Knowsley PCT Review of Community Systems

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Knowsley PCT Review of Community Systems

• Sue Brady
• Head of Programme Management

2
History of Community System Use In Knowsley

• Long established use of Comwise
• Long history and developed strong ethos of use of
  electronic systems to capture data.
• Moved some services to the LSPs Community iPM,
  however not all services could be provided in
  iPM.
• Some services remain on Comwise, such as Child
  Health
• Many standalone databases have developed to
  support specialist areas
• Much duplication of information requirements
  resulting in Silos of data developing

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What are Community Services?What are Community
Systems?

• When thinking about Community Information Models
  and systems, we need to consider what Community
  Services consist of and which systems they
  embrace links to Primary Care, Social Care,
  Independent Sector etc. Different models for
  different PCT
• Traditional systems talk in terms of Korner or
  Resource Management Need to embrace changing
  times, such as support for Payment by Results.
• A patient centred view of the care plan.
• Pathways and measurable metrics from operational
  data easily available.

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Systems Currently In Use

• Comwise
• Consultant Paediatrician (uses the appointment
  scheduler)
• Family Planning (St Helens) there is no KT31 on
  Lorenzo
• School Nursing (not patient based) St Helens
  and Knowsley PCTs
• Special School Nurses (not patient based) St
  Helens and Knowsley PCTs
• Smoking Cessation (not patient based) Knowsley
  PCT
• Speech Language Therapy Knowsley Service
  across both PCTs
• Child Health Screening and Surveillance

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Systems Currently In Use

• CPAS iPM (LSP provided system on a shared
  instance)
• Health Visiting
• District Nursing
• Phlebotomy
• Walk in Centre Huyton Kirkby
• Podiatry

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Systems Currently In Use

• Lots of standalone databases or systems
• Specialist Nursing i.e. Macmillan
• Home Loans
• Some home grown systems are unsupported and
  unscalable
• Use of the Acute PAS for some activity that are
  community services, but take place in the Acute
  Hospital i.e. Physiotherapy
• E-SAP being rolled out, currently no integration
  with community systems potential for
  duplication of effort and disjointed care.

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Functionality

• The PCT has a long history of using IT systems to
  collect information, but these tend to be paper
  based in collection and the data entered
  centrally by clerical staff, as a result there is
  delay and duplication of effort
• Current systems are basic and dated. Newer
  systems, such as CPAS dont have the all the
  functionality to replace the old.
• Staff require systems that are accessible at the
  point of care and support enter once data
  capture. Software and infrastructure needs to
  support this.
• Information needs to be provided to
  Commissioners, derived from operational
  information collected to provide patient care.
• Within Northwest, current release of Lorenzo
  doesnt completely meet level of functionality
  until Release 4 when scheduling and childrens
  services come on stream.
• Need to avoid supporting a plethora of interim
  systems.

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Benefits

• Current systems offers little direct benefit to
  overall services, but individual home grown
  systems offer benefit to pockets of services
• Administrative systems, such as Comwise, do not
  add much benefit to clinicians directly, but do
  their job reliably and well
• The benefits of using a comprehensive, integrated
  modern system which supports a single Master
  Patient Index are well understood and any
  replacement system, strategic or interim needs to
  be able to support this
• Systems need to be able to support patient
  pathways and ensure a clear view of the patient
  pathway, to ensure that effect care planning
  delivers benefits to the patient.

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Biggest risk to effectiveness

• Lack of health information systems to
• support improvements to productivity of provider
  service and clinical effectiveness
• provide evidence of effective pathways for
  commissioners
• support good performance management within
  provider services
• Support effective management of service level
  agreements between provider and commissioner

10
Information Gaps

• Information is extracted from systems and
  imported to a single Data Warehouse with
  Executive Information System
• However, quality and accuracy of data is poor in
  some parts and is untimely due to the process of
  manual data entry
• Information to provide details on community
  activity and develop community metrics to any
  degree of detail is limited in current systems
• Plans for an interim Community System until
  Lorenzo is available aim to address these gaps.
• While this is being progressed a pragmatic
  interim interim is being provided to meet the
  immediate gap using a version of the local Acute
  PAS.

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Stakeholder Engagement

• Have undertaken consultation and workshop events
  with PCT staff to understand what they want from
  IT and Information systems.
• Targeted workshops directed at services to
  understand the transition from the traditional
  PCT role to being a Provider Service
• Understanding the role of GPs in community
  services and engaging with Primary Care
• Involving LINK with the development of the
  specification for a community system

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Future Plans

• We have developed a comprehensive Output Based
  Specification for an interim integrated Community
  Information System, across Knowsley and the local
  health economy
• In the meantime looking at how we can best use
  the systems we have
• Utilise a version of the Acute PAS IMS Maxims
  to provide an interim interim to provider
  services until the alternatives are in place
• Link all systems to the EIS to enable reporting
• Review of Information Requirements to support the
  provider services model and commissioning
• Looking at how better information can help
  improve productivity and the community metrics
  that can be used to support this.