the health infrastructure optimisation roadshow 2007 david dembo & neil slater microsoft ®...
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The Health InfrastructureOptimisation ROADSHOW 2007
National Health Service (NHS)
The NHS vision
“to have a more modern, efficient, patient-led health service and to give patients more choice and control over their own health and care”
The Health InfrastructureOptimisation ROADSHOW 2007
Patient Safety and IT900,000 patient safety incidents per year
8% result in death
£2bn per year extra cost in bed days
After falls, medication errors, record documentation error and communication failure were the most common cause
IT can reduce these errors by 53% - 83%
Source: National Audit Office, 2005 www.nao.org.uk
The Health InfrastructureOptimisation ROADSHOW 2007
NHS CUI Programme Goals
Support NHS Connecting for Health in:
Increasing patient safety
Increasing clinical effectiveness
Increasing the ease of adoption & relevance of Microsoft Windows and Microsoft Office to the NHS
The Health InfrastructureOptimisation ROADSHOW 2007
NHS CUI Timeline
20032003 20042004 20052005 20062006 20072007 20082008 20092009 20102010
Phase 1Phase 1 Phase 2Phase 2
EnvisioningEnvisioning
Programme VisionProgramme Vision
The Health InfrastructureOptimisation ROADSHOW 2007
7Improving patient outcomesand the bottom line.
NHS CUI Focus AreasClinical Applications and Patient Safety
Information Worker Efficiency
IM&T Tools
Clinical Applications and Patient Safety Clinical Applications and Patient Safety
NHS Common User Interface Programme
The Health InfrastructureOptimisation ROADSHOW 2007
Clinical Applications and Patient Safety
Clinicians currently required to use a disparate set of systems from multiple vendors to do the same set of tasks
Lack of consistency for commonly performed and safety critical functions within and across systems
A need to increase User proficiency without increasing training nor compromising patient safety
Patient Safety: Focus Areas
Information Display Standards
Information Input Standards
Abbreviations and Acronyms
Terminology
Decision and Knowledge Support
Ordering and Scheduling
Patient Administration
Patient Record Views
Reports
Noting and Assessment
Structured Planning of Care
Consistent Navigation Model
Accessibility
Agent to Agent Communication
Medications Management
Generic / Miscellaneous
73 NHS Trusts have been engaged with over 200 front-line clinicians and patient-safety experts participating in research, development and testing 100 areas of Design Guidance across the following categories:
The Health InfrastructureOptimisation ROADSHOW 2007
Clinical Safety
Adoption of CUI Icon standards
InformativeAlerts
Warning alerts(Missing Data)
The Health InfrastructureOptimisation ROADSHOW 2007
Design Guidance
Developers / Designers are often inconsistent – especially with simplest of items
1/2 ? Half
01:02 ? Maybe a time
1/2/7 ? Maybe a date
Feb 1 ? What year
01/02/07 ? February (UK) or January (USA)
01-Feb-2007 Clear, Unambiguous, International
The Health InfrastructureOptimisation ROADSHOW 2007
Medications Overview - Summary Guidance• Prioritise the display of drug or item name –
spatially and stylistically
• Use dm+d term
• Use generic name (all lowercase) unless there is a specific requirement otherwise
• DO NOT abbreviate the item name
• DO NOT truncate the item name
• Avoid wrapping the item name
• DO NOT use frequency abbreviations
• Separate dose from item name with at least 2 spaces
• Always use labels where the value could be associated with more than one attribute
• Use useful forms of data (today) to increase clarity
The Health InfrastructureOptimisation ROADSHOW 2007
1st stage 2nd stage 3rd stage
Incremental Development of Guidance & Components
CUI produces guidelines & components
Not building a complete user interface
Building common-controls for clinical applications
Focus is on safety, utility & usability
Leaving plenty of room for innovation
The Health InfrastructureOptimisation ROADSHOW 2007
Faster, Easier Development of Clinical UI
• Pre-built controls implementing CUI Design Guide guidelines
• Familiar Visual Studio developer experience• Builds on the .NET Framework and Microsoft AJAX
extensions• Provides an extensible framework for Design
Guidance and Controls
Clinical UI Standards
CUIToolkit
ISV Innovation
Safe, Compelling, Clinical UX
Information Worker productivity in the NHS Information Worker productivity in the NHS
Common User Interface Programme
The Health InfrastructureOptimisation ROADSHOW 2007
Medical Research ServicesEnables users to research clinical terms without leaving the context of the work they are doing
Increases the value of the existing investment by the NHS in clinical research facilities
The Health InfrastructureOptimisation ROADSHOW 2007
Focus
“To assist NHS Entities in achieving an
easily deployable,
well managed,
and more secure
desktop and server infrastructure.”
Costs
Manageability
Safety
Productivity
The Health InfrastructureOptimisation ROADSHOW 2007
Infrastructure Optimization
• Provides capability framework to help you build an optimized infrastructure (not Microsoft-specific)
• Establishes a foundation based on industry analyst, academic, and consortium research
• Provides guidance and best practices for step-by-step implementation
• Drives cost reduction, security and efficiency gains
• Enables agility
Application Platform Optimization ModelApplication Platform Optimization Model
Business IntelligenceBusiness Intelligence
Enterprise Content ManagementEnterprise Content Management
CollaborationCollaboration
Unified CommunicationsUnified Communications
Enterprise SearchEnterprise Search
Business Productivity Infrastructure Optimization ModelBusiness Productivity Infrastructure Optimization Model
DevelopmentDevelopment
SOA and Business ProcessSOA and Business Process
Business IntelligenceBusiness IntelligenceUser ExperienceUser Experience
Data ManagementData Management
Data Protection and RecoveryData Protection and Recovery
Desktop, Device, and Server MgmtDesktop, Device, and Server Mgmt
Identity and Access ManagementIdentity and Access Management
Security and NetworkingSecurity and Networking
Core Infrastructure Optimization ModelCore Infrastructure Optimization Model
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The Health InfrastructureOptimisation ROADSHOW 2007
StandardizedStandardized DynamicDynamicRationalizedRationalizedBasicBasic
Data Protection and Recovery
Identity and Access Management
Security and Networking
IT and Security Process
Desktop, Device, and Server Management
Core Infrastructure Optimization Model
The Health InfrastructureOptimisation ROADSHOW 2007
DynamicDynamic
• Proactive
• OptimizingCosts and Quality
• Agile
• Self Assessingand ContinuousImprovement
• “Taking The Lead”
• Proactive
• Accountable
• Increased Monitoring
• Formal ChangeManagement
• SLAs
• Improvement
• Predictability
• “Quality Driven”
StandardizedStandardized
• Reactive
• Stable IT
• Request Driven
• Change Management and Planning
• “Keeping ItRunning”
BasicBasic
• Reactive
• Ad hoc
• Problem-Driven
• “AvoidingDowntime”
RationalizedRationalized
Infrastructure Optimization ModelInfrastructure Optimization ModelStage CharacteristicsStage Characteristics
The Health InfrastructureOptimisation ROADSHOW 2007
StandardizedStandardized RationalizedRationalizedBasicBasic
IO Improves IT EfficiencyAccomplish More with the Same Resources
PCs managed
per IT FTE
100100
200200
300300
400400
700700
00
Organization Organization
500500
600600
Avg PC’s per/IT FTE
IT Labor/PC
Source: IDC data analyzed by Microsoft 2006
20%
60%20%
76$1,320
172$580
442$230
The Health InfrastructureOptimisation ROADSHOW 2007
StandardizedStandardized RationalizedRationalizedBasicBasic$1,320/PC $230/PC
Limited PC Security• PC firewall• Auto patching
PC Security $130/PC Savings
Comprehensive PC Security• Anti Spyware• Enforced security compliance
with Network Access Control
Minimal PC Security• Anti-virus• Manual patching• No enforced sec. compliance
Standardization• Defined PC lifecycle• Limited policy based PC mgt• Many software configs
Stds Compliance• Defined PC life cycle, stds enforcement• Full policy based PC mgt• Minimal hw, sw configs
None• No PC life cycle strategy• No policy based PC mgt• Many hw, sw config
Standardized desktops $110/PC Centrally managed PC config $190/PC
Limited sys mgmt• Single sys mgt tool• Software packaging• Software distribution
No system-wide mgmt• Poor sys mgt tool coverage• Duplicate mgmt tools• Manual sw, patch deploymt
Comprehensive sys mgt• Hw, sw inventories• Hw, sw reporting• Auto/targeted sw dist.
Single system management tool $110/PC Automated software distribution $120/PC
Multiple Directories• Many auth. directories• No dir synchronization• Manual user provisioning
Single directory for Auth• One authentication dir.
Automated provisioning• Single Sign-on• Auto password reset• Auto user provisioning
Comprehensive directory solution $120/PC Automated user provisioning $50/PC
Source: http://www.microsoft.com/technet/io (Desktop, AD, & SMS), IDC, 2006
$580/PC
Infrastructure OptimizationIndustry Best Practices Drives Down Costs
The Health InfrastructureOptimisation ROADSHOW 2007
Infrastructure OptimisationAssessment Results – Before CUI
Security and NetworkingSecurity and Networking
Identity and Access Management
Identity and Access Management
Desktop Device and Server Management
Desktop Device and Server Management
Data Protection and Recovery
Data Protection and Recovery
The Health InfrastructureOptimisation ROADSHOW 2007
Infrastructure OptimisationAssessment Results – After CUI
Security and NetworkingSecurity and Networking
Identity and Access Management
Identity and Access Management
Desktop Device and Server Management
Desktop Device and Server Management
Data Protection and Recovery
Data Protection and Recovery