Guy’s board passes IT business cases

The first business cases in Guy’s and St Thomas’ NHS Foundation Trust’s ambitious IT strategy have been passed by the board.

The strategy, which was passed by the board in December, says the trust plans to invest £213m in IT over the next five years.

This will cover more than 100 strategic projects, bundled into related strands, that will include the procurement of an electronic patient record system when the trust’s contract with iSoft expires in 2016, clinical portals and mobile devices for staff.

“A lot of people didn’t think we would get the money we got approved, approved,” group IT director Scott Sommerville told eHealth Insider.

“A few eyebrows were raised about the big investment, but we are looking for big change and it’s still only 4% of [total trust] turnover.”

In the first year of the strategy, four business cases for ‘enabling technologies’, four for ‘applications’ and two for ‘people and process’ will go before the board. A further five business cases are yet to be confirmed.

The board recently passed the first of the ‘applications’ business cases, which is a £7.1m investment in a noteless paper-light project.

Sommerville said the e-noting system will have scanning capability, but the objective is to “stop creating paper” by creating electronic forms that can be attached to the patient record.

The first ‘enabling technologies’ business case – £1.6m for storage and telephony” – has also been approved.

Channel 3 is working with the London trust on the project and has identified telephony and the storage platform as priority areas to address. An audit report dated March 2012 says performance and stability issues have affected trust operations.

The next business case, due to be approved this month, is £1m for the migration of an ageing data centre to a new “state of the art facility” on the St Thomas’ site. This project is high priority as the data centre is the building block on which the other projects are dependent.

After that, a £6.1m Better Basics business case including desktop remediation, a replacement email system, and work on the server platform, network and monitoring, will go before the board.

The audit report says the trust’s desktop estate has “aged through repeated cuts to the equipment replacement budgets and a significant part of the estate is over the normal expected period of reliable use.”

IT is following a planned replacement programme which is focusing on replacing the oldest machines first.

The email system is falling short of user expectations and requires daily direct support to “prevent disruption of large numbers of users’ mail accounts.” Users have to regularly purge their inboxes to avoid them filling up.

The review of the server platform reveals that there are “no consistent technical standards in place to ensure a common build platform and the builds are currently performed by trust teams.”

“Patch levels across the server estate are not sufficiently managed resulting in inconsistencies and not current in conforming to manufactures recommendations,” it adds.

The fourth ‘enabling technologies’ business case is £1.5m for the migration of all community services to Guy’s. This will allow South East London Community Services – merged with Guy’s and St Thomas’ in March last year – to access the IT strategy work.

Meanwhile, Guy’s and St Thomas’ is working with fellow King’s Health Partners trusts, King’s College Hospital and South London and Maudsley, on a possible collaborative tender to replace their iSoft systems.

Sommerville said implementing the strategy would involve huge business and cultural change. “We are not under estimating that, a large part of the investment has been in process design, business engagement and change,” he explained.

Two upcoming business cases will focus on up skilling teams in terms of process and the security aspects of moving to electronic working.

“I see a level of engagement with the senior clinicians that I haven’t seen before, there’s a desire to use technology effectively,” he added.