NHS data warehouse

[tomjones2]

Hi just wondering if anyone knows anything about the NHS building a data warehoure storing paitent info etc.

I have got a short essay write so i will be following all the normal google/news channels but was wondering if anyone know of a really good source of fairly genralised info on the subject, the essay is only 1500 words so i wont cover any real detail.

Many thanks in advance.

[Carsick]

It's a pity you're not asking this in a month or two's time. My boss knows a fair amount about the NHS's current plans for centralised PACs (I forget what the project is now called, it keeps changing names) but I won't be in the office with him for a while yet.

I think a certain somebody on this board did mention being involved in designing the network infrastructure to be used for some of the new stuff.

[rictus01]

I'm building the encrypted network part, so have a fair idea of the setup.

Carsick, your right but it's two applications PACS & RIS.

Although most of the spesific imformation is restricted, I could give you a generalised outlines on the setup, PM me if you like.

Cheers Mark

[tomjones2]

I'm building the encrypted network part, so have a fair idea of the setup.

Carsick, your right but it's two applications PACS & RIS.

Although most of the spesific imformation is restricted, I could give you a generalised outlines on the setup, PM me if you like.

Cheers Mark

Have sent a PM, many thanks to both of you.

[KrZ]

I think the national spine network is very much related to what you are referring to. I have a number of work colleagues have worked on the decision support and data schema side of things. Not sure what area that you are interested in, Primary care information requirement are very much different from secondary cares, and i am not sure information/image stored in PACS and RISs is part of the national spine network specification primarily focused on primary care.

The following link gives some info about the spine network.
http://www.connectingforhealth.nhs.uk/delivery/programmes/spine/
http://www.connectingforhealth.nhs.uk/faq/spinefaqs/html2pdf

[Carsick]

Carsick, your right but it's two applications PACS & RIS.
I know, was just mentioning my boss as he has alot of contacts in the industry.

[Patch]

I was involved in the sales processes for one of the big providers and as such know a wee bit about it additionally I sold the RIS solution for London and am involved in negotiations for some delivery solutions for two out of the five clusters.

A good source of research is www.e-health-insider.com there are positives and negatives there.

As an additional a current business is the key delivery partner for BT for the spine delivery, one of my contacts there is also a biker and possibly he could give further feedback although he is in India this week.

If you want to feel free to drop me a PM with a contact number and I'll give you a call and see if I can add anything else to your research.

[_Stretchie_]

Hi

I'm working with the new system in the South West, different parts of the country are using programs from different suppliers. All will be able to connect to the the 'spine' of information i.e. Southern Cluster (anything from the east coast to the west coast and below Birmingham )using some American company, london I think is BT, the North of Brum to scotland using another and Scotland again using another company.

Sorry if that's not what you wanted or even anywhere near. I'm going to have to be useless to you here, if I can find anything out I will


Stretchie

[tomjones2]

Cheers guys for all the info, was great to read something that not about my project!!!

Amazed by how many people on here are invloved with the NHS system, then again its massive isn't it.

What i seem to have gathered is that the NHS are busy putting together a more centraised database that allows access of records/pics/x-rays etc from many locations with approitae security clearance. The data warehouse seems to be in its infancy a divison called the Analytical Intelligence Unit is putting together a DW.

http://www.cfsms.nhs.uk/directorates/isd.html

Have i got the right end of the stick here or am i being really stupid?

I also might have been the wrong idea of what a data warehouse is. My simple understanding of it is : a collection of data that for anaysis that supports more infomed decision making or detection of prevoiuly unregonised trends etc.

Is this what correct?

Again many thanks for the help

[Patch]

There are actually three different programs being undertaken by Connecting for Health (actually there are more but these are the ones that you are concerned with:

National Care Records System (NCRS)
Picture Archiving (PACS)
Spine

England was split up into 5 regions and each of these has been allocated a Local Service Provider (LSP), the regions and the LSP's are the same for both NCRS and PACS and are as follows

North West and West Midlands - CSC
North East - Accenture
East - Accenture
South - Fujitsu
London - BT

NCRS
For NCRS each LSP partnered with the following solution vendors

CSC - iSOFT
Accenture - iSOFT
South - Cerner
London - IDX (bought by GE Healthcare last October)

The NCRS project is to ensure that there is an electronic patient record for every patient in England, these will be retained at Data Centres run by the LSP. The goal is that your GP and hospitals in your area will have access to exactly the same patient information and that treatment carried out by hospitals on you is co-ordinated with your GP. Please note that this is planned Acute care.

The NCRS program includes "core" functionality such as the central Hosp[ital Information System (HIS) and additional functionality such as A&E systems. All core functionality has been contracted the Hospitals pay CfH for the implementation of these at a reduced price and CfH pays the suppliers under a fixed contract based on delivery. Additional functionality is bought by the hospitals at pre agreed prices direct from the suppliers.

The NCRS programme should be live in all Acute Hospitals and GP surgerys by 2008, it will fail to meet that target by a long way.

PACS

The busyiest department in most Acute hospitals is the Radiology department, New technology and the extortionate cost of film processing led to the digital revlution for imaging however these PACS systems are amongst the most expensive systems in a hospital as with the computers comes new imaging devices.

A seperate contract was negotiated with each of the LSP's for the provision of PACS the LSPs partnered as follows

Accenture - AGFA
CSC - Kodak (dropped after failures and likely to be replaced with GE
Fujitsu - GE
BT - Phillips

As the GE and Phillips PACS systems require and industrial strength Radiology Information System to support them HISS (for GE) and iSOFTS RadCentre (for Phillipss) were selected by the LSP's

The PACS programme has the aim of having all Acute hospitals PACS enabled by 2008, it will fail to meet that target but not by a long way.

SPINE

All these systems are so far regional and there will also be a whole load of other systems that are not provided by the LSPs at all, this is the reason that SPINE was dreamed up.

SPINE is a combination of a central repository and an integration standard that all systems will need to communicate with. The plan is that certain key clinical information like allergies and risks will be stored in the central repositary against your NHS number, thus if you go into a hospital outside your area for emergency unplanned treament such information can be accessed immediately anywhere. The integration standard then means that a more detailed enquiry could be sent to get your full medical records transferred from one end of the country to the other if you are facing a long stay in hospital.

The dream for SPINE is that it will eventually be able to go even further hence the focus on standards. An example may be that the Paramadics using the Ambulance system could eventually be able to use SPINE to access key health data at the raods side at the scene of an accident. This vision is still being developed because as suppliers develop SPINE compliant applications the uses of it will organically grow.

Finally is it all worth it? Well its a hell of a programme. The the initial contracts with the LSP's are until 2013, most LSP's calculated on an operating loss until 2008 (programme started in 2002 with the bid process) and the contracts allow them to recoup the losses and break even in the remaining 5 years, profits will be made when the contracts are renewed. The reality is though that the LSP's are behind schedule and they will not break even in th life of this contract, it was very shrewed negotiation by the CfH team that backed off close to 100% of the financial risk of this to the private sector. The contract renewal is also dependen on performance so some of the LSP's will lose a lot of money and not get renewed.

At the end of it will be the most advanced healthcare system in the world, no other country is anywhere close most have watched what happened here and are now starting their own NCRS type project. England (and it is England because Wales Scotland and N Ireland are not involved) has forged the way in this type of programme learining the hard way but benefitting from the innocence of the LSPs in signing up to the Risk.

[tomjones2]

Many thanks for the info patch :D , good to know that all that is going on behind the scenes.