Note: The Scottish Government has written to the Scottish Academy to seek the views of the Medical Royal Colleges and Faculties in Scotland on a draft eHealth Strategy. As set out below, the draft has already benefited from significant Board input but the Government is keen to establish the overall organisational view of the direction set out in the draft. The Government invited written comments on the draft eHealth Strategy 2011 -2017.
Background: This draft eHealth Strategy is intended to succeed its predecessor which ran from 2008 to 201. In many respects it provides continuity with the previous strategy in further moves to focus on outcomes rather than inputs and the concentration on the incremental and pragmatic and on convergence through agreement. It also seeks to build on previous achievements. The context in which the strategy will operate has, however, changed and the draft seeks to set out a response to that change. The emphasis on the Quality Strategy and on the consequences of a strategy of maximising the use of assets purchased 2008-11 rather than one driven by new asset purchase or creation.
It contains details of 5 strategic eHealth aims for 2011 to 2017 which are targeted at improving quality across the service and at the same time delivering savings, value for money and efficiencies. The proposed focus on 5 strategic eHealth aims, combined with changes in the way in which eHealth will be funded by the Scottish Government will have considerable implications for the way in which performance will be measured. It is proposed that, from 2012-13, the 5 strategic aims where possible will be incorporated into Boards’ Local Delivery Plans (LDP), with 2011-12 being a development year for these changes. The proposed eHealth Strategy would cover 2 complete LDP cycles, allowing Boards considerable discretion in how they make use of eHealth solutions and schedule their spending on eHealth.
COMMENTS ON SCOTTISH GOVERNMENT
DRAFT EHEALTH STRATEGY 2011-2017
The Royal College of Physicians of Edinburgh (the College) is pleased to respond to the Scottish Government consultation on a draft eHealth Strategy 2011-2017.
The College believes that a forward thinking and effective eHealth Strategy is vital to the future of safe, patient-centred medical care of the highest quality in Scotland. The College has previously called for the implementation of an electronic patient record, accessible by doctors in all settings to ensure access to all relevant patient information within seconds. In this regard, we believe progress has been made through the clinical portal system set out in the e-Health Strategy 2008–11. However, momentum must be maintained to ensure this becomes a reality.
The College has a number of comments on the contents of the consultation document; these include:
Focus on outcomes: the approach proposed in the draft strategy which focuses on outcomes is sensible: accepting the reality that NHS Boards use different IT systems and are at different stages in the implementation of eHealth initiatives acknowledges that Boards will move at different speeds towards the same end point. However, it is important that annual reporting to the eHealth Division in the Scottish Government will focus priorities on being able to show consistent demonstrable progress, and ensure that there is transferability of data wherever the patient may be treated in Scotland. Interoperability of systems remains very important.
Progress assessment: it is important that the assessment of outcomes reflects impact on the quality of service provided to patients, rather than just registering an increased use of technology. Reference should be made to the impact and effect on both medical staff and patients from the increased use of eHealth.
Efficiency: in the current financial circumstances, it is important to note that the aims of the draft strategy are to use information technology to maximise efficient working practices, minimise wasteful variation, bring about savings and ensure value for money, and that the strategy states that, from 2011-12, eHealth will no longer be a capital investment programme in Scotland.
Clinical Portals: the College welcomes the statement in the draft strategy (p.19) which promotes the standardisation of information services, using Ensemble to manage information from a variety of diverse sources, as this will assist in the delivery of clinical portals and other solutions where access to a virtual electronic patient record is required.
Interface across the UK: there is no mention in the draft strategy of any analysis that has been conducted to establish how increased use of eHealth in Scotland would effect communication or interaction with any eHealth systems in use in England, Wales and Northern Ireland. This is particularly evident when looking at the cross border flow of patients between northern England and southern Scotland.