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Digital Care Strategy

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WQ.394/2024

WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES

BY DEPUTY A.F. CURTIS OF ST. CLEMENT

QUESTION SUBMITTED ON MONDAY 4th NOVEMBER 2024

ANSWER TO BE TABLED ON MONDAY 11th NOVEMBER 2024

Question

"In relation to the Digital Care Strategy Major Project, will the Minister provide –

  1. a list of the subordinate projects that constituted the Major Project as funded in 2023 and 2024, together with details of the project deliverables;
  2. a breakdown of the expenditure by subordinate project and year; and
  3. a breakdown of the proposed £2.3 million expenditure in 2025, including the expected project deliverables?"

Answer

(a) The table below shows the subordinate projects that constituted the Major Project as funded in 2023 and 2024, together with an explanation of the projects.

 

Component

Deliverable

Status

Core  Record Platform (Electronic  Patient Record System)

New Electronic Patient Record (EPR) – Hospital Acute EPR System

Replacement of the legacy TrakCare EPR by the IMS Maxims EPR. The new EPR will increase dramatically the hospital Digital Maturity level. It also brings several clinical safety improvements  and  organisational efficiencies related to the below:

A  sustainable  and  continued  improvement  in  the quality and safety of acute care within Jersey

Improvements in acute care patient outcomes

Reduction in unwarranted variation away from clinical pathways and protocols, with associated cost savings and improvements in care

This programme also aims to deliver new EPRs for Maternity, Intensive Care and Theatres, ambulance integration, a patient portal, and workflows that support clinical recording at the patient bedside.

Phase  1  &  2 Completed

Phase  3  &  4  In progress

Phase  5  to  be commenced in 2025

Radiology  Imaging and  Reporting service  (RIS  & PACS)

Radiology Imaging and Reporting service (RIS & PACS) Replacement  of  legacy  Radiology  GE  PACS  system  for  a newer, fit-for purpose Philips PACS system that allows the Radiology department to continue operating.

Completed

 

GPOC  – Pathology/Radiolog y

GP Order Comms – Pathology/Radiology

General Practitioners (GPs) are now able to send electronic requests  of  pathology  and  radiology  studies  to  the  HCS laboratory and radiology department avoiding the reliance on post. GPs also have access to electronic results.

Completed

EPMA

Electronic Prescribing & Medications Administration (EPMA) Move  from  paper  drug  charts  to  electronic  prescribing throughout all inpatient and outpatient departments. Relevant clinical  safety  improvements  related  to  clinical  decision support, medication interactions and allergies.

Completed

Scantrack (T-Doc)

Scantrack (T-Doc)

Replacement  of legacy  solution  Scantrack  for  T-Doc.  This system allows for traceability of surgical instruments through the sterile supply workflow. It is part of the essential health & safety processes in the surgical department.

Completed

Retinal Screening

Retinal Screening

Implementation of a solution that allows the management of screening of patients with diabetes. It ensures patients are being seen at the right intervals based  on their personal medical history.

Completed

e-consent

eConsent

Moving  from  paper  consent  forms  to  electronic  consent, allowing for patients' access to information relevant to their medical/surgical/nursing  procedure  promoting  an  informed decision.

2025

Vendor  Neutral Archive (VNA)

VNA

Creation of a Cloud imaging repository for Radiology studies to mitigate issues related to local storage of files. This marked the steppingstone for the creation of a central data repository that will allow for a single point of access for imageology studies.

Completed

ISCV - Cardiology Storage

ISCV storage

Transfer of Cardiology studies from local storage to the VNA. This will minimize data storage issues and optimise access from clinicians to the required data.

2025

FIT Order Comms

FIT Order Comms

Automate bowel screening workflow. It will bring department efficiencies by removing a lengthy manual process. Includes data  quality  validation  and  ensures  that  patients  are  being reviewed at appropriate intervals according to current evidence- based guidelines.

2025

Mental Health and Social Care Services

Electronic Care Record (ECR)

The ECR will be a new Electronic Patient Record that will address  current  issues  regarding  the  inoperability  and inefficiencies of the current legacy Mental Health and Social Care Services ECR.

The  new  ECR  system  will  delivery  numerous  benefits, including:

Phase 1 – End 2025 Phase 2 - 2026

 

 

Enhanced Patient and Client Safety

Reduced Administrative Burden

Improved Data Accuracy and Integration

Increased Service User Satisfaction

Improved Staff Satisfaction

The objectives of this programme are:

Reduce  the  administrative  burden  on  staff  by streamlining processes to decrease time spent on non- patient/client related tasks by 20% at the end of Q4

2027

Enhance  patient/client  safety  by  implementing  an integrated ECR system to achieve a 25% reduction in serious incidents, serious case reviews, and medicine incidents  across  Mental  Health,  Social  Care,  and Community Services by the end of Q1 2027

Enhance reportability, data accuracy, and integration by achieving 90% data accuracy and integration with key  systems  within  12  months  of  the  new  ECR system's operation

Improve  patient  engagement  and  satisfaction  by utilising ECR functionalities that increase satisfaction scores by 25% by the end of Q1 2027

Improve  staff  satisfaction  by  25%  by  providing effective tools and reducing workarounds by 40% by end of Q1 2027

 

Sexual Health EPR

Sexual Health EPR

The  current  system  for  managing  patient  appointments, laboratory test requesting and resulting, and general Sexual Health Clinic administration is based on a model established over 25 years ago and remains heavily paper based. It also makes  the  process  of  collating  sexual  health  data  (e.g. GUMCAD, SRHAD, HARS,) virtually impossible and as such has not been carried out for some years.

The aim of the project is to deliver an Electronic Patient Record solution for the Sexual Health/GUM Clinic which will reduce errors, improve patient and staff experience, support the needs identified  through  the  Digital  Health  &  Care  strategy, specifically  the  capture  of  structured  clinical  data  and  the removal of the current paper-based processes.

Sexual Health EPR will improve clinic staff access to patient data for speedy appointment booking and result look up, protect customer's  confidential  information,  proactively  supply accurate and up to date information, and enable staff to actively use technology to meet current and future customer needs, such SMS messaging and electronic Pathology test requesting.Such a system will also enable staff to collate appropriate sexual health data as required with greater ease.

2025

 

Cervical Cancer Screening

Cervical Cancer Screening

Automate cervical screening workflow. It will bring a new screening system, and it will deliver on department efficiencies by removing a lengthy manual process. Includes data quality validation  and  ensures  that  patients  are  being  reviewed  at appropriate  intervals  according  to  current  evidence-based guidelines.

2025

Digital Health Wi- Fi

WiFi refurbishment

Critical improvement to the coverage of the current Health Care Services Wi-Fi Network Infrastructure, enabling the continued digitalisation  of  Jersey's  healthcare  landscape.  As we  look toward  2025,  our  strategic  objectives  are  aligned  with transforming healthcare delivery, enhancing patient outcomes, and ensuring the sustainability of our health system through advanced digital solutions.

The WiFi refurbishment work will deliver on:

Enhanced Patient Care and Outcomes

Operational Efficiency

Integrations and Interoperability

Enabler of healthcare professionals' mobile workflow

2025

Maternity

Maternity EPR

Specialised Maternity Electronic Patient Record that tailors for the specific needs of Maternity staff and users. It's an end-to- end Maternity Information System that is completely paperless, reducing  the  risk  of  human  error  and  supporting  your environmental targets. It provides maternity professionals with the key information they need to make more informed clinical decisions at the point of care. The main purpose is to improve standards of care for women and babies throughout pregnancy by  providing  maternity  professionals  with  the  information needed to make informed clinical decisions at the point of care and eliminating inefficient paper-based processes

2025

Draeger Network

Draeger Network

Main requirement of the patient observations integration with the Jersey Neonatal Unit, Intensive Care Unit and Theatres EPR. This will allow for an automatic feed from different medical  devices  like  the  observation  monitors,  ventilators, anesthetic,  dialysis  and  infusion  pumps  machines.  Highly reduces  transcribing  errors  and  boosts  healthcare  staff efficiencies in the respective areas of practice.

2025

Multitone – GPNet

Multitone – GPNet

This project is to ensure the hospital 999 Multitone paging services (Police CCTV and GP net) don't experience down time when the legacy JT fibre connect product is decommissioned. JT are moving services over to new solutions. This project is to ensure the solutions are fit for purpose and to ensure proper testing is undertaken before backend networks are changed over.

On hold - JT

Pathology Analyser

Pathology Analyser update

2023

 

 

Upgrade of the legacy server and supporting software to an up- to-date  server  and  system.  This  upgrade  mitigated  the cybersecurity risk associated with the old infrastructure.

 

EPR Staffing

Clinical and technical support team which is supporting the training, adoption, and use of the EPR system in clinical areas and has been invaluable in translating clinical needs into EPR processes to improve the user experience and patient outcomes.

 

Project Delivery and Licence costs

Costs for implementing and managing the individual projects including costs for EPR software, IMS Maxims.

 

  1. Please see table below

 

Project

2023

2024 Oct YTD

EPR

£ 2 , 5 48,298

£ 1 , 7 05,664

GP order comms

£ 1 4 4 ,536

£ 2 5 , 6 22

EPMA

£ 8 0 , 8 95

£ 3 9 , 8 07

Mental Health & Social Care Services

£ 2 4 9 ,131

£ 2 5 5 ,050

E prescribing

-

£ 1 6 , 2 99

FIT Order Comm

£ 2 0 2 ,439

£ 2 5 , 4 00

Vendor Neutral Archive (VNA)

£ 1 7 3 ,645

£ 2 5 , 0 00

Sexual Health EPR

-

£ 1 2 7 ,886

PACS Replacement

£ 6 8 , 3 95

£ 9 4 , 4 71

Cervical Cancer

-

£ 4 , 1 8 6

Digital Health WIFI

-

£ 7 8 , 8 50

E consent

-

£ 4 2 , 2 87

Opthalmology

£ 1 0 2 ,625

£ 7 2 , 5 41

Scantrack

£ 1 3 1 ,003

4 , 0 2 5

DH Staffing EPR Tracker

-

£ 2 2 8 ,218

DH Maternity Project

-

£ 5 , 2 8 6

ISCV - Cardiology Storage

-

£ 5 8 , 6 89

Draeger Network Project

-

£ 8 1 8

Multitone - Gpnet

-

£ 3 , 0 7 6

Pathology Analyser

£ 3 9 , 8 55

-

EPR Staffing

-

£ 2 2 8 ,218

Project Delivery and Licence costs

£ 9 9 1 ,990

£ 1 0 4 ,128

The question seems to include a typing error. The proposed expenditure for the Digital Care Strategy for 2025 is £2.003m (see below screenshot from the proposed Budget 2025-28).

The Programme has identified the following projects to be funded, however, on-going review and prioriotisation is required based on clinical needs and the ageing digital health infrastructure. Current projects include:

Patient Portal: Online portal that patients and clinicians' access to view patient records & health care information with benefits to both, patients and clinicians.

Pharmacy drug control: electronic systems for improved controlled drugs management and buying- processes.

Theatres Anaesthetic Record EPR: management of the anaesthetic record and theatres medical devices integration.

EPR v24 update: upgrade to the latest version of Maxims EPR which includes more than 300 enhancements including Jersey clinicians change requests.

E-Referrals:

Continuation of the electronic referrals project to deliver on Phase 1 of the project (HCS – GP practices) and phase 2 (other healthcare providers).

Implementations of specialist EPR modules for sexual health & other core systems  Implementation of in-flight projects like the Sexual Health EPR and major system upgrades.

ePrescribing Oncology  

Digitalisation of oncology paper drug charts removing significant clinical risk and manual procedures. Technology delivery to adhere to enhanced regulatory standards.