The Scottish government has pledged to further consolidate its SCI Gateway and SCI Store, and enhance its Emergency Care Summary Service, in its new e-health strategy for 2008-11.
The strategy lays out NHS Scotland’s approach to ‘electronic patient records and electronic communication becoming the primary means to manage healthcare information within the health system.’
While no specific budgetary commitment has been made, the Scottish Executive says it aims to boost the national e-health budget from the £40m spent in 2005/6 to £140m in 2010/11. In total it says NHS Scotland spent £225m on IM&T in 2006/2007.
It reiterates the commitment to stick to its current step-by-step approach and build on the systems already in use in Scotland: “We have already successfully implemented initiatives such as SCI Store, SCI Gateway and the Emergency Care Summary which help us to join systems and share information but we need to move further.”
Big bang approaches to e-health are rejected as risky and potentially disruptive: “An attempt to move to this new world in a single bound, even if achievable, would take a number of years and would be disruptive. NHS Scotland has to date chosen to approach this vision step-by-step; by building on what we have already successfully achieved, carefully addressing risks and resources to gain benefit from our effort as we go,” says the report.
Examples of exploiting existing systems includes using the SCI Gateway – a national system that integrates primary and secondary care systems – and SCI Store – an information repository which is integrated to other local systems – to support the information and reporting framework for the 18-week waits programme. This is envisaged to be completed by September
The Emergency Care Summary will also be enhanced over the next three years with additional items of patient information, such as a single medication record, and it will also be made available to a wider user base.
The strategy sets out areas for investment over the next three years: “The national CHI index for patient identification is set to be modernised and the service improved by the end of 2009. “The key action is to shift to full scale use of the CHI number as the primary identifier,” says the strategy.
Development of the national hospitalPatient Management System (PMS) will also continue, with the contracts in place by spring 2009 and the system set to go live in three health boards by 2011.
According to the strategy PMS will “enable both inpatient and out-patient efficient patient scheduling and waiting time management, with additional features such as online test ordering/ results reporting and scope for further functional modules such as A&E, theatres, electronic prescribing and maternity.”
National contracts for a national clinical portal, allowing single sign-on will also be the subject of an OJEC tender, working to the same schedule as the PMS. The national portal will provide “a single online entry point through which various elements of information related to a single patient can be accessed by authorised users”.
A national Human Resources system is also being considered with a business case due to be completed by September.
Patient confidentiality, safety and strategies for involving staff in planned e-health initiatives also feature in the new strategy.
Scottish health secretary, Nicola Sturgeon, said: “In Scotland, the e-health Strategy is setting a course which focuses on improved healthcare more than technology. It also seeks to build on the significant progress we have already made to move to progressively stronger and more integrated support for the provision of care.
She added: “The Strategy is firmly rooted in the aims of the Better Health Better Care Action Plan. It therefore targets effort on the key priorities we have set for health while also looking to build the wider vision of more integrated care and the use of information to promote better, more efficient and safer care for patients.”