1. society
2. welfare
3. healthcare

EMIS in Scotland
delivering the aims of the
eHealth strategy 2011-17 in the
primary and community setting.
Mark Mulholland
Regional Director – Scotland & NI
• EMIS team in Scotland
• Current regional landscape
• Working towards the eHealth strategy 20112017
• Health & Social care integration
• Future development – products + services
– PCS development roadmap
– EMIS Web GP
EMIS Team in Scotland
• Scotland previously part of NE & Yorkshire
region
• Scotland & Northern Ireland amalgamated as
a region in April
EMIS Team in Scotland
• Move away from ‘The Field’
• Towards defined functions (field and internal
structures)
– Sales / Account Management
– Training
– Service
– Commercial development
Sales / Account Management
Mark Mulholland (RD) – cross functional
----------------------------------Tom McCluskey (SAM/CAM) – EMIS Web projects
Fiona Leishman (SAM/CAM)
Diane Henderson (CAM)
– On maternity
Claire McNeil (acting CAM)
– NHS GG&C
Training
Lynn Tomlinson (CTM) – Scotland, NI, NE&Y
Jenni Lockhart (STC)
Colette Jackson (TC)
Claire Watt (TC)
– Full time secondment to GG&C
Andrew Burton (TE)
– Full time focus on EMIS Web community
Claire McNeil (TE)
– Acting CAM
Service Relationship Exec
• Will Christie
– Covering all 14 Scottish Health Boards + National
Service forums
– Remit solely focussed on service delivery in
Scotland
Commercial Development
• New function headed by Matt Murphy
• Debra Renwick representing Scotland
• Link between field and development
– Facilitating turn around of field ‘opportunities’ to
‘delivery’
EMIS in Scotland
• Regional offices
– Development presence
• 2009 – 1 member of staff (me)
• 2012 – 12… and growing!
GP Estate
• EMIS PCS installed in 528 of 1006 practices
– Across all 14 Health Boards
• 52.5% market share
– EMIS PCS practices in all Health Boards
– 3 Health Boards exclusively EMIS PCS
• Forth Valley
• Borders
• Shetland
– Due to become 4 exclusive Health Boards
• Possibly 5
eHealth strategy 2011-2017
eHealth strategy 2011-2017
• Build on the achievements delivered and foundations
set in 2008 strategy
• Quality outcomes
– Everyone gets the best start in life, and is able to live a
longer, healthier life
– People are able to live well at home or in the community
– Healthcare is safe for every person, every time
– Everyone has a positive experience of healthcare
– Staff feel supported and engaged
– The best use is made of available resources
eHealth strategy 2011-2017
Continuing towards….
Better Health - Better Care
eHealth strategy 2011-2017
• Safer patient care through availability of
accurate up to date information
– Building on ECS / KIS / ePCS
– Anticipatory care approach
• Accurate, informed diagnosis and
collaborative delivery of care
– Decision support tools
• Efficient working across settings
– Faster availability of newly recorded information
eHealth strategy 2011-2017
• Patients as responsible partners in the care
they receive
– Informed, engaged
• Improved referral processes
– Reduction in times from referral to receipt of care
– Seamless transaction across multiple systems
eHealth strategy 2011-2017
Integrating IT systems and data sharing
Mobilising primary care data
Supporting a single shared record
eHealth strategy 2011-2017
The best use of existing technology…
…the technology already exists
Local strategies
• Individual board strategies to deliver aims of
eHealth strategy and care integration agenda
NHS Greater Glasgow & Clyde
• 250 EMIS PCS – 9 InPS Vision
• EMIS Web Children’s Services Community
system project underway and resourced
• Single Organisation approach
– No immediate plan for integration with GP record
• No sites streaming…yet
• 600+ users
• Every child 0-18 years
NHS Greater Glasgow & Clyde
• Instructed development work
– SCI Store patient demographic feed
• MPI integration – Nov 2012
– Bi-directional SCI-Gateway referrals
• Jan 2013
NHS Greater Glasgow & Clyde
• Clinical Portal
– Orion portal integration
– GP data feed via EMIS Web
• Continence Service
– Early adopter of EMIS Web as clinical system
– No SEF requirement
NHS Ayrshire & Arran
• EMIS Web Community System project
underway and resourced
– Working towards Virtual Wards go-live in
November
• Girvan Community Hospital project
– Small working project
– Three Girvan GP sites sharing services at
community hospital
Other potential Web opportunities
• NHS Western Isles
– Vodafone digital pen integration
• NHS Forth Valley
• Dumfries & Galloway
• Borders
• Shetland
• Grampian
Clinical Portal
• Clinical Portal Integration
• Individual board strategies
– Orion
– CareFx (Northgate)
GP
Inpatient
Services
Health Visitors
Order
Comms
Pharmacy
District
Nurses
EMIS
Web
Child Health
Other
Services
Integration
tool
RIO
Minor
Surgery
Cerner
Millenium
Learning
Disabilities
Speech and
Language Therapy
Physiotherapy
Ascribe
CareLogic
Interoperability
Healthcare Gateway
• 50:50 joint venture between EMIS and InPS
• Medical Interoperability Gateway (MIG)
– Exchange real-time data between any third party
system and EMIS or INPS clinical systems
– 100% of patient records in Scotland are now held
on EMIS PCS or InPS Vision
• Not limited by one to one interoperability
standards between distinct systems
– Ensemble?
• Live primary care data available in Clinical
Portal, OOH, Community, Acute, etc…
• Patient care information captured in
community, acute etc available in General
Practice in real time
– Single care record
Patient centric eHealth
• Interest in Patient Access as patient portal
– Best use of available resources
• eHealth Policy & Strategy
– Possible development
•
•
•
•
Links to PIL in MR viewer
Bi-directional messaging
Capturing patient specific clinical data online
Integration with secondary care appointment systems
• Online repeat ordering TBC!
Health & Social Care Integration
• Integration of Adult Health & Social Care Bill
currently in consultation
• EMIS exhibiting at Scottish Executive
conference in Edinburgh on 19th September
Health & Social Care Integration
• Aims
– lay the foundations for an integrated model of care in Scotland
– CHPs disbanded
– Replaced with Health and Social Care Partnerships (HSCPs)
– Local council authorities and NHS boards jointly responsible
– Efficiency savings remain dominating factor in policy discourse
– Initial focus on integration of budgets for older people services
– Emphasis on improving care in patients home as opposed to care
home or hospital
– New focus on funding of community systems / decrease in
institutional budgets
Future developments
• GP IT Contract & Services Management Group
– Level of engagement
• Working relationship with Kevin Boylan (NISG Service
Manager)
• CAB / RFC / Service Management
• Regular contact + monthly NISG meeting
• Quarterly GPITC&SM meeting
• New Quarterly Service Review
– All boards represented
New patch release process
• Following recent discussions with NISG and
subsequent ratification from GP IT CAB we will
shortly be moving to a new process for
releasing PCS updates to our estate of
practices
• Move from 4 week patching cycle
• Move to 8 week patching cycle
New patch release process
• A sequence of phases of release, with an initial
clinical witness phase, followed by an extended (3
weeks) pilot phase with testing on PCS application as
well as interactions with national and 3rd party
systems.
• A period of stability where no releases are made to
the estate.
• A quick release process for issues of clinical risk or to
meet national timescales (e.g. QOF rules, read codes,
drug releases)
Future development
• Release 10 (November 2011)
– Prescribing performance release 2
– Independent Nurse Prescribing
– CMS post pilot development work
• Release A (Jan 2013)
– Instalment dispensing text for non GPs
– AMS messaging for Stored scripts
• Release B (late Feb 2013)
– GP2GP phase 1
• Release C (early Apr 2013)
– AMS messaging for dispensing scripts
– Prescribing alerts stop
GP2GP
• Transfer of structured GP record between practices
• Bi-directional cross border transfer
• Establishment of lifelong UK GP record with minimal
degradation
• MIG ?
• Working in partnership with PSD
• Minimal disruption to Docman / eLinks transfer process
EMIS Web GP
• EMIS Web requires SEF development for use
in GP estate
– Development resource committed
• No current timescale
– Original SEF group disbanded
– Not all tranches of development relevant to
hosted technology
– Practice / HB appetite varied
• Mature user base ready
• HBs not ready to support roll-out (e.g. GG&C)
EMIS Web GP
• GPITC&SM Group remain fully committed to
EMIS PCS
– Under framework contract
• Specific areas of discontent in EMIS PCS would
be addressed
– S&R, Prescribing, App Book, QOF Recall, PSD
transactions, decision support tools
What are we doing next?
• Remainder of 2012
– Move A&A and GG&C Web community projects towards
implementation
– Move all other Web opportunities to planning / preimplementation
– Drive local marketing message
– Increase awareness of EMIS products and services in
secondary domain
– Continue to seek opportunities in community / extended /
acute settings
• Interoperability opportunities (TRAK, Midas, Adastra, etc)
– Continue to support NHS Scotland efficiency agenda
2013 and beyond
• Established flag ship community project for
Scotland (a la Cumbria, Liverpool)
• SEF accredited EMIS Web GP
– Enthusiastic EMIS Web user base
• EMIS products and services established in
secondary / community care domain
– Primary care interoperability
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