Transcript Document

Scottish National User Group
NHSmail for GP’s
Inverness January 2012
Some Background
NHS Boards (since April 11) now pay for NHSmail usage so Boards likely to
look at managing demand to reduce:
• Active users charges
• Generic Mailboxes charges
• SMS charges
NHSmail contract terminates in June 2013 (16 months):
• Will have to move to new service before then or transition called off
• Business case/procurement process started
• Key principles agreed:
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Control over future decisions
One system/contract
One service provider
Subscription service
Health partner linkages
Integrated with desktop strategy
Open standards platform
Security not pivotal issue
Replacement Programme Update
•Core principles approved:
 Control over future decisions
 One system/contract
 One service provider
 Subscription service
 Health partner linkages
 Integrated with desktop strategy
 Open standards platform
 Security not pivotal issue
In-scope (Core):
 Directory & Email
 Ante Spam/Ante Virus
 Fax
 SMS
•In-scope Optional:
 Instant Messaging
 Unified Communications
 Bundled Office Applications
Roadmap – Next 12 months
CfH developments:
• NHSmail replacement
• Inbound SMS in testing e.g. patients could respond to SMS messages
• Secure email to 3rd parties e.g. Social services, patients etc
• Demand management policies likely to be implemented
NHS Scotland:
• Usage reports commissioned which Boards will use to reduce costs
• User testing of potential new email solutions
• Potential change to existing Email Policy
Service Usage and Cost
Service Usage
Jun-08
Dec-08
Jun-09
Dec-09
Jun-10
Dec-10
Jun-11
Latest Sep11
3 Mth %
Change
15 Mth %
Change
Registered Users
67,928
77,250
89,622
100,808
112,933
120,973
126,548
129,760
2.5
14.9
Active Users
44,638
50,113
51,036
66,898
71,501
73,222
79,867
80,821
1.2
13.0
SMS Messages
66,778
68,079
91,463
93,519
161,320
298,022
630,979
784,472
24.3
386.3
542
988
2,124
1,788
2,520
3,676
5,275
4,112
-22.0
63.2
86,490
90,709
91,584
98,968
98,584
91,290
88,355
86,326
-2.3
-12.4
5,313
5,689
9,104
9,336
24,457
33,169
19,710
24,505
24.3
0.2
46
154
292
298
372
521
492
405
-17.6
9.0
Registered
1.27
1.17
1.02
0.98
0.87
0.75
0.70
0.67
-4.7
-23.8
Active
1.94
1.81
1.79
1.48
1.38
1.25
1.11
1.07
-3.4
-22.5
SMS Messages
0.08
0.08
0.10
0.10
0.15
0.11
0.03
0.03
0.0
-79.4
Fax Messages
0.08
0.16
0.14
0.17
0.15
0.14
0.09
0.10
5.7
-33.2
Fax Messages
Actual Costs
Registered
Active
SMS Messages
Fax Messages
Unit Costs
Shared Resources
NHSmail provides staff with the ability to use shared functional
services. These include:
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Shared calendars
Shared generic mailboxes
Shared contact lists
Shared Distribution Lists
NHSmail Service – Shared Resources
Calendars
Shared calendars can be used for:
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Appointment bookings
Room bookings
Leave management
Training management
Equipment management
NHSmail Service – Shared Resources
Generic Mailboxes (GMs)
GMs can be used to support operational clinical/business
functions:
• Acute/Primary care referrals & discharge letters
• Managed clinical consultation points e.g. managed clinical
networks
• Functional GMs e.g. Helpdesk, GP customer facing primary
email
• Multidisciplinary Team GMs e.g. SS, Nursing, police
• National collaboration points e.g. eHealth clinical leads
• Interagency collaboration points e.g. Social services and
Child Health
NHSmail Service – Shared Resources
Contacts
• Share access to main contact lists within a GM
• Contacts can be split into functional areas by folders e.g.
Social Services contacts
• Can have GM for HC
NHSmail Service – Shared Resources
Mobile Working
Can access the service from:
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Work
Home
Mobile phone
Other work places e.g. patients home
Internet e.g. hotel, conference
NHSmail Service – Mobile Working
Mobile Working 2
Particularly good for mobile staff:
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Community Nurses e.g. District Nurses & Health visitors
Allied Health Professionals e.g. Physiotherapists
Consultants
Trainee Doctors and GP Locums
NHSmail Service – Mobile Working
SMS & Fax
• SMS Enables routine reminders:
• Sending of patient reminders:
 Reduces DNA rates
• Automatic system alerts
• Fax – Sending drug alerts to GP Practice
Value Added Services
Collaborative Working
• Enables working outside as well as within the Board boundary:
• Enables CHP working
• Working with local & central government
• Enables working within Managed Clinical Networks
• Enables working with non-NHS partners e.g. Mental
welfare Commission
Value Added Services
Dynamic Distribution Lists
(DLs)
Dynamic distribution lists are to an extent self managed as
standard staff information is used to determine which staff belong
to distribution lists.
DLs determined by directory data and avoids many different staff
keeping multiple manual and electronic staff lists up-to-date:
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Organisation – ‘All NHS Highland’ staff
Site – ‘All staff Raigmore Hospital’ staff
GP Practice – ‘All Gilmour Street GP Practice’ staff
Role – ‘All GP Practice Managers’
Specialty – ‘All Paediatrics’
Department – ‘All staff in Community Nursing’
Value Added Services
Distribution List Uses
• Faxing drug alerts to GP and Pharmacy practices
• Avoid manual time consuming processes
• Intensive Care – available shifts, notifications sent to mobiles
• H1N1 National Communications
• Targeted communications – GPs, all Practice Managers
Value Added Services
Strategic Benefits
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“Access to right info,….right place,…right time” (eHealth Strategy)
Increased clinical assurance
Improved clinical/business efficiency
Communications with health partners
Increased speed of communications
Facilitates collaborative working
Facilitates email coverage to sectors previously underrepresented
NHSmail Service
Impact of Direct Electronic Referrals to
a Hospital Eye Service
NHS Fife – Case Study
Value Added Services
Case Study –
Aims and Methods
Aim:
• A study to assess the feasibility, safety and clinical
effectiveness of electronic referral of patients directly from
optometrists in primary care to the hospital eye service
(HES) in contrast to the paper-based referral through the
GP.
Method:
• 3 Practices sent electronic referrals
• Same 3 practices compared for paper referrals
• Supported by ECCI and funded
• Clinical processes redesigned
Added Value Example - Impact of Direct Electronic Referrals to a Hospital Eye Service
Case Study –
Referral Pathway
Old Pathway (2 – 32 weeks)
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Optometrist appointment
Letter to GP
GP’s letter to hospital
Hospital records
Consultant referral file
Await further info
(e.g. case notes)
• HES appointment
New Pathway (1 – 6 weeks)
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Optometrist appointment
Electronic referral to HES
Consultant review
HES appointment
Added Value Example - Impact of Direct Electronic Referrals to a Hospital Eye Service
Waiting List & Waiting Times
>12 wks
1200
5-12 wks
0-4 wks
1000
800
600
400
200
0
May 2006 Original
May 2007 Best traditional
Added Value Example - Impact of Direct Electronic Referrals to a Hospital Eye Service
May 2008 Electronic
referrals
Case Study –
Benefits
• Speedier clinical decision making for patients
• Avoidance of unnecessary hospital appointments
• Higher level of interpersonal communication and feedback to
optometrists
• Patient satisfaction with the process
• Saving:
• 37% of patients not requiring appointment, sending images
reduces a further 22%
• O/P costs between £108 - £307 per appointment, savings
could run into £100Ks per Board
• Majority of referrals now sent electronically within Fife
Added Value Example - Impact of Direct Electronic Referrals to a Hospital Eye Service
Contacts
Ziggy Iwaniec, Programme Manager:
[email protected]
Programme Mailbox:
[email protected]
Programme Website:
www.directory.scot.nhs.uk
NHSmail Service