Download The Go-Between Issue 87 April 2009 Information for Information Users

http://www.bcs.org/server.php?show=ConWebDoc.13667
The Go-Between
Information for Information Users
The Go-Between would like to hear from potential
contributors. Articles should be on IM&T related matters
and around 250-400 words in length. Copy deadline for
Issue 88 is 20 May 2009.
For contributions etc. please write to the Editor
(address on back page).
____________________________________________________
In This Issue
ASSIST National Conference
Blood Tracking
Diabetes
Diary
Harmonising Data Standards
News in Brief
Summary Care Record Options
Training Centre Accreditation
____________________________________________________
Blood Tracking
Every year, around one million blood transfusions are
carried out safely and correctly, but occasionally things do
go wrong. Administering the wrong blood type – also
known as ‘ABO incompatibility’ – is the most serious
outcome of blood type error during transfusions. Most of
these incidents are due to the failure of final identity checks
carried out between patients and the blood to be
transfused.
Issue 87 April 2009
sample for cross-matching, to administration of the blood
transfusion.
The pilot will evaluate the blood tracking from the point of
view of:
•
its effectiveness for managing blood;
•
reducing the likelihood of errors in blood transfusions;
and
•
the potential applicability to other areas of healthcare
delivery.
A full independent evaluation of the Mayday NHS Trust
pilot will be undertaken to ensure that the processes are
mapped, the views of all users are taken into account, and
the recommendations and lessons learnt are accurate and
useful.
The pilot includes the passive use of Radio Frequency
Identification (RFID) in patients' wristbands to enhance the
final patient identification check before transfusion.
Mayday NHS Trust intends to track the journey of the blood
from the blood issue fridge to its destination. The hospital
will be installing a Wi-Fi based asset tracking system to
track the location of the blood bags.
The anticipated benefits of an electronic blood tracking
system include:
•
a reduction of inpatient safety incidents
•
automated checking of information
•
a reduction in the number of samples discarded by the
lab; and
•
improved traceability of blood and blood products.
More Information:
http://www.connectingforhealth.nhs.uk/systemsandser
vices/bloodpilot
_______________________________________________
Between 1996 and 2004 five patients died as a direct result
of being given ABO incompatible blood.
ABO
incompatibility also contributed to the deaths of a further
nine patients and caused major illness in 54 patients. The
National Patient Safety Authority set a goal to reduce the
number of ABO incompatible transfusions by 50% within 35 years from January 2005.
Mayday Healthcare Trust in Croydon is piloting an
electronic blood tracking system to further improve the
safety of blood transfusions.
A specification has been developed by the National Patient
Safety Agency (NPSA), National Blood Transfusion
Committee (NBTC) and Serious Hazards of Transfusion
(SHOT): and the Electronic Clinical Transfusion
Management System (ECTMS).
The ECTMS provides guidance on how to ensure patients
receive blood which is cross-matched for them i.e. 'right
patient, right blood'.
The scope of the specification
includes the automated tracking of blood products from
'vein to vein'. Guidance is provided on ordering of blood
transfusion for a patient, through to the taking of blood
Harmonising Data Standards will enable the electronic
sharing of information – see page 2.
_______________________________________________
Training Centre
Accreditation
The objective of the Training Quality Improvement (TQI)
work-stream within NHS Connecting for Health (CfH) is to
improve the overall effectiveness of training to support the
National Programme for IT (NPfIT).
One key aspect of the programme is the Training Centre
Accreditation (TCA) project, which has been initiated in
response to requests from the strategic health authorities
(SHAs) and other local NHS organisations for CfH to
consider the creation and provision of a voluntary,
nationally funded NHS accreditation scheme for IT training
departments.
There are several hundred training centres with
approximately 290 that have responsibility for the delivery
of training for electronic care records and other national
applications, to thousands of NHS staff. NHS training
centres are typically based within Trust Information
Management and Technology (IM&T) departments and
have anything up to 30 people providing a range of training
and development support for organisations that are
implementing new IT systems. In addition, the centres
usually provide general IT skills training, including basic IT
skills and training in the use of Microsoft applications such
as Microsoft Word, Excel, PowerPoint etc.
The Training Centre Accreditation project has been set up
to provide a nationally funded scheme for accreditation that
NHS IT Training Departments can seek to gain and then
retain in the future.
The project will provide a co-ordinated scheme for the
accreditation of NHS IT Training Departments, against a
set of specific standards, to drive up quality of training
delivery over the short and long term. This will incorporate
best practice products and services designed and
developed by the National ETD team in conjunction with
the SHAs and wider NHS.
In order to better understand how current NHS IT Training
Departments currently work, how they are staffed and what
training they provide to their users the TCA project team
ran a survey recently.
Contact: [email protected].
_______________________________________________
ASSIST National
Conference
The theme of this year’s ASSIST National Conference is
“Quality Informatics: your role in delivering the NHS Next
Stage Review” and takes place on Thursday, 4th June
2009 10.00am – 4.00pm at The Gallery, National Exhibition
Centre, Birmingham.
The Government is committed to providing a first class,
modernised National Health Service for all. This requires
the best possible use of information and technology to
support the delivery of the NHS Next Stage Review. The
work and commitment of the health informatics
professional is fundamental to this goal, and the
conference will allow you to hear directly from the people at
the forefront of informatics in the NHS about its future
development. Speakers will include:
•
Christine Connelly, Director General of Informatics,
Department of Health (subject to Parliamentary
commitments);
•
•
Tim Straughan, Chief Executive, NHS Information
Centre for health and social care (NHS IC);
Dr Mark Davies, Medical Director, NHS IC and leading
on clinical metrics, and practising GP.
Delegates will also be able to attend a choice of
workshops, including:
•
Clinical Metrics
•
Electronic Document and Records Management
•
Social Care
•
Summary Care Record and HealthSpace
•
Technical Innovations in Health Care
•
World Class Commissioning and its impact on
Informatics
The conference will also have an exhibition involving a
number of suppliers and delegates will have ample
opportunity for networking with other participants during the
day. The Conference is free to ASSIST members, and
non-members can attend the conference by joining
ASSIST in advance of the conference.
To book and for more information:
www.bcs.org/assist/natconf09
_______________________________________________
Harmonising Data
Standards
Providing holistic care to patients among the various care
settings, agencies and practitioners is dependent upon
good information sharing and good information flows. As
these become increasingly electronic it is vital that the
component data sets are compatible – harmonised – to
ensure that the correct information is shared and systems
can “talk” to one another.
The Logical Record Architecture (LRA) for Health and
Social Care is an initiative that has arisen out of the
increasing need to treat information flows holistically
throughout the NHS, from one care encounter to another,
through to public health and strategic planning services.
The LRA initiative is part of the CfH Informatics Data
Standards Programme set up following the publication of
The Darzi Review and the Health Informatics Review.
Breaks in the information flow, unavailable information (e.g.
through patient records going missing, not being shared
appropriately, or not being immediately accessible), and
large amounts of manual transcription result in patient
safety issues and significant inefficiencies in care planning
and care delivery.
The LRA will harmonise the way that data standards are
specified and used, and provide a process that allows
application designers to fit together information systems in
a way that will allow for better information sharing.
The LRA will determine what data should be shared across
multiple applications, and how data will be managed,
accessed and interpreted between independent information
systems.
The initial release of the LRA is now available (see web
site at the end of this article). It includes:
•
An overview of the LRA
•
A draft of the LRA Release management strategy
•
A description of the scope of release 1
•
A description of the purpose and structure of the key
artefacts that will be produced by the programme.
Release 1 will provide users of the LRA with a set of
Knowledge and Technical Models that accurately reflect
the type of content to be published in future releases. LRA
Release 1 is also intended to test the process for
generating LRA content and to develop metrics that the
LRA team will use to scope the content of future LRA
Releases.
The content of LRA Release 1 is not comprehensive or
fully validated and therefore not suitable to be used in a live
environment.
More Information:
http://www.uktcregistration.nss.cfh.nhs.uk/
_______________________________________________
Summary Care Record
Options
The Summary Care Record (SCR) has been central to the
vision of the National Programme for IT (NPfIT) since its
inception. Whilst the notion of making critical clinical
information available at the point of care – wherever care is
needed in the NHS – is widely supported the contention is
about what is shared and issues around consent. To
address these issues an opt-out option has been piloted by
early adopter sites.
Initially the SCR will contain only basic information such as
current medications, adverse reactions and allergies.
Patients will be able make informed choices concerning
their participation in the electronic sharing of records in two
respects:
•
Storing – they may decide whether or not to have their
GP Summary Record created and uploaded to form
their Summary Care Record, on the NHS Spine;
•
Sharing – a patient whose Summary Care Record is
stored on the NHS Spine, will also have options as to
whether their record is allowed to be shared between
healthcare professionals.
Patients can be reassured that not only will their
permission be asked before their SCR is accessed by any
of the healthcare team, but if they change their mind at any
point about their SCR being available to healthcare teams,
this can be easily prevented.
More information:
http://www.connectingforhealth.nhs.uk/systemsandser
vices/nhscrs/scr/
_______________________________________________
Diabetes
Diabetes is a long term condition affecting nearly 2.5
million people in the UK. People with diabetes often
require contact with several medical specialties for the
surveillance and monitoring of complications. Even people
with no complications still make regular visits to their GP,
hospital diabetes service, retinal screening, a dietician and
podiatrist, whilst others maybe under review by
cardiologists, ophthalmologists, vascular surgeons, renal
physicians to name but a few.
The electronic care record, which allows all this information
to be available in one place and, that can be accessed at
anytime day or night, is an opportunity to make patient care
safer and more efficient.
By ensuring that this information is collected in a
standardised way across England, the quality and
effectiveness of care can be monitored, whilst helping to
inform the commissioning process.
People with diabetes will also be able to access their own
records through HealthSpace which can also be used as a
communication tool between patient and healthcare
professional.
NHS Connecting for Health (CfH) has set up an early
adopter programme designed to discover what works best
and to make improvements for the rest of the NHS, based
on experience in real-life healthcare situations.
Key projects being coordinated by NHS Connecting for
Health and priority areas include:
•
In Bishop Auckland, diabetes templates are being
developed by Dr Paul Peters and colleagues for
Lorenzo.
•
Over in Airedale, Richard Pope is the clinical lead
developing templates for use across the Yorkshire and
Humber region for TPP SystemOne.
•
The 'National Diabetes Audit' for which data collated
from 1.3 million people in England, hosted by the NHS
Information Centre.
•
Ensuring that new IT systems collect data in a
standardised way helps to facilitate data extraction and
makes it much easier for clinicians to contribute
information on patients in England with diabetes.
Following feedback from these early adopters and an
independent evaluation by University College London,
advice has been issued to make it possible to opt out
without attending in person.
Adrian Scott is the National Clinical Lead for diabetes. He
is currently consultant physician in diabetes and general
medicine at the Diabetes Centre, Northern General
Hospital in Sheffield.
The original guidance in 2007 was based on the need to
ensure that patients understood the implications of opting
out.
One of the early adopters, Dorset, has a
geographically-dispersed rural community and has
successfully used a web form, which can be posted.
CfH is also working with the Department of Health's new
National Clinical Director for Diabetes, Dr Rowan Hillson
MBE and Diabetes UK. As well as collaborating with the
Year of Care team to ensure that national IT systems
support the care planning process, Adrian is also a
member of the National Diabetes Information Service
project board which aims to bring together all sources of
data on diabetes in England and make them available to
health professionals and people with diabetes.
Patients will be able to reconsider their choices, if they
wish. The original thinking was that a decision not to share
the record can be altered by the patient at any connected
NHS facility; a decision not to have a record stored can
only be altered at the patient’s GP practice.
Based on this experience and wider feedback, it will
become possible for all patients to opt out by post; an
easier way to opt out than through a visit to the GP
surgery. Patients who wish to discuss their options still
can, either in person or over the phone.
While it is important that patients are given the opportunity
to talk through options, the aim is to make it as easy as
possible for those who have already made up their mind.
More information:
http://www.diabetes.nhs.uk/
_______________________________________________
News in Brief
NHS Mail and Blackberries
Until now, Blackberries have not been supported by
NHSmail. The use of these devices has broken the
NHSmail Acceptable Use Policy. NHS Connecting for
Health has been working with suppliers on an Exchange
ActiveSync solution for Blackberry users. A licensed
Blackberry Exchange ActiveSync solution provided by
Notify now allows users to securely connect their device to
NHSmail. NotifySync is available to NHS staff at a special
discounted rate. See www.nhs.NotifySync.co.uk.
Encryption Update
The national encryption software for the NHS – Safeboot –
has changed its name to Endpoint (although end users
continue to see the Safeboot logo). The software is also
being upgraded: device control replaces port control and
later in the year “ePolicy Orchestrator” management and
reporting is being introduced.
Service Management Web Site
LPfIT (London Programme for IT) has launched a new
public service management web site. There is also a
secure area for LPfIT user group members.
See
http://www.london.nhs.uk/lpfit/service-management.
ID Management Guidance
NHS Spine Upgrade
NHS Connecting for Health will shortly publish toolkits to all
NHS organisations to support their identity and access
management work. The toolkits will focus on strategic
decision making, integration of local HR / RA business
processes and implementation of Position Based Access
Control. Roadshows in the spring and autumn are planned
to support the use of the toolkit.
In March a new release of the NHS Spine introduced
significant changes to the Spine functionality including:
•
implementation of the Summary Care Record
permission to view model
•
ability to edit demographic data through Summary
Care Record Application (SCRa).
•
postcode search via the Clinical Spine Application.
Mental Health Bulletin
Midwives Leaflet
In England, during 2007/08 nearly 1.2 million people were
in contact with NHS specialist mental health services for
adults – a rate of 1 in 50 of the population – of which about
one in eleven (8.9 per cent) spent time as an inpatient For
more statistics see the Information Centre’s Mental Health
Bulletin
at:
http://www.ic.nhs.uk/statistics-and-datacollections/mental-health/nhs-specialist-mental-healthservices/mental-health-bulletin:-second-report.
User Management
NHS Connecting for Health has centrally procured a
software solution for automated user management, prepaid to all English NHS organisations. Automating starters
and leavers minimises administrative overheads and
improves security.
London Info Sharing
There is a proposal for a pan London information sharing
framework. A shadow board has been established to
oversee the rollout which includes representatives from
local authorities (both children’s services and adult social
services), the police, health and London regional
organisations. With one framework, legal requirements
can be managed in one place, reducing cost and
simplifying the system. The framework will include an
information sharing protocol and specific sharing
agreements. London organisations are being asked to sign
up to the framework and make a contribution to the costs.
GP2GP Reaches 500,000
GP2GP is a national system that enables patients'
electronic health records to be transferred directly and
securely from one GP practice to another. More than
5,000 practices are now using GP2GP. This means that
fewer patients have to wait weeks or months for their
medical records to reach their new GP practice. GP2GP
recently completed the 500,000th record transfer.
ESR Users to Use Smartcards
On 7 April NHS Connecting for Health (CfH) announced
that the Electronic Staff Record (ESR) is moving to smart
card access. This is to ensure that staff data is secure to
the same level as patient data. The move is scheduled to
take place between May and August 2009. Trusts are
required to book a slot for the change over and plan for the
change. Contact: [email protected].
NHS Connecting for Health has developed a leaflet
explaining the relevance of the National Programme for IT
to midwifery. See: http://www.connectingforhealth.nhs.uk/
engagement/clinical/ncls/midwives/midwives_lo%20res.pdf
FT Compliance Framework
The Compliance Framework describes Monitor's (the
independent regulator) approach for monitoring compliance
by NHS foundation trusts with the terms of their
authorisation requirements. The latest revision to the
Framework includes assurance of adequate information
governance. See: http://www.monitor-nhsft.gov.uk/ under
– “Our publications”.
___________________________________________________
Diary
28 - 30
Apr 09
HC2009 (Healthcare Computing 2009),
Harrogate
(http://www.hcshowcase.org)
05 May 09
Social Care Information Seminar,
London
(http://www.ic.nhs.uk/news-and-events/events)
20 - 21
May 09
04 Jun 09
Primary Care 2009, NEC, Birmingham
(http://www.primarycare09.co.uk)
ASSIST National Conference, NEC,
Birmingham
(www.assist.org.uk)
___________________________________________________________
Address for correspondence:
The Go-Between,
c/o David Green, Director of IM&T,
SW London & St George’s Mental
Health NHS Trust,
Springfield University Hospital,
Tooting, LONDON SW17 7DJ
020 8772 5602
[email protected]
London & South East