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SystmOne eDSM

By: | Tags: | Comments: 0 | May 16th, 2016

SystmOne eDSM

Leicestershire Implementation

NHS Leicestershire Health Informatics Service {LHIS) developed and implemented a data sharing model across multiple organisations and agencies across Leicestershire.

The SystmOne Enhanced Data Sharing Model (eDSM) facilitates sharing patients health records with other health providers involved in the patient’s care, through a model which uses patient consent to control how the record is shared between different teams of clinical staff both at the point of contact and in the future. The model works on a patient-by-patient basis, which means that if a patient moves to a different area, they will remain on the eDSM model.

Implementing eDSM meant that LHIS found itself facing the challenge of supporting CCGs, and a range of healthcare providers, to agree a consent model across Leicestershire ensuring safe and compliant record sharing. As eDSM touches on all SystmOne users this led to a project with multiple agencies involved in the decision making process which included:

  • University Hospitals of Leicester NHS Trust the provider of Leicestershire acute services
  • Leicester Partnership NHS Trust the provider of mental health and community services
  • Local Hospices such as LOROS and Rainbows which are providers of End of Life Care
  • General Practices (GPs)
  • Prisons units
  • Minor Injury Units

First steps

As LHIS provided support to almost all providers across Leicestershire, who were users of SystmOne, and were the key point of specialism in SystmOne functionality, the IT service were able to guide the healthcare community in aspects of scenario based discussions and decision making.

A project board for implementing eDSM, not led by LHIS, was instigated. The Project Board was supported with strategic, planning and implementation advice from the LHIS Programme and Change Manager (qualified PRINCE 2 Practitioner, MSP), and in depth functionality advice from Business Change Managers (qualified in Change Management and Benefits
Management).

To ensure a successful project LHIS undertook capacity planning both of the LHIS team
implementing the change and for the skills and training that needed to be delivered. Initial project steps prior to going live included a series of facilitation workshops and engagement sessions with all levels and  agencies allowing input on the eDSM sharing model design and how best to
implement the change to eDSM. The workshops also provided a platform to ensure that all managers had a consistent level of knowledge and to provide supplementary information
regarding SystmOne capabilities. This ensured that all staff who were discussing solutions had the same base level of knowledge. In turn this enabled productive discussions and more rapid decision making.

Following the workshops and sessions active engagement was sought with the small
number of organisations that felt they faced challenges by not implementing the model, in alignment with the majority decision. This engagement initially took the form of documenting and understanding the organisations concerns and was followed by dialogues and working with the organisations to delivers some additional training. This approach proved
successful with these organisations who were able to adopt the proposed plan, having
understood the impact of the change to workflow and processes.

Project planning was undertaken to fit in with local strategies and priorities, around the
unmovable go-live date, imposed by TPP.

In addition to the above aspects of the pan Leicestershire support, LHIS provided additional planning advice and guidance to LPT, in respect of implementing the change across a wide range of community services. Plans and timetables were aligned to the overall healthcare
community. Approaches used were a mixture of engagement sessions, run in conjunction with the Trusts Clinical Change Management Team, as well as running over 65 training
sessions for champions, who in turn would cascade train their own teams. The sheer number of staff and timescales left to implement eDSM, meant that this was the best fit method. Guidance and supporting materials were produced and provided in order to support the cascade trainers. Specialist services, such as Child Health and Single Point of Access, received more targeted training and support, as well as floor walking around the go-live.

Electronic referral

Pathways were agreed with the Single Point of Access (SPA) which strengthened links between and workflow across providers. The SPA coordinates all urgent and non-urgent referrals for community nursing, intermediate care, therapy services and admission to community
hospitals across Leicester,

Leicestershire and Rutland. This enables patients receiving care from LPT community health services to call one number for advice or care in between planned visits. Healthcare profes­ sionals can call for advice on referrals, prioritising clinical need and matching a patient’s needs to the right service, avoiding the need to navigate complex systems and multiple points of contact.

Specific templates were developed to support SPA electronic referral processes. This was made possible as LHIS has considerable SystmOne template experience and was able to deliver a template master class which included cascading of SystmOne template skills within LHIS. The electronic referral process supports workflows to primary care using SystmOne and replaces emails and telephone calls.

The LHIS training department (which has been accredited by the Learning and Performance
Institute for 13 years) has ongoing active engagement and linking with the LHIS Information Governance (IG) team. LHIS delivered a series of joint workshops with the GEM Information Governance team (IG) in support of governance requirements.

Transition

To aid the transition and support SystmOne users LHIS developed a comprehensive suite of support materials which included help sheets, patient leaflets, posters, and guides for clinicians. This was
supplemented with future state process maps and amended operational policies and procedures.

At the point of the transition LHIS teams provided support throughout over the migration period. LHIS in agreement with stakeholders took the opportunity to redesign the clinical tree to include the tabbed journal and this was included in delivered user training.

Click here to download this case study in full

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