festine lente: our eswift journey - ehealth ireland irelan… · opportunity to make decisions...
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Festine Lente:
Our eSwift Journey
eHealth Ireland Ecosystem, DCU
04/09/2107
www.stpatricks.ie
St Patricks Mental Health Service: Who are we?
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Willow Grove Adolescent Service
• Largest mental health services organisation in Ireland
• Independent, not for profit• Founded in 1746 by author of
Gulliver’s Travels, Jonathan Swift
Our Patron Swift
• 2 campuses• 3 MHC Approved Centres• 7 Dean Community Clinics• 6 Associate Dean Community Clinics• Over 700 staff• Over 25 Day Programmes
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Our Values
• Grounded in Human Rights.
• Believe in and promote people’s rights to be treated with dignity and respect.
• Believe in and promote people’s rights to be protected against discrimination.
• Seek to provide the least restrictive, least intrusive treatment.
• Seek to promote independence and personal autonomy and to give people the opportunity to make decisions about their own care.
• Seek to empower recovery by fostering positive coping and management skills and by providing individual care plans grounded in evidence based best practice.
• Believe in and promote full inclusion and equal opportunities for those experiencing mental health difficulties.
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Our Key Activities
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Service Delivery
Advocacy
Research and Training
Service User Participation
Our Aims
Strategic Aims: To work towards a Society where
• Mental Health is valued and promoted
• Mental Health Difficulties are better understood
• Those experiencing mental health difficulties are viewed as equal citizens, their rights are fully acknowledged and they are included as active participants
• There are adequate high quality services and sufficient preventive initiatives
Specific Aims: To work towards ensuring that :
• The highest quality care is made available to more people who need it
• The rights of people experiencing Mental Health Difficulties to appropriate services and supports are adequately enshrined in legislation
• Stigma and discrimination are reduced
• Awareness among young people of mental health is enhanced
• Those experiencing mental health difficulties are treated as equal partners
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Empowering Recovery Strategy: 2013 - 2018
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Annual Report & Financial Statements
Through the Empowering Recovery Strategy we have committed to :
• The development of a National Mental Health Wellbeing and Recovery Campus providing excellent mental health care.
• The establishment of a nationwide community mental health service (Dean Clinics)
• The development of a Later Life Mental Health Wellness Campus on the St. Edmundsbury Hospital site.
• The development of a range of technology based support services.
eSwift People
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Why? Benefits summary
2013 to 2016 – The Birth of eSwift
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• Decision to transition to an Electronic Health Record system has not been taken lightly and
is based on a number preparatory activities.
a. An exhaustive analysis of our SPMHS functional EHR requirements,
b. A competitive and robust EHR re-tender and vendor selection process,
c. A comprehensive evaluation of the total cost of ownership (TCO) and the ability to
resource the EHR investment.
d. A structured plan to engage and manage key stakeholders and buy-in.
• A recognition that decisions of this size always present risks but so does doing nothing.
• Full Board, Executive, Senior Management and Clinical support
• In June 2016, SPMHS signed a 5 year contract with Servelec UK, to provide an hosted
Electronic Health Record (EHR) solution.
• This decision represents a major strategic investment and commitment by the organisation
with the objective of transforming our care processes.
The system chosen…Open RiO
22 years’ experience
In 59 UK sites
Used by over
150,000 clinicians…
…providing support to approx.
25%of England’s population
1st implementation in Ireland
How: Organisational, Functional Governance Frameworks
SPMHS’s ICT is a key organizational asset which like other strategicassets requires governance to create value. SPMHS’s ICT StrategyCommittee is responsible for ensuring good governance practice inrelation to these assets (See Appendix A, Terms of Reference ofCommittee). The 2013-2018 priorities for SPMHS ICT are to;
▪ Guide and oversee the key strategic investment decisions on thedevelopment, procurement, implementation and management ofTechnology supporting SPMHS.
▪ Ensure appropriate investment decisions are made and priortisedon SPMHS’s ICT architecture, infrastructure and technicalenvironment.
▪ Ensure a formal Project Management Approach is adhered to forall approved ICT projects so that they are delivered in scope, onbudget and time.
▪ Monitor ICT expenditure against budget & ensure ICT contributioneffectively achieves SPMHS’s strategy and promised benefits.
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eSwift Programme Governance Structure
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Enters SPMHS
Current Inpatient Process
Demographics & Insurance
Find Chart Find relevant info Assessment Repeat Info
Assessment Repeat Info
Arrive on Ward
TreatmentTreatment & Care Plan
Continuous Update
DischargeOutpatient Treatment
Enters SPMHS
SU – Why do I have to repeat?
- Barriers
MDT Updates & Review
Service User Access
Current Inpatient Process
Assessment Repeat Info
Arrive on Ward
Treatment
MDT Updates & Review
Treatment & Care Plan
Continuous Update
DischargeOutpatient Treatment
Enters SPMHS
Demographics & Insurance Find Chart Find relevant info
SU – Why do I have to repeat?
- Removing the Barriers
Find relevant Info Assessment
SMS
Diary
MDT update & Review
DischargeContinuous Update
Outpatient Treatment
Service User Access
Diary
SurveysOnline Resources
Care Plan Tele Health
Access to Previously recorded Information
Care Plan: Paper Vs Electronic
How eSwift will meet our Requirements
Who? eSwift Team
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eSwift Implementation Roles
Departmental Resources
• IT Operations Manager
• Integration Engineer x 1
• BI Lead x 1
• Network Engineer x 2
• Lead Systems Engineer x 1
• Senior Systems Engineer x 1
• Service Desk Analyst
• ICT Trainer x 1
Vendor Resources
Programme Specific Resources
• Emterprise IT Programme Manager
• Enterprise Architect (1 year)
• Business Analysts x 2
• Project Managers x 2
• Configuration Lead x 1
• Superusers x 2
• Device Deployer; 3rd level student
Design Advisory Team
• Chief Pharmacist 1 WTE
• Psychiatrist 1 WTE
• CNM 1 WTE
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Our Approach The Following is the high-level approach that will be adopted by the teams during the Build Phase of the Project – UAT included for completeness. This is based on the Prototyping approach above.
Change Request Log
Change Request Log
Decision Log
Decision LogWith OutcomeRejectedAcceptedDeferredEscalated
Start
Users/EHR Team
Conduct Transformation Workshops with Key
Stakeholders
As Is Process MapsBusiness
Requirements
Inputs
Captured Transformation Requirements
Inputs
EHR Team
Build and Configure Functionality/Product
Rio
Users
Review Prototype Functionality/Product
No
Gaps Identified?
Yes
Capture Updated Requirements/
ChangeRequests
EHR Team/Servalec
Release Functionality/Product to Baseline
Environment
Users/EHR Team
Unit TestReleased
Functionality
Defects/Bugs Identified? No
EHR Team/Servelec
Release To Pre Production
Environment
Users
Regression Test
Yes
All
Cutover to Production/Live
End
EHR Team/Servelec
Fix Bugs/Defects
Defects/Bugs Identified?
No
Yes
And
Users
Execute UAT
EHR Team
Create To Be Process Maps
To Be Process Maps
And
Users
Create Updated Procedures Documents
Updated Procedures
End
End
If
Accepted
Product Working Group
Review and Prioritisation of Updated Requirements
and Change Requests-Change Management
To PWG
Decision
Escalation Required
Steering Group
Review of PWG Outputs
Accepted
Decision If
Project
Update Decision Log with Outcome:RejectedAcceptedDeferred
Rejected
EndUsers/EHR Team
Conduct Transformation Workshops with Key
Stakeholders
Note these will be conducted with Key
Users and Stakeholders only
End Rejected
Baseline Env
RIO
RIO
RIO
Pre Production Baseline Environment
RIO
eSwift Implementation Approach
RiO Implementation RoadmapFeb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17
RiO Solution
As Is Mapping
ToBe Mapping
Servelec Hosting Environment
RiO Configuration
Training R1
Pilot Training
RiO Test Planning
RiO Test Execution
RiO Dependencies
Infrastructure Projects
User Access - Last Pass
MS Office License Negotiation
MS Office 365 Install
SPMHS Hosting - Microsoft Cloud First
Network Improvements Project
Network Upgrade @ SPUH
Devices Deployment
Secure Printing
Other Applications, Processes & Procedures
Disaster Recovery/Business Continuity
Data Dictionary
Staff Recruitment
Training
Migration - Medical Records to RiO
Migration - Old PAS to RiO
Business Intelligence / Management Reporting
Data Protection
Integration [build; Pharmacy; Laboratory]
Billing
Finance [MS Dynamics]
BAU Operational Support bu Helpdesk & Servelec
Complete Solution Test
Point 2 Point Test
System Test
UAT
Stress Test
Go- LiveGo Live Activity - including handover to BAU
eSwift Dependencies
eSwift HQ
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eSwift Timeline
Training (6-8 weeks)
Testing and revisions complete
Start the design and
build of the solution
System build completeSelect vendor and
sign contract
Report built and
tested
GO LIVE
• Some staff may never have used PCs as part of their job
• These staff will be supported with training before the EHR
• Training Needs Analysis quantified numbers
• Around 600 staff to be trained
• Classroom-based with hands-on experience
.
• Initial support -on the floor
• Ongoing support
• Refresher training
• Training for new staff
• Online videos, crib sheets, manuals
3 phases of Training
Pre-EHR EHR Post- EHR
Classroom Training• Pilot completed
• Level 1 underway shortly
Learning Management System• Totara in place• Just needs to be populated
Rooms• No permanent training room
• 2 portacabins are being sourced
Superusers• 2 trainers from the hospital for 6 months• Experienced staff to train other users
Training activity2017
Stage JJ F M A M J J A
Level 1
Level 2
EHR
