|Graham Frost and Anne Pryke|
The States of Jersey Health and Social Services Department has selected InterSystems TrakCare to facilitate an island-wide Integrated Care Record. In this exclusive interview, ICR programme manager Pamela Gordon explains how the project grew from an urgent need for a new PAS at the island’s general hospital and discusses the challenges ahead.
The States of Jersey Health and Social Services department is responsible for health, mental health, ambulance and social services for more than 90,000 people living on Jersey and its surrounding islands.
“Our population may be small, but we have all the issues that face larger health services,” says Pamela Gordon, the Department’s Integrated Care Record programme manager. “We also have a business strategy to address the needs of the growing proportion retired people in our population. IT will help us deliver our strategy for doing that.”
A visionary project
The States of Jersey Health and Social Services Department has just embarked on a visionary programme to create an Integrated Care Record to modernise its health and related services and to prepare for demographic change, with InterSystems TrakCare health information systems at its centre.
Eventually, it hopes the record will be among the first in the UK to provide support full support for patients, wherever they are and whatever time of day it is. However, the project started with a more pressing need: a new patient administration system for Jersey’s General Hospital in St Helier.
“Our hospital system is 25 years old and in need of replacement,” Gordon says. “Then, our PAS provider announced it might not be able going to support the system beyond 2011, and that really pushed the replacement to the top of the issues list.
“We knew that we were not providing our clinicians with the technology they expect – we have no RIS or PACS, either – and we wanted to improve the way we work and our information management. So we really got into looking into our business requirements.”
This was in 2006. Eventually, the Department launched a procurement process involving 13 suppliers, who were steadily whittled down to two. InterSystems won the PAS/integrated care record contract, with its partner, JAC Medicines Management, providing pharmacy/electronic prescribing. Another firm will install a PACS/RIS.
“We did lots of due diligence,” Gordon says of the decision to go with InterSystems TrakCare. “We looked at the company’s background, we looked at the product. We went to see a deployment site in NHS Lothian and we got references from Lothian and Guernsey, which has also gone with InterSystems.
“What really appealed to us [about TrakCare] was its ease of configurability. We are confident that it can be adapted to do what we want it to do.”
Delivering in phases
The Department is now embarking on the first phase of what will be a multi-phase project to get the new hospital systems in place and then implement further functionality, while making the new systems available to more of Jersey’s health and social care services.
In the first phase, the TrakCare PAS, Maternity, Accident & Emergency and Theatre modules will be deployed, along with Mental Health Law Administration, Pharmacy from JAC and the PACS/RIS.
As this is happening, the Department will explore ways to secure the funding for the second phase, in which Order Communications, Results Reporting and e-Prescribing will be added, along with Community, Adult Social Care, Care Planning and Care Pathways.
The scope of the project also includes integrating data from 15 departmental systems, including the new PACS/RIS and an existing child health system, using InterSystems’ rapid integration platform Ensemble, which is an integral part of the TrakCare solution.
“The first phase is a foundation phase,” says Gordon. “We will get a PAS and an interface for linking with other systems, and we will get PACS/RIS. Our clinicians are very excited about that, because they are still using film – which in storage terms alone is just not sustainable.”
“We will also be getting more detailed and timely management information. At the moment, getting information takes too long and requires quite a lot of time-consuming manipulation of data. We want to be able to get information in real-time.”
“Phase two will build on that, and provide more new functionality; a clinical professional record of care, which will help us deliver targeted quality improvements. In this phase, we will also start looking into the community and mental health areas.
“We have signed a contract with InterSystems for phase one and phase two, and we do not plan to get another supplier. When we get the money, we will move onto phase two. We know where we want to go.”
Jersey’s politicians and the senior management of its Health and Social Services Department have kept a close eye on the project. The ten-year contract with InterSystems was signed by minister for health and social services Anne Pryke, while the project’s senior responsible officer is the Department’s chief executive, Mike Pollard.
He says: “A single, integrated record that extends beyond the acute environment and across all our departments will improve data quality and support for staff, enabling them to offer a far superior service to our patients, wherever they are operating.”
Further options under discussion include working with Jersey’s independent primary care doctors so they can access the central TrakCare patient master index and make use of its electronic patient record summaries, referrals, scheduling, results reporting and order communications.
However, Gordon is under no illusions that there are challenges ahead. One of the big ones will be keeping clinicians on board, and making sure they really use the technology and get the benefits from it that are expected.
Clinicians were involved in drawing up the Output Based Specification and the procurement process, and are now embedded in the programme, project and change management boards; so lines of communication are at least open.
The other big challenge identified by Gordon is simply “expectation”. “Lots of people have been involved in getting us as far as we have got today,” she says. “The danger is that they will think they will now get everything, immediately.”
“Also, technology and business requirements change. We will need to keep reminding people what our requirements were and what we agreed. I am not going to make this a 15 year project, where we keep changing our ideas and we never deliver anything. We want to deliver on what we promised, and then build on that.”
At the signing ceremony, Graham Frost, InterSystems managing director, northern Europe, pointed out that: “The provision of a citizen’s healthcare record at any point of care is that holy grail that most large healthcare organisations are seeking.”
Now, he said: “Jersey will be at the forefront of illustrating how this can be achieved and delivered rapidly.” Gordon is even more succinct. “It will happen. It is really exciting.”
To find out more about InterSystems and the technology behind these applications, join us at the InterSystems UK Symposium, 22nd September ’09, Twickenham Stadium. For further information about this feature or any other matters please contact Alison Singleton on 01753 829 670.