The document discusses healthcare change within the NHS, emphasizing the importance of people, processes, and technology, as well as the role of international leaders like VA and VISTA. It outlines various challenges such as integration, code and community issues, and usability, while proposing next steps towards a gold standard NHS model. Key strategies include user-centered design, agile development, and collaboration with local innovators to improve healthcare integration and documentation.

1. Healthcare Change in the NHS
Practical considerations of VistA
Dr. Tony Shannon

2. Tony Shannon
M.B. B.Ch. B.A.O. Ireland
Fellow of College of Emergency Medicine England
Fellowship in Informatics USA
MSc in IT Management England
Consultant in Emergency Medicine, Leeds Teaching Hospitals
Chief Clinical Information Officer, Leeds Teaching Hospitals
(Clinical Lead, NHS Connecting for Health – National Programme for IT)
(Chair, Clinical Review Board, openEHR Foundation)
Honorary Research Fellow, University College London

3. Key points
• Healthcare Change
– People, Process & Technology
• VA & Vista International Leaders
• Challenges in the NHS
– Integration
– Code & Community
– UI & Usability
• Next Steps
– Towards Gold Standard

7. NHS Model Communities: People + Process + Technology
Thinking in silos Clash between process and IT

8. Standards & Interoperability
Templates
Specific
Generic
Archetypes

9. Test Requirement
AoMRC Generic Medical Documentation
Build Design

12. eHealth Ecosystem
International Standards
eHealth Bodies
& Vendors
Local Innovators

13. International Leaders

14. NHS Innovation- from Bottom Up
• Leeds, England
• 4 Hospital Site
• 14,000 employees
• £800m annual budget
• £7m annual IT spend
• Clinically Led
• Process Improvement
• Agile OS development

15. Informatics Strategy
CUI Clinical Portal
PAS 1
Scheduling 2
Orders Results 3
ePrescribing 4
Clinical Docs 5
TIE
200+ Primary Care
A B C

16. Clinical Portal: Patient Oriented & User Centred

17. A B C
Common Web UI
VA Vista
Modular Enterprise
SOA Core Process 1 Wide
Core Process 2
Enterprise
Core Process 3 wide
Core Process 4 System X
Core Process 5 Cache
PPM Gt.M
SQL
Integration Engine
Leeds TH ESB
200+

18. Challenge # 1: Integration

19. Challenge 2: Code & Community

20. Challenge 3: UI & Usability

22. LeedsTH NHS: Steps towards VistA
• User Centred Design
– Clinically Led
• Agile Development
– 10 Days
• Technology
– ExtJS4
– EWD
– Mumps
– Gt.M/Cache NoSQL

23. North- User Context
Clinical UI Patterns
West Centre East
Data Group in focus Data in Detail
Navigation
(Via Via Chart/Grid/Table
Accordion
+/- data source to
+/- Tree)
explain data context
Create/Update/Delete
Inc external (eg Leeds/
Data
sources
Washington)
Data Entry done
Eg in popup
Meds
NB may be
Allergies
external
Diagnosis
component
Clinical Docs
Create Data Update/Delete
Save Data

24. High level- Aggregate Patient Data
ClinUiP.wordpress.com

25. Mid level- Patient Group Data

26. Low level- Patient Detail Data

27. Patient Detail Data- Data Entry

28. ClinUiP on Vista

29. ClinUiP Benefits
• Intro to OS EHR development
• Intro to ExtJS/EWD/GtM
• Introduction to Mumps & Vista
• Align towards Vista/Vista Integration

30. Next Steps
• Knowledge Transfer in the NHS
• Gold Standard for NHS
– Standards- CUI & AoMRC
– Admission, Handover & Discharge
– Integration with a.n.other
• Explore Integration with Vista & Others
– EWD & NodeJS- XML, Mumps/Javascript
– NoSQL & SQL

31. ...towards evolving ecosystem….
International Standards
National eHealth Bodies
& Vendors
Regional
Local Frontline Innovators

32. Key points
• Healthcare Change
– People, Process & Technology
• VA & Vista International Leaders
• Challenges in the NHS
– Integration
– Code & Community
– UI & Usability
• Next Steps
– Towards Gold Standard

33. Thank you
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