and an Information Revolution.
In addition to the national information strategy, NHS England published an associated
strategy ‘achieving integrated health and care records’ (2014) this forms part of the Safer
Hospital Safer Wards technology fund which highlights the benefits to the NHS of investing
in the creation and routine use of integrated digital care records. It is however recognised
that the creation and adoption of iDCR is not an end in itself, it is the catalyst upon which
increased transparency and participation in our health and care system depends. It is
therefore the purpose of the Trust Right Care strategy to address the wider requirements
and the delivery of truly integrated care setting, therefore the technology used is only an
enabler to the process.
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The delivery of an iDCR is enabler toward supporting the following outcomes;
To help organisations assess their digital progress, NHS England has produced a clinical
digital maturity index (CDMI) which enables organisations to benchmark against each other.
It is hoped that this tool will enables NHS Trusts to better understand how investing in, then
effectively using, information technology can achieve better patient outcomes, reduce
bureaucracy, improve patient safety and deliver efficiencies. It is the aim of this strategy and
its subsequent delivery to utilise this benchmarking tool as evidence and achievement of
success. The Trust is currently positioned at number 27, out of 160 NHS organisations. It is
therefore our overall aspiration and intention to improve on our digital maturity standing by
achieving a top ten position.
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The local health and social care economy faces a significant financial challenge in continuing
to deliver safe, high quality care to an increasing, ageing population, without a
corresponding increase in allocations. Through its current strategic approach on the future
state, the Foundation Trust is setting out a vision of patient centred, integrated and
coordinated care across the , primary, secondary, social and voluntary care sectors as well as
in patients own homes that shall transform the manner in which services are provided and
generate greater efficiency across the health and care sector.
We want our local community to trust us to always provide the Right Care, with our focus on
putting patients at the heart of everything we do. We need to enable patients to be in
control of their health and care and respond to their needs and wants in a way that best suits
them, when it is safe to do so.
Right Care is a health and social system-wide approach to care with the patient, around the
patient and for the patient. Driven by the needs of each person, not those of professionals or
organisations, Right Care wraps itself around the individual in a way that is right for them
and makes them feel empowered, active and safe. Care is provided by a range of care
providers - dependent upon the needs of the individual - utilising community assets and
enabled by technology to both improve the patient experience through a more integrated,
right first time offer that makes the best use of tax payer resources.
As set out in the following diagram, our patient is at the heart of the picture, supported at
home in a way that best meets their needs, enabled by technology.
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Both technology and information models have traditionally focussed on the hospital based
approach and whilst these have evolved in recent years to include the integration of
community services, full system wide service integration would be reliant on both supporting
information and technology across a number of settings. Without the ability to analyse care
and services in this way, there is a danger that decisions made in one setting will adversely
affect patient care in another setting. Without integrated systems, the patient experience will
continue with repeating of information to professionals.
In addition to the Right Care Strategy, the Right Care programme being run within the
Foundation Trust is supporting the transformation of service delivery across a number of
programme areas whilst maximising efficiencies that aim to achieve the following
transformations objectives
The Digital Care programme is a key enabler and provides the relevant mechanism for
providing the appropriate governance around the prioritisation and delivery of the key
systems that support the Right Care portfolio. It also provides a supporting role for service
transformation through the Integrated Care Board (ICB) across the district.
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The creation of this IM&T strategy has been informed by the Trusts strategic five year plan
2014 to 2019, which encapsulates the Right Care vision. In addition and further to our Right
Care vision, IM&T are informed by the wider business requirements of the Trust and external
factors such as the Safer Hospital, Safer Wards Technology fund that have and continue to
influence our information and technology choices.
The following supporting themes and associated layers have been created in response to
those key drivers;
Business Patient Clinician
Transforming Clincial Service Delivery
(Business Change)
Transforming Clincial Service Delivery (Applications)
Developing the Information Platform (Information)
Enabling Technology - Infrastructure & Supporting Services (Technology)
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Improving the Patient Experience
The patient is at the centre of everything that we do and the following core themes aim to
support the Trusts objectives towards the delivery of the Right Care vision. It must however
be noted that this IM&T strategy cannot deliver the benefits in isolation, it is only an enabler
and therefore it must be led by a robust business and clinical change programme to fully
realise the benefits and to ultimately achieve our vision of the future – Right Care.
a) Transforming Clinical Service Delivery (Applications & Business Change)
This theme is a continuation from the previous IM&T strategy and supports the delivery of
the digital care programme and our vision towards a digital hospital. The focus will be
centred on the delivery of an integrated digital care record across secondary, primary care
and social care.
To date a significant amount of work has been accomplished towards realising this vision
and notably our implementation of SystmOne PAS and Bed management. This has enabled
the foundation of an integrated digital care record to be created and has already delivered
the associated benefits expected. This is soon to be joined by Social Services, who are
currently in the early stages of implementing a specific social care module using the same
shared platform, SystmOne.
b) Developing the information platform
As we continue to implement and integrate information systems across the Trust, we are by
default creating a rich information economy that we can use to improve both our business
and clinical advantage. This theme will focus on how we deliver and evolve our information
and business intelligence requirements for the future, not just within the Trust, but
potentially across the region.
c) Technology Standards and improvements
The above three themes can only be fully supported by the delivery of a modern IT
infrastructure and supporting service that can respond quickly to a diverse and ever evolving
workforce and associated business priorities. Our aim is to ensure that underpinning
infrastructure is fit for purpose and truly integrated and scalable, not only within the Trust,
but across health and social care boundaries.
The next section highlights the key outcomes expected from each theme.
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Key Outcomes enabled by the supporting themes.
Online access to a range of clinical services
that provides information pertinent to the
patients individual healthcare needs,
The ability to access their care record online,
empowering each patient to understand and manage
their healthcare needs.
Access to information about clinical
performance and information about
individuals associated with the delivery of
healthcare to the patient.
Clear navigational pathways and accessible via a
range of media, such as smart phones, tablets and
social media
Access to telemedicine and tele-monitoring
technologies in support of their current and
future healthcare needs.
The use of automated outpatient booking and check
in services & SMS text appointment reminder
services.
Access to information kiosks and displays to
help guide patients and visitors through the
hospital.
Access to wireless hotspots enabling access to a
range of digital services, such as email, digital TV and
internet based services.
TTrraannssffoorrmmiinngg CClliinniiccaall SSeerrvviiccee DDeelliivveerryy Key Outcomes
An integrated digital care record (iDCR) that
provides a real time, shared and accurate record
of care for all patients and that provides clinicians
with the ability to operate anywhere across the
health care community, within the bounds of set
information governance and security standards.
Developing a partnership approach with key
stakeholder organisations regarding Pharmacy
and through the use of the integrated digital
record thus enabling self-care management with
the Patient, GP, Pharmacist and Consultant which
will support the reduction in the wastage in drug
prescribing.
Risk reduction of medicine related adverse
reactions, misadventures and complications, &
reduction in Trust’s overall drug budget through
provision of a sophisticated Electronic Prescribing
& Medicines Management system
The ability to communicate electronically with
GPs involving the transmission of discharge
summaries and results and other clinical
correspondence relating to the care of the
patient.
Through the use of self-care application diagnosis
support, potentially reducing demands on GP and
Outpatient follow up requirements;
A Trust wide resource scheduling (discharge
planning & bed management) system to ensure
clear visibility & communication of patent activity
The greater use of e-consultations e-advice and
Telemedicine with the potential to reduce or
replace Outpatient first attendances and follow up
appointments
Ease of access to the information systems
facilitated via a single sign on authentication
process, eliminating the need for multiple system
logon across a range of disciplines.
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The use of innovative mobile end point devices
that enable the recording and retrieval of
healthcare information near to the bedside, such
as digital dictation and voice recognition and
eObservations (Vital Signs)
Less reliance on paper and a move towards paper
lite working practices.
DDeevveellooppiinngg tthhee IInnffoorrmmaattiioonn PPllaattffoorrmm Key Outcomes
Access to clinical knowledge and intelligence that
supports them in their treatment of the patient.
Access to enhanced business intelligence tools for
monitoring and managing the performance
requirements of the Trust.
Real time information exchange between
operational and back office systems to enable
requirements such as patient level costing (PLiCs)
to be delivered.
information that they need, reduces the need for
the information team to be involved in low level
transactional requests allowing them to focus on
more complex analysis and data mining
Improved Business Intelligence capabilities
supporting business planning and business cases.
Merging legacy community & speciality SystmOne
units with the Acute unit to ensure a single
SystmOne instance is in use
Improved access to information Improved Data Quality
Improved management and decision making of
patient care.
Enhanced document management capability to
ensure greater control of information assets.
Improved integration of information between
PAS and other hospital systems
Enables users to self serve and mine information
pertinent to their needs
Standardisation of reporting
TTeecchhnnoollooggiieess,, SSttaannddaarrddss aanndd IInnffrraassttrruuccttuurree Key Outcomes
Improved access to information via a range of
mobile technologies
Enhanced business continuity and security
Availability – high availability of systems and
networked services
Assurance and Integrity – stringently audited and
accredited networks and applications
Sustained Reliability – improving resilience,
infrastructure performance and support services
Increased Capacity – enhanced back office
information management infrastructure and
storage.
Flexibility – flexible use of services to meet the
business need
Sustainability – adoption of carbon efficient
technologies
Integrated voice and data Shared service and centralisation of data
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Transforming Clinical Service Delivery (Digital Care) 2019 Vision
Integrated Digital Care Record / Co-ordinated Care / Real Time working / Self Care / Anticipatory Care / Data Quality/ Accessible / Paperlite / Care closer to home – Right Care.
Central to achieving the Right Care vision is the development of one patient, one record,
with the various health and social care providers all having access to one centralised patient
record. With our recent investment and implementation of SystmOne Acute system and a
significant central allocation received for the Safer Hospitals Safer Wards programme, we are
one of the first hospitals in the country to have a shared record with primary care. This is
soon to be followed with social services also being integrated with this system. This will really
help avoid duplication, enable front line teams to make quicker decisions and better
communicate with other services, which in turn improves safety and enhances patient
experience. This also helps to close the gap between primary and secondary care.
Having shared records and self care devices will help us build up a detailed picture of the
health status of our local population’s health status. This in turn helps us better understand
their needs and helps us respond to population needs in a better way, tailored to the needs
of the individual.
By further refining our operational process aimed at closing the gap between our
administrative and Clinical process.
Evolving from a formative PAS system into a real-time integrated digital care record
To further refine our patient flow process and evolve the system away from bed
management to patient management.
By continuing our systems implementation of SystmOne Acute modules;
eDischarge
EPMA
Service Requesting
By introducing further enriched functionality, such as real-time vital sign monitoring
By upgrading and replacing and further integrating our supporting non SystmOne
application portfolio to enrich the information experience.
We will achieve this by
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Developing the Information Platform 2019 Vision Business Intelligence / Data Quality / Systems Integration / Self Serve / Automated / Information Analysis / Standardisation / Real Time / Ownership / Visibility
Our vision for information management is centred on total systems integration and quality
standards for managing information. It is also will enable users to take greater ownership
over data and how they retrieve information by using self serve automated process..
Building on the foundation of SystmOne Acute and the wider business and clinical
application landscape the further development of the information platform will focus on four
key areas to further strengthen information provision supporting clinical and business
requirements, for use both within and outside the organisation;
1) Integrating Key Data
2) Standardised Approach to Information Systems Management
3) Centralised Corporate Information Business Intelligence
4) Clinician Owned Information
Integrating Key Data Historically the Trust has operated a significant number of different clinical and corporate
information systems and some exceptions, these information systems have not been
integrated into a central trust wide data warehouse. This has resulted in the following
pressures:
Multiple entry of the same information within different systems.
Different proprietary reporting tools used by different systems.
Multiple data models (i.e. ways of representing information).
Significant resource spent extracting, transforming & manipulating information
In addition, the Foundation Trust does not currently have a unified system for displaying,
searching or interrogating key clinical, performance and financial information.
In response to this our Digital Care programme now sets out a roadmap for replacing many
of the existing clinical systems with SystmOne functionality. The implementation of this
provides the basis for a full enterprise electronic patient record (IDCR).
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In addition to the immediate clinical and operational benefits provided by an iDCR, there will
be significant information and reporting benefits from reducing the number of data silos.
Additional benefits to this approach will be the standardisation of clinical and management
reporting and a greater emphasis on information analysis rather than data collection,
processing and reporting.
Acknowledging that investment to increase the size of the information provision in the
organisation is unlikely, our priority approach will be to integrate clinical and business data
through a data warehouse, automate the processing to provide centralised standard
information through self-service function and in doing so, develop the information services
function to provide greater analytical support to the organisation.
In November 2012 the Foundation Trust became the first General and Acute hospital to
adopt TPP’s SystmOne as a Patient Administration System (PAS). The majority of Airedale’s
patients now have a shared record between primary and secondary care.
SystmOne also has a social care module and so the platform exists to develop a combined
health and social care record for the Foundation Trust’s patients.
reducing Information Silo’s – (In addition to the immediate clinical and operational
benefits provided by an iDCR, there will be significant information and reporting benefits
from reducing the number of data silos.)
the standardisation of clinical and management reporting and a greater emphasis on
information analysis rather than data collection, processing and reporting.
to integrate clinical and business data through a data warehouse, automate the
processing to provide centralised standard information through self-service function and
in doing so, develop the information services function to provide greater analytical
support to the organisation.
We will achieve this by
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Standardised Approach to Information Systems Management
A number of different information systems currently exist within the Foundation Trust, many
of which play a key role in the delivery of patient care and corporate management
operations. Information management within the Trust has historically been provided at both
a departmental and corporate level, depending on the usage of the particular application
system. System level security policies (SLSPs) provide some measure of governance
standardisation across the Trust.
Information management within the Trust has historically been provided at both a
departmental and corporate level, depending on the usage of the particular application
system. System level security policies (SLSPs) provide some measure of governance
standardisation across the Trust.
The evolution of the Electronic Patient Record means that information management
increasingly cuts across the organisation since the record is shared and no longer ‘belongs’
to a particular department. Data is increasingly entered directly by clinicians rather than
being transcribed from a paper record by an administrator.
A need to assess the management of these systems so that they work to optimum best
practices and have controls that are aligned to information Governance standards and best
practice in application management.
Established change management processes;
Effective monitoring of data quality and adherence to standard operating procedures for
data entry;
Real time data entry.
Centralised Corporate Data Warehouse
This part of the strategy will focus on integrating both clinical and non-clinical data a
centralised corporate data warehouse. Reference has already been made to the fact that
there is a large volume of data which resides in decentralised data silos, resulting in the
dilution of the usefulness of the data. Implementing a centralised corporate data warehouse
would remove this obstacle as data will now reside in one central point.
The key principles are:
The Foundation Trust will support clinicians and managers by developing a centralised
data warehouse meaning that data no longer will reside in data silos.
We will achieve this by
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Data extraction and manipulation should be accomplished using proven industry
standard extract, transform and load (ETL) tools.
Data storage should be accomplished using proven industry standard data warehouse
software and hardware.
Industry standard hardware and software will be used as the platform for the data
warehouse to function so as to maintain high performance, functionality and integrated
security.
Improving data quality through the fact that data has to be entered just once and
multiple times leading to conflicting answers.
Bringing the data together will allow the Trust to make more informed decisions as it is now
possible to create a richer picture from the data that can now be utilised by the business
intelligence solution.
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Centralised Corporate Information Business Intelligence
This part of the strategy will focus on utilising integrated data and making it available to all
through Intranet and SharePoint environments.
The key principles are:
The Foundation Trust will support clinicians and managers by developing a centralised
intranet based reporting portal to access key information.
Data presentation should be delivered to the end users via proven industry business
intelligence reporting solutions.
Replacement key information systems should provide industry standard data warehouse
interfaces.
Clinicians will be given drill though access to their information.
Information services staff will transition away from data processing and instead provide
more added value analysis.
Through improved use of data it follows suit that data quality will improve due to the fact
that data quality issues are quickly highlighted.
Dashboards will be developed to present a key message so that the end user will be able
to quickly understand if there is an issue which needs addressing.
Using the Trusts data to be able to easily present a story as to what may or not be
occurring within a story.
Linking complex data in a straight forward, easy to comprehend visual report or
dashboard.
Enabling access to data when the end user wishes to access it as opposed to when a
member of the information services team provides it to them.
Patient care will be improved through enhanced decision making derived from high data
quality.
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Clinician Owned Information
Information plays an increasingly important role within the NHS and is used to:
Measure Clinical Outcomes
Determine provider income through the payment by results framework (PbR)
Measure Performance
Inform planning and commissioning decisions
Benchmark different organisations
Provider Trusts are required to submit a variety of granular data to commissioners and
national bodies to support these objectives.
Once information is forwarded, the Foundation Trust usually has little control over how it will
be used or interpreted. It is therefore vital that information flowing externally is complete
and accurate so as to protect against damage to reputation within the wider health and
social care economy and loss of confidence from patients.
Clinicians are best placed and qualified to ensure information held about the services
provided and their patients is complete and correct.
The Trust must also ensure that local information is produced in line with the following
principles:
Timely
Accurate & Complete
Consistent / Secure / Relevant
Efficient
Accessible
How clinicians access both high level reports and patient data.
Mechanisms for clinicians to address inaccuracies, data completeness and data quality
How managers access the information they require to monitor performance, drive
improvement and improve patient care.
Optimal processes for the production and dissemination of information
We will achieve this by
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Enabling Technology – Infrastructure & Supporting Services
Vision 2019 Integration & Common standards / High Availability / Enhanced Security & System Integrity / Business Continuity / Agile & Mobile Working / Accessibility / Resilient / Flexible / Partnership, Shared Working / Virtualisation / Self serve / Secure Cloud / Unified Communications
Patient driven and Right Care led, IM&T are informed by industry best practice
which enables us to ensure the effective delivery and support of high quality,
value added, innovative information and technology solutions and services to
the Foundation Trust.
Recognising that a hospital centric IM&T service is no longer viable in the future, IM&T will
seek to identify a new ways of delivering IM&T service models for the future. This likely to
include partnership and shared working arrangements with peer organisations, or even
private sector partnerships as appropriate. This work will be addressed via the improving
corporate service programme that is responsible for the re design of corporate services and
associated functions.
In terms of the Trusts technical infrastructure, such as networks, storage and desktop
services, we will continue to progress our agenda by adopting appropriate technologies and
universal standards that meet the current and future needs of the organisation. By doing so
we can ensure that any future integration and or re design of services is as seamless as
possible, minimising any unnecessary disruption to the business and clinical operations of
the Trust.
Actively seeking out opportunities with potential partners and to identify where synergies
can be delivered in the provision of IM&T services. Collaborative working, shared
capabilities and the procurement and acquisitions of services and infrastructure which
are all common to our peer organisations.
Utilising the Trusts IP network infrastructure by converging both voice and data together
enabling the support and delivery of a range of unified digital services, including
telemedicine, telephony, video conferencing, remote working and wireless services to
both, public and private users.
We will achieve this by
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Continuing to evolve our desktop infrastructure from a localised to a centralised virtual
service, providing an enhanced user experience that enables greater efficiencies and
flexible ways of working. Virtualisation of the desktop will also enhance our ability to
manage applications and increase our resilience with regard to information security and
greater control and appropriate allocation of licensing.
Storage – where ever possible we will look to reduce our onsite storage by utilising
shared data stores within the Cloud setting. This will enable greater business continuity
and disaster recover options and a reduction in continued capital investment in server
architecture.
Software – a move to software as a service, or pay as you go options for software
provision. This approach will enable greater choice and convenience and ultimately
reduce our cost in the way that we use application software in the future. We will also
look to review open source software solutions and where this approach can support the
business.
maintain a focus on identifying and exploiting new and innovative mobile based
technologies and applications that will enable us to reach new practices of care that
supports the needs of the modern mobile worker, allowing them to work anywhere and
at anytime in a safe and accessible way.
Security – always remains paramount in terms of the work that we do and we will look to
assess the risks and to ensure that appropriate and safe and secure infrastructure in place
to protect the integrity of the service that you provide and ultimately paint information
Maintaining a high level of strategic awareness, enabling us to be responsive to the
challenges, constraints and opportunities of the Trust and to identify were suitable
appropriate technologies can be deployed to help and support the Trust meet its
objectives.
Working together with industry partners to identify and assess innovative solutions that
can support the business by driving down cost with a real focus on adding value.
Maintaining professional standards and working practices aligned to best practice
methodologies such as ITiL, CoBiT, ISO standards, that will provide a basis for the
attainment of professional accreditation of IM&T Services. Recognition of accreditation
will provide confidence to new and emerging business development opportunities and
provide assurances to the Trust that professional standards are being met at all times.
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Providing of a modern and responsive IT service desk that promotes greater ownership
and the use of self help tools. This will allow more time for support operatives to deal
with more complex and value added support requests and incidents
Responding to Caldicott2 recommendations and making information more readily
accessible and that maintains a stringent focus on information governance and security
to maintain the confidentiality, integrity and accessibility of information at all times.
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The IM&T strategy will be supported by two capital schemes, one centrally funded via NHS
England, Integrated Digital Care Fund, the other will part of the Trust 10 year annual Capital
Programme
NHS England / Strategic Systems & Technology / Integrated Digital Care Fund
AHNSFT in partnership with Bradford District Care Trust, Bradford Teaching Hospitals and
Bradford Council and support from the regional CCG’s submitted a joint application for
funding to support the delivery of an integrated digital care record across the whole health
community. The outcome of the bid was successful and in addition to the £6Million funding
awarded the bid consortium have been selected to be one of NHS England’s accelerator
sites. The Bradford partnership is one of three organisations selected from across the
country to demonstrate an exemplar approach towards modernising healthcare through the
use of an IDCR.
ANHSFT allocation of the £6Million amounts to £4Million, of which the first tranche of
funding of £780k is profiled for financial year 2013/2014. The remainder will be delivered
over the course of 2014/2015
This funding is specifically aimed at the delivery of the following initiatives through the
acquisition of skills and capabilities and supporting infrastructure.
ePrescribing/Medicines Administration,
eDischarge
Service Requesting
Infrastructure / enhanced Wireless capability
End user devices, such as tablets, laptops and PC’s
Trust Capital
The second capital scheme will focus on the business as usual requirements such as the
scheduled desktop replacement scheme, increased storage capacity and network
maintenance. Investment may also be used to develop and deliver applications used to
support clinical and business practices.
The approved financial investment profile for the next five years is as follows;
14/15 = £500k
15/16 = £1M
16/17 = £1M
17/18 = £1M
18/19 = £1M
27
In addition to the investment made by the Trust, the use of capital schemes will incur
deprecation charges. Based on our £1Million annual capital allocation we could expect
deprecation charges up to £200k, depending on the life of the asset, typically five years on
an average basis.
Further to the capital charges incurred, new systems and services will inevitably involve new
and additional revenue charges. It is therefore the focus of the received business cases to
demonstrate best value and return on investment in the choices that we make.
66.. BBeenneeffiittss MMaannaaggeemmeenntt
To support the implementation and delivery of this Strategy to its full potential will require a
level of development both within the Foundation Trust and wider health and care system to
ensure the effectiveness and efficiency of processes are maximised and benefits realised.
The IM&T opportunities identified will need to be fully considered and evaluated and where
change is considered to be crucial to supporting implementation, improvement and
sustainability, it will be essential to ensure this is identified, understood and embraced at all
levels in the organisation and that the relevant engagement is in place to support delivery.
Our overall approach therefore needs to consider the following;
System – What are we trying to achieve?
Capacity – Have we got the resources to complete, what are the gaps and how do we
reduce these?
Strategy – What is our approach to development, implementation and transformation?
Culture – What are the key values and behaviours required to deliver, implement change
and realise benefits?
System Wide Change – How we develop this change across our health and care system?
Focus - Ensuring at all times we remain patient focussed and have the right level of staff
engagement in the changes we are trying to bring about.
(Based on NHS Employers/NHS Leadership Academy Doing OD in the NHS (2013)
Identify Plan Execute Review
28
77.. IIMM&&TT SSttrraatteeggyy GGoovveerrnnaannccee
The delivery of the IM&T strategy will be managed by the Executive IM&T Steering Group in
particular those initiatives that support the delivery of an integrated digital care record will
be delivered by the Digital Care Programme.
The aim of this group will pull together all of the Trusts information based services under
one overarching governance structure, with the objective of asking;
Are we doing the right things?
Are we doing them in the right way?
Are we doing them well?
Are we realising the benefits?
And to;
Ensure that IM&T strategy and innovation is aligned to Trust Strategy and vision
Ensure that infrastructure is in place to enable appropriate service delivery
Manage IM&T Risk
Provide IT Programme and Project Oversight
Resource Management
Investment decisions (Value Appraisal)
To mandate new projects in support of the Trust objectives and priorities
Thereby ensuring that the following benefits for the Trust
Strategic oversight and independent assurance of IM&T
Promote idea generation, innovation and strategic alignment
Clarity and consistency of IM&T communication
Reduction and visibility of information risks
Promote the delivery of value to stakeholders
Visibility of performance
A standardised and consistent approach to the delivery and ongoing support of
information system
Outputs from the group will include;
the delivery and ongoing maintenance of the IM&T Strategy
Escalation and management of key risks to EAG
An agreed investment priorities to CIT
A resource plan aligned to operational and development activities
A monthly performance dashboard to Board
29
IM&T Governance Framework
The following diagram illustrates an overarching IT governance framework recommended for
our purpose. Aligned to industry best practice *CoBIT, which is widely used across Public
Sector and many financial institutions globally, it will serve as a robust framework intended
to strengthen and provide greater visibility and accountability of critical IM&T investments
for now and in the future.
Programmes &
Projects
(MSP/Prince2)
IT Service
Management
(ITiL)
Information
Governance
(ISO 27001/ DPA)
Information
Management
(HSCIC Standards)
Clinical Coding
(National Clinical
Coding Standards)
Medical Records
(RM NHS Code of
Practice)
Programme
Director /
Programme Mgr /
Project Mgr
Head of IT Head of IT/IG
Head of
Information
Head of Clinical
Coding
Head of Medical
Records
Right Care
Digital Care
IT Capital Prog
Other
IM&T Strategy
Design
Transition
Operations
Central Systems
Administration
Development
Support
Information Security
Corporate Info
Assurance
Clinical Info
Assurance
Data Quality
Ext Reporting
Int Reporting
Business Intelligence
Clinical Coding
Data Quality
Medical Record
Strategy
Data Quality
IM&T Steering Group
(CoBiT)
Strategic Alignment (Strategy)
Value Delivery
(Investment)
Risk Management
Resource Management
(Capabilities)
Performance Management
30
88.. IIMM&&TT SSttrraatteeggiicc PPrriinncciipplleess
In support of the IM&T strategy there are some fundamental principles that will enable us to
heighten our success of delivery. The following principles will inform and guide our decision
making with regard to appropriate IM&T investments;
PPaattiieenntt EExxppeerriieennccee DDrriivveenn && BBuussiinneessss LLeedd
the requirements of this strategy will be guided by the Right Care strategy
an appropriate business/clinical sponsor must be appointed to each project.
the value of technology can only be realised by a collective approach to systems
implementation, i.e. people, process and technology. Technology is only an enabler.
we will listen to and involve all of our stakeholders in the design and delivery of IM&T
systems and services.
BBeenneeffiittss DDrriivveenn VVaalluuee aanndd CCoosstt
IM&T will invest in appropriate technologies, ensuring they are proportionate to business
requirements; sustainable and represent best value.
IInnvveessttoorr iinn PPeeooppllee
In order that we continue to provide an effective service post implementation of services,
we must ensure that adequate investment in made available to aid the development and
sustainability of key resources
SSeeccuurree aanndd RReessiilliieenntt
We will deliver IM&T solutions that meet the standards required for the safe
implementation of clinical systems and services.
We will maintain the confidentiality, integrity and availability of information systems and
ongoing compliance against the requirements of IG toolkit
IInntteeggrraattiioonn aanndd SSttaannddaarrddss
Any new technologies that we procure or adopt must adhere to NHS Information
interoperability standards and reporting tools
BBeesstt PPrraaccttiiccee
IM&T are informed by industry best practice which enables us to ensure the effective
delivery of high quality, value added, innovative information and technology services.
IM&T will constantly review the market both within and external to the NHS, recognising
innovation and trends globally.
SSuussttaaiinnaabbllee
We will continue to support the Trust sustain carbon targets by selecting appropriate and
proportionate technologies that minimise the impact on the environment
