04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 11

Changing Clinical SoftwareChanging Clinical Software

Dr Colin BrownDr Colin Brown

General PractitionerGeneral Practitioner

SCIMP Conference SCIMP Conference

Dunblane 2006Dunblane 2006

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 22

Why we are doing this?Why we are doing this?

Where are we starting from? Where are we starting from? GP systems are specialist engineered products with the GP systems are specialist engineered products with the

unique function of constructing a life-long record of unique function of constructing a life-long record of unconstrained scale and content with accuracy and security unconstrained scale and content with accuracy and security – and usable in front of a patient in their precious 7.5 mins. – and usable in front of a patient in their precious 7.5 mins. by any users in Primary Care Teamby any users in Primary Care Team

Where are we going?Where are we going? How do we get there?How do we get there?

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 33

Clinical System ChangesClinical System Changes Versions Versions referenced:referenced:

Ascribe Ascribe to Visionto Vision EMIS PCS EMIS PCS to Visionto Vision

from GPASS, Vision, EMIS LVfrom GPASS, Vision, EMIS LV GPASS GPASS to EMIS PCS, GPass Clinical, Vision to EMIS PCS, GPass Clinical, Vision

from Torex HMCfrom Torex HMC iSoft Synergy from Meditel, PremiereiSoft Synergy from Meditel, Premiere Torex HMC to GPASSTorex HMC to GPASS TPP TPP from EMIS LVfrom EMIS LV Vision Vision to GPASS to GPASS

from GPASS 4x, 5x, Seetec, Microtest, from GPASS 4x, 5x, Seetec, Microtest, EMIS LV, VAMP Medical EMIS LV, VAMP Medical

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 44

Overall PlanOverall PlanPre-migration practice development statusPre-migration practice development statusPre-migration data quality issuesPre-migration data quality issuesData migration issuesData migration issuesData freeze periodData freeze periodGo Live DayGo Live DayNew-system learningNew-system learningNew-system design issuesNew-system design issues3rd-party issues 3rd-party issues General incl. Lessons LearnedGeneral incl. Lessons Learned

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 55

Practice development statusPractice development status SoftwareSoftware Hardware and systemHardware and system Business processesBusiness processes TrainingTraining - - what are the training what are the training

needs?needs?IT training IT training Specific new-system trainingSpecific new-system training

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 66

Pre-migration data qualityPre-migration data quality

CodesCodes – Read versions, other, SNOMed – Read versions, other, SNOMed System admin data System admin data - - Non-standardNon-standard

PrioritiesPriorities Recalls Recalls ADRsADRs Drug dictionaryDrug dictionary - a dictionary migration - a dictionary migration

also?also?Issues - “OP”, ADRs, BAN/RINN, old Issues - “OP”, ADRs, BAN/RINN, old scriptsscripts

Metadata: Metadata: [PRIORITY = LOW] [PRIORITY = LOW]

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 77

Pre-migration PlanningPre-migration Planning: : phone a friend phone a friend ask the audienceask the audience

1 - access the UG1 - access the UG2 - the patients - involve them2 - the patients - involve them3 - check with occasional team users 3 - check with occasional team users

E-working?E-working?

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 88

Data MigrationData Migration

Extraction of data from old database Extraction of data from old database Conversion of the extracted data to new databaseConversion of the extracted data to new database

format, and of old to new data types.format, and of old to new data types.Quality Assurance.Quality Assurance.

Conversion accuracy? Conversion accuracy? Coded and Uncoded data Coded and Uncoded data InPS - 2 utilities provided InPS - 2 utilities provided EMIS - these functions built in to the main EMIS - these functions built in to the main

softwaresoftware

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 99

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 1010

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 1111

Data FreezeData Freeze

Computer DowntimeComputer Downtime

Is there any need for this?Is there any need for this?

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 1212

Go Live DayGo Live DayHints and Tips from Supplier Hints and Tips from Supplier

Business Continuity Plan – as if paperless Business Continuity Plan – as if paperless No routine surgeries, clinicsNo routine surgeries, clinics Print-offs for the actual downtimePrint-offs for the actual downtime Hardware and system configuration on siteHardware and system configuration on site

Data Melt Data Melt You've got to do this? - not necessarily You've got to do this? - not necessarily so…so…

Clinical value is max. if sooner not later.Clinical value is max. if sooner not later.

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 1313

New System Learning 1New System Learning 1

Function re-modelling Function re-modelling - Predict the functions to be changed…. to Predict the functions to be changed…. to

anticipate how your new system will work anticipate how your new system will work differently and re-model your business differently and re-model your business processesprocesses

- Original s/w method of delivering a Original s/w method of delivering a function may not be the only wayfunction may not be the only way

- Version-specific not brand-namesVersion-specific not brand-names

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 1414

New System Learning 2 New System Learning 2

Design issuesDesign issues

on-the-fly coding on-the-fly coding Keyboard use Keyboard use Appointments Appointments Better Display > Data Quality issuesBetter Display > Data Quality issues

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 1515

3rd Party Issues3rd Party IssuesDocmanDocmanLabeltraceLabeltraceSCI Gateway / 2nd OpinionSCI Gateway / 2nd OpinionManaged ServerManaged Server

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 1616

GeneralGeneral

Clinical - specific benefits? Clinical - specific benefits? Detailed Pros/Cons – per user?Detailed Pros/Cons – per user?

Practice Management - similar challenges?Practice Management - similar challenges? Summarising for training status Summarising for training status Lloyd George to A4Lloyd George to A4 Going paperlight Going paperlight Changing premisesChanging premises Changing partnersChanging partners New jobNew job

Combine some of these?Combine some of these?

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 1717

DO - LISTDO - LIST #1 - for Suppliers #1 - for Suppliers online connectivity on Go Live Dayonline connectivity on Go Live Day share the Drug Dix / coding migrationsshare the Drug Dix / coding migrations bulk prioritising functionsbulk prioritising functions improve handling of non-coded dataimprove handling of non-coded data consider appointments migrationsconsider appointments migrations customise migration advice for “donor” systemcustomise migration advice for “donor” system custom-configure the initial setup of new custom-configure the initial setup of new

systemsystem guarantee access to archive data + audit trailsguarantee access to archive data + audit trails

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 1818

DO - LISTDO - LIST #2 - for NHS Board IT Depts #2 - for NHS Board IT Depts keep original s/w live.keep original s/w live. test s/w on hardware platform test s/w on hardware platform beforebefore

Go-Live.Go-Live. contract with suppliers to retain contract with suppliers to retain

legibility of archive data + audit legibility of archive data + audit trails.trails.

support GMS IT Facilitators in custom support GMS IT Facilitators in custom data quality fixes pre-migration.data quality fixes pre-migration.

share local expertise in new business share local expertise in new business processes.processes.

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 1919

DO - LISTDO - LIST #3 - for #3 - for UsersUsers create custom benefit lists for each create custom benefit lists for each

team member.team member. prepare … then prepare some moreprepare … then prepare some more engage your local friendly new-system engage your local friendly new-system

user to check out your test data.user to check out your test data. engage your patients - they can engage your patients - they can

sympathise about computer problems!sympathise about computer problems! access all UG supportaccess all UG support

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 2020

DON'TDON'T ( (= specific "errors of commission“)= specific "errors of commission“) SuppliersSuppliers Change the GoLiveDayChange the GoLiveDay Use non-standard codesUse non-standard codes PCOsPCOs

Strip kit from the site if needed for original Strip kit from the site if needed for original s/w to run. s/w to run.

UsersUsersLeave it all to the leaderLeave it all to the leaderGo on Holiday!Go on Holiday!

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 2121

04/21/2304/21/23 Changing Clinical SoftwareChanging Clinical Software 2222

THE ENDTHE END…………

………………………………..

is just the beginningis just the beginning

www.visioneer.pbwiki.comwww.visioneer.pbwiki.com

colin.brown99@nhs.netcolin.brown99@nhs.net