SALISBURY NHS FOUNDATION TRUST. TITLE - Information Strategy Annual Review

Transcription

1 SALISBURY NHS FOUNDATION TRUST PAPER - SFT 1931 TITLE - Information Strategy Annual Review PURPOSE OF PAPER To inform the Board as to progress made within the Information Systems Strategy during the past year. EXECUTIVE SUMMARY The IS Strategy remains largely on course despite delays and deployment of limited functionality in CfH provided systems. Whilst many national systems are providing basic support to business processes locally deployed systems have and are being deployed to support local need with significant success. The isoft7 arrangements under CfH for provision of the Patient Administration System (PAS) are starting a planned strategic review which, in the light of the current uncertainty around CfH arrangements for Trusts in the South of England is timely and appropriate. This, combined with a need to support local Trust needs more effectively that is currently available through CfH provided systems, suggests that alongside the deployment of targeted departmental systems (such as maternity) the Trust should deploy an Ordercomms system in 2009/10. The main IT network will also be replaced in 2009/10 providing a continued high level of service to Trust users well into the next decade. This will also allow scaling to support new builds and the ability to be upgrades to support technologies such as Voice over IP. The isoft7 review offers the opportunity for an early update of the IS Strategy. This will be accomplished by re-establishing the Information Systems Strategy Group which will regularly report to the Board. ACTION REQUIRED BY THE BOARD The Trust Board is asked to note the contents of this report. Name Position Peter Russell Head of IT

2 IS Systems Strategy Update December 2008 Author s name Peter Russell Head of IT Peter.Russell@salisbury.nhs.uk

3 Version Control Version Number Date November 2008 Draft for CEO comment Reason/Comments/Approvals November 2008 Final version incorporating CEO comments Due Revision Date: Not due for revision once final 2

4 Contents Executive Summary... 4 References Current Position Progress against Strategy National Systems Locally owned systems Issues Short Term Recommendations Clinical systems deployment Other systems Infrastructure Security Strategy Review Summary

5 Executive Summary The IS Strategy remains largely on course despite delays and deployment of limited functionality in CfH provided systems. Whilst many national systems are providing basic support to business processes locally deployed systems have and are being deployed to support local need with significant success. The isoft7 arrangements under CfH for provision of the Patient Administration System (PAS) are starting a planned strategic review which, in the light of the current uncertainty around CfH arrangements for Trusts in the South of England is timely and appropriate. This, combined with a need to support local Trust needs more effectively that is currently available through CfH provided systems, suggests that alongside the deployment of targeted departmental systems (such as maternity) the Trust should deploy an Ordercomms system in 2009/10. The main IT network will also be replaced in 2009/10 providing a continued high level of service to Trust users well into the next decade. This will also allow scaling to support new builds and the ability to be upgrades to support technologies such as Voice over IP. The isoft7 review offers the opportunity for an early update of the IS Strategy. This will be accomplished by re-establishing the Information Systems Strategy Group which will regularly report to the Board. References A. Information Systems Strategy Current Position 1.1 Progress against Strategy The general principles set out in the Strategy apply and are still valid and provide guidelines for the procurement, design, deployment and use of systems well into the future. 4

6 In many cases the NHS is now starting to enforce the requirements identified in the Strategy e.g. use of the NHS number which is now mandated by October 2009 is adequately covered in the Strategy (Reference A, 8.3.4) National Systems Care Records Service (CRS) The isoft PAS was deployed to a CfH data centre managed by the company CSC in December 2008 as part of the isoft7 programme. It is acknowledged by both CfH and CSC that the current product set is less than optimal and the Trust is suffering due to poor functionality. This has caused clinical risk and delays to programmes such as Choose & Book and the use of Teletracking and is only now starting to be slowly rectified. In accordance with the agreement with CfH the isoft7 are now commencing the strategic review of the use of isoft PAS with regard to future use and alignment with other Trusts in the region. It is anticipated that this work will be concluded in summer 2009 and will set a strategic direction for the core CRS for the Trust. Until this has been concluded and new products delivered there will be delays in matching systems functionality to business expectations. Potentially these will have to be countered by short term tactical deployments of specific systems. This has already occurred in the Trust with the procurement of a maternity system and discussions around similar procurements for specific theatres and ordercomms systems, as examples. PACS/RIS PACS/RIS has been deployed in the Trust for 3 ½ years and is functionally little better than the original deployment. This has led to significant frustration with clinicians and excessive expenditure of time and effort by the IT Department to attempt to get CfH to develop the systems to meet the changing needs of the NHS. New functionality should have been delivered by now in the form of a security release. This would have brought with it cross organisational image sharing as well as the key deployment of smartcard access to PACS/RIS and eventually other key systems. 5

7 In mid 2008 CfH terminated the contract with Fujitsu for the provision of PACS/RIS and since then there has been no significant deployment of upgrades; and none are expected until a new supplier has taken over. This may possibly take until mid As with the CRS the IT department is investing significant time and energy into managing this situation. This has been typified by the recent failed upgrade to RIS and the subsequent difficult implementation of the business continuity option by Fujitsu. This is unlikely to be rectified much before end December Locally owned systems Whilst the national systems have experienced some delay the deployment of locally procured and owned systems has been more successful. Pharmacy The Pharmacy Robot was deployed in early 2008 and integrated into the JAC pharmacy system. The Head of Pharmacy is reviewing options for e- prescribing preparing for a future year deployment. Alongside the deployment of the Trust s Wireless LAN (WLAN) and the robot the pharmacy staff have been reviewing the options for mobility with some exciting results relating to making ward to-ups more efficient. Pathology The pathology systems were successfully upgraded in preparation for GP ordercomms to be deployed as linked to the Care Records Service project. That project is currently in progress and is seen as one of the key marketing components for keeping GPs aligned with the Trust. Maternity A successful procurement process has led to tender award and the forecast deployment of maternity in a phased approach starting in 2009 with the onsite staff. A subsequent phase will see the potential for mobile working being explored with community midwives. 6

8 Other systems Systems such as GUM were deployed and others such as the ED systems prepared for upgrading (this should now occur in the next quarter). Wherever possible users are now on HAS 2003 using Office 2003 and other modern applications (a move to Office 2007 is currently discounted). However, the Trust still has some old applications (over which we have no control) which will not work on modern technology and a business critical. These continue to be supported by the IT Department. Integration The Trust has deployed a business integration engine which over time will allow systems to talk to each other and for business logic to be applied to those messages. For example changes to patient information are currently relayed from one LSP s data centre to our other LSPs data centre. In future sophisticated automatic checking will be applied to ensure consistency between systems in the information they hold. The Trust is currently awaiting the delivery from CfH of key integration messages from the isoft PAS. Once delivered these will facilitate the deployment of Teletracking and allow better support into other systems for demographic and admission, transfer and discharge information. This process will further help with key targets such as NHS Number and RTT management as well as allowing more detailed analysis of patient flows for dashboarding. 2 Issues The biggest issue facing the Trust for Information Systems is that of the deployment of effective CfH systems which have not as yet been fully realised. The strategic review being undertaken by the isoft7 Trusts is an ideal opportunity for the Trust to examine options for the future and determine the most appropriate way forward to meet our business objectives. This discussion is further compounded by the termination of the Fujitsu contract last summer. This termination has caused many commercial and contractual problems for Trusts in SPfIT with no clarity as to which LSPs will provide services to Trusts in the future. 7

9 In general the Trust, whilst moving forward in some areas, has suffered from planning blight in critical decisions regarding key systems such as PAS and associated clinical systems. The Trust can probably no longer sustain such blight especially as any option for a move to a new/upgraded CRS will take a minimum of 18 months to get to initial deployment. 3 Short Term Recommendations 3.1 Clinical systems deployment In the coming year it is recommended that the existing isoft PAS is upgrades to a release known as MR6. This will rectify many of the existing known faults in the system. From this local tactical solutions such as maternity, theatres and ordercomms can be bolted on so that the Trust has control over these systems and their impact in business processes. Aside from maternity being deployed the critical system to be deployed is ordercomms. Ordercomms will bring not only benefits to clinical safety and cost reductions it will also (in a similar manner to PACS) engage with the clinical staff and culturally move the organisation to a new level of IT adoption. Thus setting the foundations for deployment of e-prescribing and more advanced clinical use of the systems such as electronic noting. The opportunity to capitalise on the success of the H@N IT project is not being lost and will be sold to other Trusts on a quasi-commercial basis during the coming year. It will also offer the basis for hosting locally developed software supporting processes such as e-discharge. 3.2 Other systems Integration of data as already discussed is vital and the coming year will see increasingly sophisticated deployments supporting both clinical and administrative processes. Many other systems will be deployed and enhanced. As an example there is the potential for the successful digital dictation pilot to be rolled out wider as a full business application. 8

10 3.3 Infrastructure Deployment of replacement and enhanced IT infrastructure must continue to meet the increasing needs of the Trust. The IS Strategy called for Network 1 to be upgraded in This has been delayed, but the major investment in replacement equipment is now necessary to ensure adequate IT service levels. Network 1 provides the core network for all of the Trust s IT outside of the specialist imaging network established for PACS (Network 2). The equipment is old, but has served the Trust well. However Cisco has now declared this obsolete and will longer provide maintenance on the hardware not the firmware that runs the network. Upgrade and expansion is also vital to ensure the option to scale capacity to allow future building work such as Phase 3. Opportunity will also be taken to ensure that further expansion to a Voice over IP (VoIP) telephone network is possible when the Trust requires it. 3.4 Security In modern IT systems security is a key component. Effective security is critical to ensuring the Trust s reputation is not tarnished and maintaining the trust of our patients and staff. Security technology, processes and systems have been enhanced and will continue to evolve to meet the needs of the Trust and the expectation of our stakeholders. Reference B outlines the position in more detail. 3.5 Strategy Review Once there has been clarity of direction of travel from the isoft7 work it is recommended that the IS Strategy is reviewed. This is as recommended in Reference A, but needs to occur during 2009 rather than Summary The Information Systems Strategy remains largely valid despite delays in CfH delivery of fit for purpose systems. Locally procured systems have been more successful at meeting business needs and expectations. It may be that in the short term there is a greater 9

11 need for such systems to fill the gap left by CfH due to non delivery and contractual issues. This would also give the Trust increased control over benefits realisation and meeting local need. Much work needs to be done in the coming year to meet the needs of the existing Strategy and set the foundation for more rapid delivery of new systems in the future. During 2009 the Information Systems Strategy should be reviewed and reissued. This will occur under the guidance of the re-established Information Systems Strategy Group which will be reporting to the Board through the Finance Sub-committee. Peter Russell December