trakcare - december 2011
Lothian NHS Board
Waverley Gate
2-4 Waterloo Place
Edinburgh
EH13EG
Telephone 0131 536 9000
Fax 0131 536 9088
trakcare - december 2011
Glenn Faulkner
request-97142
Date29/12/11
Your Ref
Our Ref
Enquiries toRichard Mutch
Extension35687
Direct Line0131 465 5687
trakcare - december 2011
DearMr Faulkner
Freedom of information –total cost of Trakcare
I write in response to your request of 15 December 2011 for information in relation to the cost of Trakcare within NHS Lothian.
I have been provided with information to help answer your request by Mr Martin Egan, Director of eHealth – NHS Lothian.
Question 1:-
- I would like to know the full cost of installing the IT equipment for deploying a single instance of InterSystems TrakCare (tm)?
Answer:-
The charging model agreed with InterSystems was payment of quarterly charges upon usage following implementation and operational acceptance at each of Lothian 4 main acute sites – Royal Infirmary of Edinburgh, Western General Hospital, Royal Hospital for Sick Children, St John’s Hospital.
The total cost was £6.9million spread across 5 years. This included a failsafe hardware configuration spread across two Computer Rooms, all Software and Interfaces, and the technical and applications implementation resource.
Question 2:-
- I would also like to know if it has met any of the following aims and what evidence have you that these aims have indeed been fulfilled?
Question:-
a)Allow Practitioners to refer patients to hospitals electronically through interoperability with the Scottish National e-Referrals service.
Answer:-
An electronic referrals interface has been live for 2-3 years and all electronic GP referrals (approximately 13,000 per month) are received electronically into TrakCare and managed via a TrakCare referrals workbench.
Question:-
b)Increase the use of NHS Scotland national patient numbering conventions by provision of a single patient index within TrakCare and integration with the Scottish National Demographic database.
Answer:-
The Scottish National Demographic database is referred to as the Community Health Index (CHI) system.
The TrakCare system has a single patient index with all Scottish patients registered on TrakCare having the national CHI number as part of their demographic information. There is also an interface to the CHI system to support staff when registering new patients. There is also a daily “CHI Broadcast” which provides any updates to CHI patient demographics (including GP details) directly into TrakCare.
Question:-
c)Meet Emergency Department waiting time targets by efficient admission, triage, and the use of visual alerts to ensure prompt attention to patients.
Answer:-
The Emergency Department module is in use across all of Lothian’s A&E Departments and makes significant use of visual alerts to help manage patients through the department. In addition real-time reports available to the department allow staff to manage its waiting times.
Question:-
d)Provide complete and accurate patient information to authorized care professionals at all Lothian locations, reducing duplicate data entry and enhancing overall care.
Answer:-
The implementation of TrakCare across NHS Lothian replaced 11 individual Information Management and Technology (IM&T) systems each being used to record patient information. For example, each of the 4 main hospital sites had its own Patient Administration System (PAS) to manage outpatient appointments specific to local departments. In many cases the same demographics would have existed on each PAS and would have been entered 4 times; now, with the implementation of TrakCare, patient details are entered in one department on one site and are immediately available to staff on other sites if required.
Within the TrakCare Electronic Patient Record staff with relevant authorisation can access GP Referral letters, Hospital discharge letters (A&E, Inpatient, and Outpatient), informationabout Drugs on Discharge, Laboratory Results, Radiology Reports, digitised X-Ray Images, Echo-Cardiograms and patient handover information. Previously this information would only have been available to care professionals if they were in possession of the patient’s case note.
As well as the general patient information above the system also now provides both a full Maternity and Community electronic patient record.
Staff with the relevant authorisation across NHS Lothian, whether hospital or community based, have access to the above information.
Question:-
e)Implement electronic ordering of lab tests and radiology investigations including transcription of radiology reports and clinician access to PACS images.
Answer:-
Electronic ordering of laboratory tests and Radiology investigations has been in place for several years with over 1.5 million laboratory tests and approximately 350,000 Radiology investigations ordered and resulted electronically each year. Alongside the Radiology report the clinician can also access the associated digitised X-Ray,Picture Archiving and Communications System(PACS) via an interface to the NHS Lothian PACS system.
With the implementation of electronic ordering, as well as seeing results, clinicians also have visibility of pending orders and NHS Lothian has been able to introduce more standardisation of orders placed per specialty.
Finally this functionality has provided improved support for the Laboratory and Radiology departments by:
- Providing a minimum dataset of patient demographics (Including the CHI number) with each order
- Mandating the provision of additional clinical information for certain investigation types
- Enabling a more efficient use of staff and improved management of requests (no paper forms, no data input, fewer telephone enquires from clinical departments due to order status being available on TrakCare, improved turnaround time)
Question:-
f)Securely exchange patient information including diagnostic results and clinical correspondence for use within the wider health-care community.
Answer:-
All Radiology reports produced via TrakCare are immediately available to GP’s via an interface to one of the Scottish national IM&T systems, Scottish Care Information (SCI) Store.
Approximately 13,000 patient discharge letters (A&E, Inpatient and Outpatient) produced via TrakCare are sent electronically to Lothian GP’s each week. This ensures a much faster communication with GP’s than if the letter had been sent in paper form.
In addition (reference question (d) above) key elements of patient clinical information are available on TrakCare for staff with the relevant authorisation.
I hope this helps with your request.
If you are unhappy with our response to your request, you do have the right to request us to review it. Your request should be made within 40 working days of receipt of this letter, and we will reply within 20 working days of receipt. If our decision is unchanged following a review and you remain dissatisfied with this, you then have the right to make a formal complaint to the Scottish Information Commissioner.
If you require a review of our decision to be carried out, please write to FOI Reviewer - NHS Lothian, at the address at the head of this letter. The review will be undertaken by one of our two Reviewers not involved in the original decision making process.
trakcare - december 2011
FOI responses (subject to redaction of personal information) may appear on NHS Lothian’s Freedom of Information website at :-
Yours sincerely
Alan Boyter
Director of Human Resources
and Organisational Development
Cc: Chief Executive