Smart Healthcare: South | SmartHealthcare.com

Security leads NHS to avoid flashy mobiles

Thu, 25 Feb 2010 15:11:19 GMT

Healthcare officials have warned that service providers expose their community staff to security risks if they issue them with obtrusive mobile devices

Several speakers at the SmartHealthcare.com Mobile and Wireless Healthcare conference, held in Birmingham on 24 February 2010, said that their choices of mobile equipment for community use had been influenced by the need to make hardware easy to disguise.

Tracy Andrew, head of information security and compliance for Berkshire Shared Services, said his organisation had chosen Dell's smaller D and E series laptops for this reason. "If they can be small and unobtrusive, that's better," he told the audience.

He added that the service, which provides IT for Berkshire East and Berkshire West Primary Care Trusts and mental health foundation trust Berkshire Healthcare, has to take account of high levels of crime in Slough and Reading.

Andrew said that £32 Pacsafe bags, which can be locked to a luggage rack or the inside of a car's boot with a laptop inside, provide "a fantastic return on investment" for such workers.

Tina Quinn, clinical and operational lead for Kirklees Community Healthcare Services, said unobtrusiveness was among the reasons that led her organisation to order 600 Panasonic Toughbooks for mobile working. "It's small enough to fit in a normal workbag. It goes into the workbag, and no-one's the wiser that they have the kit on them," she said. A low weight and long battery life were among Kirklees' other reasons for choosing the laptops.

Richard Sargent, ICT change control specialist at Portsmouth Hospitals NHS Trust, said that the trust's trial of BlackBerrys and Anoto digital pens for midwives followed the same logic. "There are some undesirable areas in Portsmouth. We didn't want to show they were carrying a laptop," he said.

The Portsmouth scheme, which allows midwives to record information on mothers to be both on paper and digitally at the same time, also includes an alarm function – if a midwife scores through the trust's logo on a form, the microphone on the BlackBerry is activated and an email sent to the senior midwife, who can listen and contact the police if necessary.

The project is about to go live, following a trial and a training period during which 130 midwives have been getting used to the system.

County and PCT collaborate on telecare deal

Mon, 22 Feb 2010 16:19:32 GMT

The county council and primary care trust for West Sussex have joined forces in awarding a contract for telecare services

The two organisations have signed a £2.35m deal with Wealden and Eastbourne Lifeline under which staff from both will be able to make referrals.

Dee Christie, the county's operations manager for occupation therapy and sensory services, told SmartHealthcare.com that such technology has several benefits for clients. "Telecare can help them feel safer and more independent, and can also provide reassurance to their family," she said.

Older people will be the prime users of the service, but it will also be available to others, such as those with long term conditions. "In the longer term, I'd want to think about that even more," said Christie.

The service will be available across West Sussex, and will include the provision of fall detectors, movement devices able to check if someone getting up from bed at night returns within a set period, medication dispensing reminders and devices able to check that the likes of gas and water taps are turned off. Initially, it is likely to provide equipment and services to hundreds of clients, rising to thousands in the future.

"Our first ambition is to get a good baseline across the county. We've had pockets of good practice up to now," said Christie.

Pilots have shown good results, she added: "The most common thing was that people said they felt so much safer." She said they had the same response from families, who were "able to stand back a little".

Use of telecare elsewhere has also allowed a reduction in the number of hours of care needed for each user, which could save money.

At home with the upwardly mobile: using mobile technology in patients' homes

Wed, 17 Feb 2010 09:00:00 GMT

Treating patients at home requires mobile access to data. A few trusts are learning how to make this work

Home-based care could save the NHS more than £1bn a year, according to a report by Dr Foster Intelligence for Healthcare at Home. But effective community healthcare depends on wider availability of the clinical information used by practitioners in hospital.

For health service organisations, this means providing mobile access to clinical and patient information. Early adopters in the NHS are using mobile devices ranging from smartphones to ruggedised laptops to near field communications (NFC) enabled mobile phones for monitoring, time and location recording.

"In my experience, the use across the UK of technologies to support mobile working among nursing staff is patchy," says Nicholas Hardiker, eHealth adviser to the Royal College of Nursing. "While there are excellent isolated examples, it is frustrating that the majority of front line community staff still do not have the basic technology they need to do their jobs."

Portsmouth Hospitals NHS Trust, with funding from South Central strategic health authority, is introducing BlackBerrys with pen input across its midwifery service from the beginning of March, following a pilot. The so-called 'digipen' technology transmits handwritten patient notes to electronic hospital files.

Deputy head of midwifery Jayne Jempson says: "Our service has 6,000 births a year, about a quarter of which occur in the community, which is very unusual for a maternity service. It could easily be expected that a woman may have between 15 and 20 contacts during the course of her pregnancy and postnatal period so it is those that we are really trying to capture with the digipen.

"We would anticipate that this would really improve patients' experience by giving midwives time to be with them," she adds. "Also, we can better capture the activity that the midwives are doing for payment by results for which maternity services get their funding."

Previously, midwives were required to make multiple copies of patient notes. The project aims to eradicate duplication of data entry and errors, as well as providing real time mobile access to patient data.

In the run-up to its full introduction, 130 clinical staff are training on the new system. "The majority of these will be midwives but there will be some obstetric colleagues, because there are obstetric clinics that take place that need to be recorded, as well as some of the support staff," says Jempson. "People are looking to see what results we get, how it works and take it from there."

Lincs to the community

As director of informatics at NHS North Lincolnshire, Trevor Wright was responsible for deploying mobile technology to support service transformation of community services. He implemented ruggedised laptops developed in conjunction with Panasonic and based on a BT mobile contract that includes special arrangements with other mobile service providers.

This model of mobile working is being developed nationally according to Wright, who adds: "It is fair to say that Yorkshire and Humber have led the way."

Wright now works for NHS Yorkshire and Humber, the local strategic health authority. It has expanded the use of mobile technologies in the community into other primary care trusts including NHS Calderdale, NHS Kirklees and NHS Sheffield.

"North Lincolnshire uses about 600 devices for community based treatment, accessing clinical records while out in the community. It was the first full scale deployment and we have learned lessons from that," says Wright.

The lessons mainly revolve around transformational change and technology: "The transformational change issues are primarily about ensuring that the organisation owns the deployment and the deployment is service-led rather than technology led."

"Initially in North Lincs we put it straight in – give the equipment to the staff and it will deliver," he says, but adds: "That is not the case. The need for a transformational change programme is the first serious lesson."

"With training there was an expectation that staff were well versed in IT," Wright continues. "They were using IT but the introduction of mobile devices and the use of IT in different settings brought with it different challenges so there is certainly a significant need to increase support both in terms of training and technical support.

"Secondly there was a need to review business process and ways of working so rather than just doing the things they used to with the aid of technology there was a need to spend the time reviewing the way they do things to optimise the use of technology."

The biggest technical problem was network availability. "A certain amount of effort in every deployment now goes into testing different service providers and you cannot guarantee good coverage anywhere. What we now advocate is to only assume that this will work 75% of the time," says Wright. "We are now working with suppliers to develop their applications so that they will work in a disconnected way."

He cautions: "Mobile access to clinical systems is very helpful, however you must have robust clinical systems to access to make it worthwhile."

* Portsmouth Hospitals is among the trusts presenting its work at Kable's Mobile and Wireless Healthcare event next week, on 24 February in Birmingham. For more information, click here.

Kent and Medway thins its IT

Thu, 28 Jan 2010 11:50:24 GMT

A mental health and social care trust with 3,000 computers on 100 sites expects to save money with thin client technology

Kent and Medway NHS and Social Care Partnership Trust reckons it will cut £250,000 from its annual costs, as well as saving staff time, by moving to thin client computers.

Les Manley, director of information and IT for the trust, said the £650,000 initiative will generate two type of savings. One is an annual cost saving of £250,000, the other is cost avoidance.

"We are becoming more IT enabled, putting increasing pressure on our networks, so that if we don't do something like this very soon, we would need to upgrade our networks," he told SmartHealthcare.com.

"And that is a significant cost because we are a large organisation with many sites. By using a thin client solution we will be able to put off or even delay indefinitely some of those upgrades. So we are achieving a further £290,000 one off cost saving and £145,000 in ongoing support costs."

The project was not primarily driven by cost savings, but by benefits to patients and staff, Manley said. These include an extension of mobile and remote working, better data security and environmental benefits.

The first phase of the project will see 250 mobile workers and 750 users at locations with smaller network connections going live in early 2010.

"A major issue with remote and mobile working is how you connect back to your office systems, and typically there are two approaches," Manley said. "One is that you are connected to your office systems and the other is that you are disconnected and you synchronise by going back to the office.

"There are problems with both of those generally. If you are connected, it is potentially costly and you have to have quite big connections, unless all your applications are thin to start with. And if you if you synchronise, then you probably have multiple copies of things out there.

"How thin client helps is that it means we can be connected to our systems, but deliver performance as if we had nice big fat network connection. And we avoid all the complications of synchronisation, the risks of information being out of date, and the information governance issues of confidential data having to be on those machines."

This is one of several ways in which the project will improve data security, said Manley. Others include better data quality because staff have the ability to enter data immediately rather than transferring information, and central storage eliminating the need for multiple copies.

"There are benefits in terms of carbon savings and sustainability," he added. "Once we have this solution in place a lot of out technical support is centralised.

"But also the energy usage of all of these machines running across the organisation, whereas the devices that we buy will be lower energy and have a longer life, because all the processing is done at the centre."

The project will also manage software licences on behalf of the trust. "From time to time we can reallocate a licence, but we also know that we won't over use a licence," he said.

"Business continuity is another one, because if we can provide the desktop to any machine operating a browser we can run from pretty much anywhere."

The trust paid IT consultancy Centralis to design and building a proof of concept based on Citrix's XenApp and Appsense to centralise desktop delivery to staff.

Oxfordshire puts out-of-hours GPs on GPS

Tue, 26 Jan 2010 17:06:52 GMT

A south-eastern primary care trust is paying CSC £728,000 for a system which will allocate out-of-hours doctors' visits through satellite tracking

CSC said that Oxfordshire PCT will be the first NHS user of its OmniLocation system, which is used to allocate mobile staff based on their location then track them as they travel.

"It makes the reporting easier, and makes the allocation of staff easier," said Andrew Spence, CSC's UK director of healthcare strategy. The system is already used in other sectors, such as mobile engineers working for utility firms.

As part of the deal, CSC will also provide the PCT with its SystmOne electronic patient record system to record treatment carried out by GP out of hours services, as well as emergency dental services, minor injury units and first aid centres.

The firm will start installing its systems in April as part of a three year contract with the trust, which has an option to renew for a further three years. The deal covers installation, project management and maintenance of the system.

Spence said CSC is exploring how it can offer other systems and services it provides to other sectors to the NHS, including server virtualisation and mobile working using dynamic desktops.

The firm recently said it will introduce new healthcare systems to NHS customers, including its clinical information portal, joining up data on a trust; its electronic patient folder, for digitising patient records; and self-service kiosks, allowing patients to 'check in' saving receptionists' time.

The firm acts as local service provider to the North, Midlands and East area of the NHS, covering 60% of England.

Stolen hospital laptop held 33,000 records

Mon, 25 Jan 2010 00:05:00 GMT

Southampton University Hospitals has promised to improve data security after the theft of a laptop holding thousands of unencrypted patient records

Chief executive Mark Hackett's formal undertaking follows an incident in October last year when a member of staff left an unencrypted laptop containing personal information in a retinal screening vehicle.

The unlocked vehicle had been parked when the laptop, with about 33,000 password protected patient records, including details about patients' type of diabetes and results of retinal screening tests, was stolen. The thief cut through a security cable which attached the device to the vehicle.

The Information Commissioner's Office (ICO) said on 22 January 2010 that the trust had breached the Data Protection Act.

Storing large volumes of personal information on portable devices is unnecessarily risky, said Sally-Anne Poole, head of investigations at the ICO. "Why were so many records downloaded on to an unencrypted laptop in the first place?" she asked.

"It is vital that NHS organisations ensure their staff handle personal information securely, especially where so much sensitive personal information is concerned," Poole said, adding that she was pleased the trust had taken action to guard against security breaches of this type in future.

The ICO is urging senior executives of organisations to sign up to its "Personal Information Promise", as a demonstration of their commitment to protect personal details. Organisations which have signed already include schools, police services, councils and government IT suppliers Fujitsu and Oracle.

Sussex Health Informatics seeks framework deal

Wed, 13 Jan 2010 13:18:33 GMT

An informatics organisation serving 10 NHS trusts is setting up an information management and technology framework worth up to £7m

In an advertisement in the Official Journal of the European Union on 13 January 2010, primary care trust NHS West Sussex said it was looking to set up a four year framework on behalf of the Sussex Health Informatics Service (HIS).

The framework, which is expected to have a value of between £3m and £7m, will enable Sussex HIS to order technical services through mini-competitions to supply NHS organisations across Sussex and occasionally Surrey and Kent.

Sussex HIS claims to be largest such service by user base, supporting more than 36,000 users at 10 NHS trusts: the primary care trusts for Brighton & Hove, East Sussex and Weald, Hastings and Rother, West Sussex; Brighton & Sussex University Hospital; East Sussex Hospitals; South Downs Health; Sussex Partnership Foundation Trust; Western Sussex Hospitals; and the local strategic health authority, NHS South East Coast.

The deal will be made up of three lots, with the first covering information governance and security, systems integration, information management and technology development, clinical systems and data migration. This is valued at between £1.5m and £4m.

The second lot is for web services, including development and design, and is expected to be worth between £1m and £2m.

Lot three covers management services and has been broken down into services categories covering projects and programmes; portfolio management; service management; business case development; change management and training; and procurement management. The value is estimated at between £500,000 and £1m.

NHS West Sussex expects the maximum number of suppliers to be 50. The deadline for initial applications is 15 February 2010.

Six southern trusts to get Cerner upgrade

Mon, 11 Jan 2010 00:05:00 GMT

The government has announced new work in the south of England on a key NHS software system

Health minister Mike O'Brien said the upgrades of Cerner Millenium, the patient administration system for trusts in the south of England, will take place after BT has transferred their systems from a data centre run by the local service provider Fujitsu. It expects to complete the preparatory work by the end of March 2010.

"Timing of completion of the upgrades will depend on the outcome of ongoing discussion between the national health service locally and the company," O'Brien said in a parliamentary written answer on 5 January 2010. He added: "Discussions are continuing with BT with regard to implementing Cerner Millennium at some further sites in the southern programme for IT area."

BT has a £546m contract to provide National Programme for IT services to 12 acute trusts and 25 mental and community trusts in the region. The first of the latter group, Surrey and Borders Partnership NHS Foundation Trust, went live with CSE's RiO patient record software in December.

O'Brien saidt the eight acute trusts in the south already using Cerner Millennium are Winchester and Eastleigh Healthcare, Surrey and Sussex Healthcare, Weston Area Health in North Somerset, Taunton and Somerset NHS Foundation Trust, Nuffield Orthopaedic Centre, Milton Keynes General Hospital, Buckinghamshire Hospitals and Worthing and Southlands Hospitals. He added that the system is typically also used by the local primary care trusts in these areas.

In answer to a number of questions from his Conservative shadow Stephen O'Brien, the minister provided a full list of trusts using the National Programme for IT software. In London, Cerner Millennium is in use at seven trusts: Barnet and Chase Farm, Queen Mary's Sidcup, Barts and the London, the Royal Free Hampstead, and since November 2009 Kingston Hospital.

Homerton and Newham had already installed Cerner systems independently of the National Programme, but they are now being managed by the London section of the programme, he added.

Version 1.0 of iSoft's Lorenzo is in use for radiology at Morecambe Bay and Bradford Teaching Hospitals in general surgery and urology, and in December the latter trust also started using its clinical documentation software. South Birmingham Primary Care Trust has a number of podiatrists using the system.

O'Brien said that in October 2009 Hereford Hospitals NHS Trust went live with Lorenzo's clinical documentation software for rheumatology, while Five Boroughs Partnership NHS Trust started using the software at five of its sites. In December, Stockport Primary Care Trust went live with the system. The new version of Lorenzo, version 1.9, is currently only in use at Bury Primary Care Trust.

Wireless hospitals see bigger picture

Cath Everett — Wed, 06 Jan 2010 09:00:00 GMT

Few hospitals have adopted wireless networks, with adopters linking projects to the likes of PACS imaging systems

Despite the potential benefits that wireless networks can bring in supporting clinical care at the bedside, uptake among NHS trusts has been patchy to date and is likely to remain so into the foreseeable future.

Peter Weller, a senior lecturer at the Centre for Health Informatics at City University London, estimates that less than 10% of hospitals have currently adopted the technology across their organisations. Where deployment does take place, it is most likely to be in more traditionally high-tech departments such as radiology.

"There's not massive uptake and adoption is flat, with projects mainly taking place when hospitals are moving to new sites or are undertaking expansion," he says.

Where they do occur, however, such initiatives do not tend to be an end in themselves. Instead they are generally integrated with a wider project such as introducing electronic patient records (EPRs) or picture and archiving communications systems (PACS).

One organisation that chose to go down this route as part of a move to a new building in July 2006 was University Hospitals Coventry and Warwickshire NHS Trust. It considered that support for wireless technology was important in order to enable the introduction of PACS, EPR systems and other future mobile applications, which the organisation expects will grow in number.

Danny Roberts, head of programme delivery at the trust, explains the rationale: "The principle was one of flexibility and an overarching benefit was that clinicians could record and review data at the patient bedside."

PACS was the first application to be introduced and clinicians now access X-rays and other images as well as patient administration data using trolley-based PCs. Nurses are also able to input data about patients' vital signs at the bedside using PDAs running the Learning Clinic's VitalPAC software, enabling practitioners across the hospital to view and share pertinent information.

Roberts warns that good user engagement is key to making such projects work effectively, because they involve "big changes to people's way of working". As a result, the trust set up an integrated project team, which included both clinical and technical personnel, in order to "engage with them and identify and maximise resources based on their requirements".

This activity included developing models of care, evaluating appropriate hardware devices and deciding how many should be allocated to each ward, with figures being tweaked based on feedback in the field.

A further consideration included ensuring that the network was "future-proofed" in terms of both bandwidth and density of coverage so that it could cope when more applications were added.

Another was ensuring that monitoring tools were put in place. Rather than simply relying on user complaints, the goal here is to alert technical staff through a console, email or SMS messages if the network slows or goes down so that they can proactively sort the situation out.

Act of faith

Gloucestershire Hospitals NHS Trust's business case for deploying its wireless network was likewise about supporting patient care more effectively. Steve Edwards, head of IT development services at the trust, explains: "It wasn't based on direct financial benefits, but on quality of patient care and more flexible service delivery. So it was a bit of an act of faith, for which the trust's board deserves plaudits."

The organisation started introducing Aruba Networks' technology across the organisation at the end of 2008 in order to support mobile access to its patient administration applications, PACS results and internal email system.

"One of the issues that we faced was that there simply wasn't enough space in the ward area for IT equipment. It's a real challenge as everyone tended to cluster around the nurses' station and so it was a very busy area. But this provides a way of opening things up relatively easily," Edwards says.

Implementation of the network across the trust's 63 wards at two sites in Cheltenham and Gloucester took "quite a long time", however, as the aim was to minimise disruption to both staff and patients by tying it in with other activities such as redecoration.

It also required thorough design and planning due to the nature of both buildings. Because the Cheltenham site was built in 1854 and has walls that are four feet thick, it was necessary to undertake a physical survey of the entire facility in order to ensure good coverage and prevent black spots.

The Gloucester site also had to be handled with care. Although it is housed in new premises, it – like many modern structures – includes a lot of metal studding, which interferes with wireless signals. This design and planning activity was initially based on recommendations from the vendor, before being tweaked by in-house staff.

Edwards adds that security was another major area for consideration. The trust deployed data encryption, user profiles and smartcards to control system access by staff using authorised laptops only. But Edwards believes that it is important not to underestimate the value of good user training. "Security is as much to do with user education as anything else. You can have all of the technology in the world, but if it's not used properly, you'll still have a problem," he says.

The next step, meanwhile, will be to extend use of the wireless network to home users. By early 2010, the aim is to provide clinicians that are on call with a wireless router and laptop to enable them to access information through a secure virtual private network as if they were still on site.

"It minimises the impact at home as it's just a box on the wall and a laptop and not everyone has the space for a lot of equipment. But it also means that people don't have to spend time driving to the hospital if they don't need to or can get there quicker if they do, so it solves a lot of issues," Edwards says.

The trust is also evaluating whether to introduce RFID-based asset tracking system in future, which might also be used to track patients, using its wireless network. The aim would be to cut costs by improving asset maintenance and retrieval.

Danny Roberts will be speaking at the Smart Healthcare Mobile & Wireless Healthcare one-day conference in Birmingham on 24 February. Click here for further information.

Cath Everett

First southern trust turns on RiO

Wed, 16 Dec 2009 12:06:05 GMT

Surrey and Borders has gone live with BT's patient record system for mental and community health trusts

Surrey and Borders Partnership NHS Foundation Trust is the first in the south of England to install CSE Healthcare Systems' RiO electronic patient record system, as part of the extension to BT's National Programme for IT contract agreed in April. It connects the trust to the NHS Care Records Service, including the Spine database.

BT will be paid £546m to install RiO in 25 mental and community health sites and Cerner's Millennium system in four acute trusts, and to manage existing Cerner installations in eight it has taken over from Fujitsu Services.

The RiO software will in time be used by some 3,000 staff at Surrey and Borders at 125 locations. Chief executive Fiona Edwards said: "RiO will enable us to offer better care to the people we serve. Our staff work across multiple care settings and geographically dispersed sites, but we will now have accurate, up to date information that is quickly and securely accessible."

RiO is replacing some paper based systems, and will cover clinical and administrative work including case records, caseload management and treatment records. It includes a single sign-on system using smart cards, and provides users with access to national systems including patient demographics and Choose and Book.

BT said that it is more than 80% through its RiO implementation programme in London, where it is the programme's local service provider.

RiO has also been adopted by the Isle of Man government, which recently went live with the software. It used System C Healthcare to implement it for its mental health and social services staff.

South asked to buy systems by April

Wed, 25 Nov 2009 14:47:17 GMT

The Department of Health expects 'the majority of trusts' in the south of England to procure informatics systems in the first few months of next year

Christine Connelly, the department's chief information officer, told NHS staff and suppliers that she wants trusts to start formal procurement in January and, if possible, complete the process by the end of the fiscal year in April. Trusts would be expected to use the Additional Supply Capability and Capacity (ASCC) system.

She announced the plan at a market awareness event for the ASCC process in London on 24 November 2009.

The event was closed to the media, but a departmental spokesperson said: "The aim is to begin the formal procurement process in January 2010 and have completed the process and awarded contracts by the end of the fiscal year. This procurement exercise is taking place across the three southern SHAs and we expect the majority of trusts to take part in this."

Trusts in the south, which covers the South East Coast, South Central and South West strategic health authority areas, have been without a local service provider since Fujitsu left the National Programme for IT last year.

Business intelligence: NHS learns to use its intelligence

Gill Hitchcock — Wed, 25 Nov 2009 09:00:00 GMT

The NHS in England is making increasing use of business intelligence software to plan its services and monitor quality

Faced with the recession, demographic changes and rising expectations, the NHS is under increasing pressure to do more with less.

Rising to that challenge is likely to require health service managers to make greater use of business intelligence: information providing historical, current and predictive views about how their organisations operate.

"This sort of information helps people understand where there are opportunities for improvement," says Brian Derry, director of information services at the NHS Information Centre. "And in this particular environment, evidence-based change is imperative."

Primary care trust NHS Manchester uses business intelligence for two main reasons, says its associate director of information management and intelligence Mike Jones.

"One is to help us plan our healthcare, by looking at what has gone before, use of hospitals services, GP services and to tell us how people are using those services and where we can make changes to improve the care," he explains.

"The other is at an operational level, to look at how we are getting the most in terms of staff and that the quality of care we provide is the best it can be."

The trust uses a combination of in-house business intelligence applications, some of which are based on Access, and standard applications, particularly a Microsoft SQL platform and data mining software.

"Effectively that allows us to measure performance and then drill down into that measurement and look in more detail to perhaps understand where issues may lie," Jones says.

The trust is planning to use enterprise wide agreements between Connecting for Health (CfH) and Microsoft for the latest versions of SharePoint, which contain business intelligence tools to enable information to be presented in, Jones says " a more meaningful way".

Elements of the NHS National Programme for IT are helping business intelligence, says Jones, citing examples of the clinical dashboards initiative, to provide frontline clinicians and managers with high level information on the quality of those services. Meanwhile the Secondary Uses Service supports the collection of data about different NHS activities for commissioning PCTs, so that those data sets can be analysed locally.

Usually the NHS uses the same business intelligence software as the commercial sector – provided by SAS, Business Objects, Cognos and Oracle – according to Derry. He believes that implementation of major new software is unlikely: "The big players are already in place and they are continuing to develop their systems and tend not to launch brand new ones."

So where is the push for business intelligence coming from? "I don't think it's a push, it's a pull from frontline services," Derry responds. "People are constantly trying to improve their services, and yes money is part of it, but it is not the only thing."

Observing improvements

Lord Darzi's 2008 report High Quality Care for All has been a significant driver. It recommended that each strategic health authority should set up a "quality observatory" to develop existing analysis tools and enable local benchmarking and the identification of opportunities to help frontline staff innovate and improve the services.

Some SHAs have yet to launch observatories, but one of the first, the South East Coast Quality Observatory covering Kent, Surrey and Sussex, opened in April.

One of its first tasks was to find evidence about the impact of a specialist team in reducing MRSA infection rates. "So successful were the interventions the trust put in place, as evidenced by the analysis, that they were presented at an international conference," says Katherine Cheema, specialist information analyst at the observatory.

Cheema also says that an online peer review tool, to allow staff to assess how patients are treated with privacy and dignity in acute trusts, has help to raise awareness of possible problems and improve patient experience. "The tool allowed members of staff to assess standards in their own organisations, compare them with peer reviews and link them to action plans," she says. "The online delivery of the tool made it easier to access and meant that reviewers weren't reliant on email or paper based mechanisms."

In Brian Derry's experience the NHS is getting better at using business intelligence, partly because of technological advances. "If you went back five years even, the IT made this stuff very expensive and quite difficult to do, and that is no longer true," he says. "It is easier to implement, more cost effective and people have got more enthusiastic about an information based model of management.

"With all of that, and the present economic situation, I would expect demand for this to rise."

Gill Hitchcock

Kent tests payment card for healthcare

Wed, 25 Nov 2009 00:05:00 GMT

Kent CC is to run a pilot on the use of its citizen smart card in paying for health services

In a move that could point towards a radical change in the method of delivering healthcare, the county council has laid plans with Eastern and Coastal Kent Primary Care Trust to make the Kent Card available for some patients to obtain services from a list of approved suppliers.

The Personal Health Budgets pilot is scheduled to run for three years from April 2010 and will involve 75 using maternity, continuing healthcare, end of life, carers and mental health services. The Department of Health is to provide funds for the evaluation.

Peter Gilroy, chief executive of Kent CC, told SmartHealthcare.com that the Royal Bank of Scotland has been redesigning the chip and PIN card for use in the process.

The PCT will determine what services would be appropriate for a patient and what monetary value should be loaded onto the card. Card holders will then be able to make their own choices in areas such as maternity services, equipment and continuing care, from a list of suppliers approved by the PCT. This is likely to include private and voluntary organisations as well as NHS bodies.

"It will be quite a jump in healthcare provision," Gilroy said. "For example, for maternity there will be a prepared list of contractors, so the business may go to the NHS or to the private or voluntary sectors.

"It marks a shift away from the notion of bulk and volume contracts in the commissioning strategy."

Gilroy said that under the system there is no guarantee of any supplier on the approved list actually winning business, because that would be the choice of individual patients.

Kent CC already uses the Kent Card for a similar process to provide social care services, and has estimated that providing the Personal Health Budget should not cost more than delivering NHS services through conventional routes.

Alison Davis, assistant commissioning director from NHS Eastern and Coastal Kent, said: "The Kent Card is designed to give people more control of their own lives. This pilot programme will give a small group of people a chance to find out how taking more control of their healthcare might work out in practice.

"As the priority with the Kent Card is choice, it is important to remember that the Kent Card is not a compulsory approach to health care and there is no expectation that it would become compulsory. It is simply about providing choice for those who want to take more control."

She added that using the card will not cut out the patient's GP or nullify a doctor's advice, but would give the patient more choice.

Gilroy said there are also plans for the council to further develop its telecare service by making it available through BlackBerrys.

Sheffield and Wandsworth buy iSoft PAS

Tue, 24 Nov 2009 14:06:42 GMT

A foundation acute trust and a primary care trust have agreed contracts for patient administration systems, as southern trusts meet alternative suppliers

Sheffield Teaching Hospitals NHS Foundation Trust will pay iSoft £2.04m to move to a single PAS. It currently uses iSoft at the Northern General Hospital, and McKesson's Totalcare at its Central Campus, which includes the Royal Hallamshire Hospital.

The six year contract includes a payment of £570,000 for licences and implementation, and £1.4m for support and maintenance, iSoft said. The firm will move both sites to the latest version of its PAS and provide new hardware from HP.

Primary care trust NHS Wandsworth will pay £965,000 to iSoft for the latest version of its PAS at Queen Mary's Hospital in Roehampton, which provides services including outpatient facilities, a minor injuries unit and wards for the elderly and intermediate care. It will pay £182,000 for licensing and £580,000 for support over three years.

The announcements have come as the Department of Health holds a market awareness event for alternative suppliers to trusts in the south of England, which have been without a local service provider since Fujitsu's departure from the National Programme for IT last year. iSoft said in October that it plans to sell directly to trusts in the region.

The event, held in London on 24 November 2009, allows suppliers accredited to the Additional Supply Capability and Capacity (ASCC) scheme to exhibit to trusts in the South West, South Central and South East Coast strategic health authority areas, in advance of a series of procurements starting in January.

"The market awareness event open to all ASCC suppliers in the acute, community and child health service categories demonstrates that we plan to move ahead with ASCC framework procurements in the south," said a spokesperson for the department.

ICO chastises NHS over data losses

Mon, 16 Nov 2009 00:10:00 GMT

NHS organisations were responsible for 30% of the security breaches reported to the Information Commissioner's Office over the last two years

The ICO said that, of the 711 reports of security breaches it has received since HM Revenue and Customs reported its loss of 25m child benefit records in November 2007, 209 came from the NHS.

"We have investigated organisations, including several NHS bodies, that have failed to adequately secure their premises and hardware, which has left people's personal details at risk," said Mick Gorrill, the assistant commissioner with responsibility for investigations.

"I encourage organisations, especially NHS bodies, to ensure that the level of security at premises is commensurate with the type of data they are holding. Many breaches are avoidable and are often the result of poor management processes."

The figures came in the same week as three trusts were reprimanded by the ICO for poor information security. Two primary care trusts, Great Yarmouth and Waveney and Gloucestershire, signed formal undertakings to improve their data security after putting thousands of patients' sensitive personal information at risk.

Great Yarmouth and Waveney reported the theft of two PCs to the ICO, containing the personal details of more than 1,000 occupational therapy patients and staff. The personal information had been held on the computers, rather than on a network server, and was not password protected.

In addition, their offices did not have a burglar alarm, internal doors were unlocked and the computers were unencrypted.

Gloucestershire Primary Care Trust reported the theft of six laptops containing the personal data of 2,270 patients. The computers, used by medical secretaries for preparing letters and patient notes, were password protected and held in a locked office, but the ICO said the data should have been held on a server.

Maidstone and Tunbridge Wells NHS Trust, an acute trust, reported the theft of an unencrypted laptop computer from its audiology department. This held test results on 33 patients, as well as other personal details on an unknown number of patients. The trust reported a further three laptops as stolen during August 2009 from its Maidstone site, but these were encrypted.

As with the primary care trusts, Maidstone and Tunbridge Wells has signed an undertaking to improve information security, in its case by encrypting all personal data on laptops and removable media within six months.

The ICO said its research showed that burglaries and theft are the single biggest security risks for organisations processing people's
personal details.