The document summarizes the transformation of the Royal Brompton & Harefield NHS Foundation Trust's information technology and infrastructure over the past few years led by Chief Information Officer Joanna Smith. It describes the trust's clinical services and sites. It outlines Smith's background and goals for the trust's IT strategy. Progress made includes improvements to clinical systems like PACS and EPMA, the network infrastructure, and a more effective help desk. Feedback from clinicians has been positive about improved image quality, data access, and reduced paperwork. Challenges included gaining trust during the transformation, but relationships and credibility have increased.

1. Out of the wilderness, our journey to
transformation
Joanna Smith
Chief Information Officer
The Royal Brompton & Harefield NHS Foundation Trust
May 2016

2. Introduction
Royal Brompton & Harefield NHS Foundation Trust
– UK's largest centre for the treatment of adult congenital heart
disease.
– 130,000+ outpatient appointments, >30,000 inpatient & day
cases per annum
– UK’s largest specialist heart and lung centre
– 2 sites: Chelsea, West London and Harefield, Middlesex
– Europe's top-ranked respiratory research centre
– Europe's largest unit for the treatment of cystic fibrosis
– The cardiac, cardiovascular & critical care teams are rated in
the top three most highly-cited health research teams in
Europe.
– >3,000 angiograms & cardiac catheterisations, 1,800 thoracic
surgery operations, 2,400 coronary angioplasties, 2,000
treatments for respiratory failure & 1,200 heart bypass
operations (including heart and lung transplants)
Joanna Smith
• 30 years in pharmaceuticals,
primarily in IT
• Global and local roles – business
facing
• First role in Public Sector/ NHS
hospital
• I&T inc. Imaging IT, IG & BME

3. The way it was
Under investment in the infrastructure
1/3 PCs had admin rights & no anti-virus
75% of print was colour, < 10% was duplex
50% of print was done via local printers

4. Our I&T Strategy & 3
Year Planfrom here…..
….. to here…..
I&T Strategy & 3 Year Plan approved March ‘14
….. and finally here

5. Progress so far
Clinical Transformation
• PACS Remediation Plan – faster, more resilient, remote access
• Clinical Data Warehouse & analytic tools – delivering new
insights and reducing time spent on research
• New EPMA – improving safety and effectiveness
• New EDM & PAS go live this summer – improving safety,
efficiency and effectiveness and driving towards paperlite and
a true EMR
Infrastructure
• New core, edge & wifi network – faster and more reliable
• New virtualised compute & storage solution – fewer outages
• Migration to W7 and PC refresh - faster and more reliable
• Exchange upgraded – email archiving, presence, unlimited mailbox, improved OWA
• Skye for Business – internal meetings, messaging, remote consultations with patients
and HCPs
• Single Sign-on and VDI – faster access to systems including UYOD
• New IG services – better value for money
• New managed print service – better service, better value, follow-me print
• New telecoms contract – converged all voice & data, saving £1.5m over 5 years
Organisation
• New structure and roles
• Fewer contractors (in BAU roles)
• Goals & Objectives
• Appraisals & PDPs
• Competency framework
• Training plans
Impacts
• Dialogue has improved
• Credibility has increased
• Positive feedback received more often
• Reduction in outages and time to fix
• Helpdesk more effective - more calls
answered and in shorter time
• Complexity reduced
• # of physical servers reduced by > 20%

6. In summary
Calls to our helpdesk, are being
answered significantly more
quickly, improving from, on
average >4m to <30s to answer a
call
SMARTBOARDS
“Quality of the images was excellent”..... “thank you for all of
your work to get us this far”, Professor P.
“Overall - Powerful, impressive, will be important when working
with other hospitals”, “This will be contribute to 2015 being a
great year”. Professor P.
“Video quality and sharing content very good”, “Great news for
our referrals”, Mr M – Divisional Director
CDW
In support of Service Evaluation
Myocarditis, “That is amazing –
Thank you very much”, Dr. W
ITU Dashboard providing valuable
continuous feedback on medication
metrics, allowing clinicians to detect
trend changes in prescription, “I like
it”, Dr. F
Using the SAS toolset and the Clinical
Data Warehouse to identify a cohort
of Lymphangioleimyomatosis
patients took 30 minutes, saving
several weeks of investigative work.
REMOTE ECHO CONSULTATIONS
OJ - “more than good enough, very good /
great example of collaborative work across
the teams with innovative, enthusiastic and
open minded attitude”
Average boot time from 17s to 11s and average logon duration from 1m 21s to 40s
42% reduction in
devices seeing high CPU
usage issues
“This upgrade to the Trust Infrastructure will greatly assist CSC in successfully
deploying and operating Lorenzo” - Solution Architect CSC UK&I Healthcare
Significant improvement
in VTE completion
following EPMA roll-out
“@RBandH finally
has good Internet!
Makes clinic visits
a whole lot better.
Top marks!! “– via
Twitter
“Marked
improvement
in IT service” –
SJ
Dr S - “EPMA is going to revolutionise the
way we work. Electronic prescribing will
reduce the amount of paperwork and the
administrative burden associated with
medicines management. I can’t wait to
use it in the rest of the Hospital.”
MS (Nurse) - “ the system
has already helped
improve care and service
in just the first week
New Image Viewer
Prof H - it is very, very impressive –
in fact no glitches in my trial so far on
3 different devices. Astonishingly
quick access to large CT data sets
“Charring Cross
Hospital doesn't
have Wifi??!! so
spoilt on Foulis
Ward at @RBandH
@CFAware” – via
Twitter
• Reduction in manually intensive activities
• Improved patient safety and experience
• Greater & more effective collaboration inside and
outside of the Trust
• I&T is becoming more aligned and proactive
• Faster, more reliable access to services
• Greater mobility, x-site and remotely
Coming
next:
• Migrate to the Cloud
• Asset tagging and fridge monitoring
solution (RTLS)
• Replace legacy bleep solution
• Upgrade AV estate/MDT service
• Migrate legacy PBX switchboard to
VOIP
• Implement the Imaging strategy

7. Key Success Factors
& Challenges
• Be seen and practice what you preach
• Be authentic
• Be clear that you are here to help
• Pick your battles
• Be credible – get the basics right
• Identify key stakeholders and develop
strong relationships with them
• Establish some allies
• Learn the business and be part of it
• Talk in business terms and about benefits
And the biggest challenge? Gaining trust and buy-in, particularly from my team

8. Thank you, any questions?
Joanna.smith@rbht.nhs.uk