Digital Trendspot 2010 NHS Direct

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Slides from the NHS Direct Presentation which was given as Digital Trendspot on 13/10/10.

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  • Multi-Channel service providing health advice and information out of hours support for GPs and dental services telephone support for patients with long-term conditions pre and post operative support for patients 24 hour response to health scares remote clinics via telephoneCore staff of experienced nurses and health advisors 34 sites across the country.   26,000 calls a day. 
  • 33 contact centres linked into a single virtual contact centre26,000 calls per day - That’s over 9 million calls a year (including all commissioned services)Health information and advice line (0845 46 47) deals with 14,000 calls a day. That’s over 5 million calls a yearWebsite receives 1 million visits each month and over 30,000 patients access core NHS Direct services through the internet every day
  • A key stakeholder in delivering the multi channel future for NHS Direct is our chief executive. Nick get’s what we are doing from a multi channel perspectiver and is instrumental in delivering key internal messages such as this one back into our frontline staff.
  • Digital access to health professionals, think about banking in the 1980’s
  • 40 online health and symptom checkersCovering 210 clinical algorithms Produced by our Clinical Development Team Clinically safe Mirrors call centre processes Dispositions & explanations (Call 999, Go to A&E, Call-back from a nurse) Distributed via multiple channelsWeb, Digital television, Mobile devices,
  • The vision is that NHS Direct feeds into a digital NHS with self service at its core so that tasks that involve a visit to GP, Pharmacy, Hospital done via net books, PCs, mobile devices or iTV to suit patients.
  • Top 2 integrate with third party services
  • Shows the different components of the site
  • These elements are NHS Directs internal inputs. Staff Internal Systems (OES) Arezzo (Clinical Decision Tool)
  • External Inputs Third party applications APIs
  • Methods of viewing the siteStandard web pages currentPlanned: Via mobile website/ application Embedded on other sites Internet TVEssential that content and presentation are separated to allow for all the different output formats
  • All powered by Sitecore
  • I am going to discuss the Self Assessment Tools on the site which allows a user to self diagnose an issueIt makes use of the highlighted components
  • They are used to self diagnose an issueIt will ask you questions
  • Questions can be multiple choice, text entry, dropdowns
  • The SAT may from time to time present information instead of questions
  • The information returned might be to call 999, see your GP or self care.
  • Describes the different elements that go to make a SAT Clinical Teams who design the guidelines and ensure they are clinically safeContent Teams ensure that they questions themselves look correctArezzo is the decision engine that decides what should be presented to the userSitecore contains all the content to present
  • Going to run through the process of running a SAT
  • The user answers a SAT question that get sent to the website
  • We send the answer data to Arezzo
  • Arezzo tells us the next set of questions or information to present to the user base on the last and all previous questions
  • We then ask Sitecore what content we should display for each question
  • Sitecore returns the content we need to display
  • The site combines data from Arezzo with the content from Sitecore to return the page.Arezzo decision making process is non-linear therefore we need a content management solution that could handle not being accessed in a linear manner and makes a complete separation between content and presentation. Sitecore allows use to access the content we need when we need it and via a fast API.
  • I am going to go through some of the challenges and solutions when developing the SATs.
  • Sitecores extensibility means that adding a different rendering method is a fast and simple process. To do this all we need to do was: Create a template to represent the spark files Create a class to create the Spark control at rendering Add one line of configurationSitecore comes with loads of icons out of the box, so we found a cool icon
  • We apply workflow to the root item of a SAT.When the want to create a version they submit it, using workflows we lock the entire tree to stop any further editing while it awaits approval. Once approved the SAT can be edited again.Guidelines exist outside the root of the tree, i.e. Not below the home node
  • To link to the SAT we have a placeholder page in the site for each SATThis contains a field that indicates which SAT version a user should use when starting a new SATThis is a quick and easy method of switching between the different available guidelines.
  • Explain what is meant by clinical integrity, i.e. A publish does not interrupt the current usersGive an example of what this means
  • I am going to look at how we maintain a users journey through a SAT and how Sitecores split of presentation and content helps us do that.
  • We have a new user to the site who uses version 1 of the Cold and Flu SAT
  • As they progress through the SAT the NHS Direct team release version 2 of the SATIt is important at this point that for clinical integrity the user in version 1 of the SAT remains on version 1 of the SAT. When version 2 of the SAT is released they must not be switched to version 2.
  • A new user decides to use the Cold and Flu SAT, they access it via the same URL as the original use. They are automatically directed to the new version, version 2.The existing user is still using version 1
  • Sitecore allows us to do this because it allows us to complete control the content we choose to render and to which users.We use the same rendering mechanism and same URL but pull different content from the Sitecore CMS.
  • Digital Trendspot 2010 NHS Direct

    1. 1. NHS Direct & Sitecore<br />Roger Donald<br />Head of Digital Delivery<br />12/10/2010<br />1<br />#SitecoreDT10<br />
    2. 2. What is NHS Direct?<br />12/10/2010<br />2<br />
    3. 3. What is NHS Direct?<br />A health information and advice line (0845 46 47) <br /> 14,000 calls a day. That’s over 5 million calls a year<br /> Web site alone receives 1 million visits each month <br /> 3,400 staff<br /> over 1,400 of whom are trained nurses (including dental nurses)<br />National infrastructure, but with regional/local engagement<br />Commissioned by the East of England Strategic Health Authority<br /> on behalf of NHS<br />12/10/2010<br />3<br />
    4. 4. The digital challenge<br />12/10/2010<br />4<br />
    5. 5. “The internet has changed the way we shop, find information and access services or all sorts, including health care. The revolutionary effect of the web will continue to grow, and all organizations need to understand how to harness this to achieve their goals. <br /> Our patients currently think of NHS Direct as a telephone service. We must, of course continue to be available to patients who just pick up the phone as now. But to ensure we continue to give a service that is highly valued, we need to think about patients who choose to access us by looking on the web first, and then seek phone contact if that is what they need. This needs our full attention.”<br />Nick Chapman - Chief Executive<br />5<br />
    6. 6. Public access to health services?<br />Historically...<br />Face-to-face communication only<br />At a time that suits the health professional<br />Organised around geographic locations & communities<br />Some telephone based access (NHS Direct)<br />Our research demonstrated a public demand for digitally delivered health services<br />12/10/2010<br />6<br />
    7. 7. Delivering digital health services<br />The challenge...<br />40 health & symptom checkers (sometimes called SATs) that are clinically safe<br />That are easily altered by our clinicians & content authors<br />From a single source of clinical algorithms<br />That meet Government accessibility standards <br />Delivered across multiple channels <br />That allow for patient / health professional interactive communication<br />Which capture and pass patient data securely to our systems<br />12/10/2010<br />7<br />
    8. 8. 8<br />
    9. 9. An NHS with accessible health services <br />All done via <br /><ul><li>net books
    10. 10. PCs
    11. 11. Mobile devices
    12. 12. iTV
    13. 13. Gaming consoles</li></ul>9<br />
    14. 14. The Sitecore solution<br />12/10/2010<br />10<br />
    15. 15. Sitecore was chosen because...<br />It integrates with other Microsoft platforms<br />Specifically Arezzo a clinical decision support tool from InferMed (Prime Contractor to NHS Direct)<br />Easy to implement workflow<br />It versions our content<br />Inline editing out the box<br />An easily accessed web interface<br />An API to syndicate our services to other organisations<br />Delivery of content across multiple channels <br />A proven service used by major organisations<br />12/10/2010<br />11<br />
    16. 16. Over to Michael...<br />12/10/2010<br />12<br />
    17. 17. 13<br />12/10/2010<br />Developing the Online Service<br />Michael Edwards<br />Web Consultant<br />
    18. 18. 14<br />12/10/2010<br />Who is Eduserv?<br /><ul><li>10 years experience providing information services to public sector
    19. 19. Not-for-profit registered charity with commercial approach
    20. 20. 1stUK Sitecore Partner
    21. 21. 7 years delivering Sitecore solutions
    22. 22. 14 Sitecore Certified Developers </li></li></ul><li>15<br />12/10/2010<br />Features<br /><ul><li>Find Your Nearest
    23. 23. Job Search
    24. 24. Health Enquiries
    25. 25. SATs
    26. 26. Syndication</li></li></ul><li>16<br />12/10/2010<br />
    27. 27. 17<br />12/10/2010<br />
    28. 28. 18<br />12/10/2010<br />
    29. 29. 19<br />12/10/2010<br />
    30. 30. 20<br />12/10/2010<br />
    31. 31. 21<br />12/10/2010<br />
    32. 32. 22<br />12/10/2010<br />What is a Health and Symptom Checker?<br /><ul><li>A series of questions that follow a NHS Direct clinically developed pathway that lead to multiple dispositions.
    33. 33. Contains
    34. 34. Questions
    35. 35. Information</li></li></ul><li>23<br />12/10/2010<br />What is a Health and Symptom Checker?<br />
    36. 36. 24<br />12/10/2010<br />What is a Health and Symptom Checker?<br /><ul><li>A series of questions that follow a NHS Direct clinically developed pathway that lead to multiple dispositions.
    37. 37. Contains
    38. 38. Questions
    39. 39. Information</li></li></ul><li>25<br />12/10/2010<br />What is a Health and Symptom Checker?<br />
    40. 40. CDE<br />HaSC<br />26<br />12/10/2010<br />
    41. 41. HaSC Process<br />27<br />12/10/2010<br />
    42. 42. CDE<br />Website<br />28<br />12/10/2010<br />
    43. 43. CDE<br />Website<br />29<br />12/10/2010<br />
    44. 44. CDE<br />Website<br />30<br />12/10/2010<br />
    45. 45. CDE<br />Website<br />31<br />12/10/2010<br />
    46. 46. CDE<br />Website<br />32<br />12/10/2010<br />
    47. 47. CDE<br />Website<br />33<br />12/10/2010<br />
    48. 48. The Challenges<br />34<br />12/10/2010<br />
    49. 49. 35<br />12/10/2010<br />The Challenge<br /><ul><li>Clinical Decision Engine uses a full object model
    50. 50. We use a full object model with Sitecore (in house framework)
    51. 51. Sitecore XSLT Renderings can’t be used</li></li></ul><li>36<br />12/10/2010<br />The Solution <br />SPARK<br />
    52. 52. 37<br />12/10/2010<br />What is Spark?<br /><ul><li>View engine for .NET
    53. 53. XHTML focused
    54. 54. Uses domain objects as content source
    55. 55. Open Source
    56. 56. Lives here: http://sparkviewengine.com/</li></li></ul><li>38<br />12/10/2010<br />Why Spark?<br /><ul><li>Less code
    57. 57. Quicker development
    58. 58. Compiled rather than parsed
    59. 59. Very fast rendering
    60. 60. XHTML compliant</li></li></ul><li>39<br />12/10/2010<br />Why Sitecore?<br /><ul><li>Fully extensible
    61. 61. Full integration
    62. 62. Flexibility
    63. 63. Simple
    64. 64. Uses Sitecore inbuilt caching
    65. 65. Accessible via the layout editor</li></li></ul><li>40<br />12/10/2010<br />Spark in Sitecore<br />
    66. 66. 41<br />12/10/2010<br />The Challenge<br /><ul><li>A SAT is a hierarchy of many items
    67. 67. Versioning is typically per item
    68. 68. The whole SAT must be versioned
    69. 69. The ability to change SATs versions quickly</li></li></ul><li>42<br />12/10/2010<br />The Solution<br />Workflow<br />
    70. 70. 43<br />12/10/2010<br />Why Sitecore?<br /><ul><li>Customisable
    71. 71. Full Control
    72. 72. Simple
    73. 73. Extensible</li></li></ul><li>44<br />12/10/2010<br />
    74. 74. 45<br />12/10/2010<br />
    75. 75. 46<br />12/10/2010<br />The Challenge<br /><ul><li>SAT must be shown complete
    76. 76. Maintain clinical integrity
    77. 77. Multiple users, possibly on multiple versions</li></li></ul><li>47<br />12/10/2010<br />The Solution<br />Presentation <br />split from Content<br />
    78. 78. 48<br />12/10/2010<br />Why Sitecore?<br /><ul><li>Content and rendering split
    79. 79. Content always accessible
    80. 80. Fast and powerful query language</li></li></ul><li>Time<br />Version 1<br />49<br />12/10/2010<br />
    81. 81. Time<br />Version 1<br />Version 2<br />50<br />12/10/2010<br />
    82. 82. Time<br />Version 1<br />Version 2<br />51<br />12/10/2010<br />
    83. 83. Time<br />/liveguidelines/v001/c001/coldandflu<br />Version 1<br />Version 2<br />/liveguidelines/v001/c002/coldandflu<br />52<br />12/10/2010<br />
    84. 84. Summary<br />Produced Health and Symptom Checkers<br />Provided a method to rapidly update HaSC<br />Updates don’t interfere with users already on the site<br />HaSC can be distributed through multiple channels<br />12/10/2010<br />53<br />
    85. 85. 54<br />12/10/2010<br />Any Questions<br />?<br />Michael.Edwards@Eduserv.org.uk<br />Roger.Donald@NHSDirect.nhs.uk<br />Follow Digital Trendspot on Twitter- #SitecoreDT10<br />

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