Integration Strategy Newcastle

Robert Shaw

The Newcastle Upon Tyne Hospitals NHS Trust

Agenda

• About the Trust• Why Integration and messaging approach• Network support• Architecture• Examples of projects with benefits

– Electronic Referrals– PACS

• National Programme• Future ……..

Who are we

• Dr Foster Hospital of the Year

• Large Teaching, Tertiary Acute Trust– £0.5 Billion turn over– 12,000 employees– Over 2,000 beds, 58 theatres– 120 specialities and sub specialties– Local, Regional and National services

Why integration

• Delivery of business critical information

• Uncertainty of future

• Volume of Multiple specialties

• Interoperability with other Health and Social Care

• Put Trust in control of which systems are changed

Network infrastructure …….

Summary Architecture

P.A.S.

Pathology

PACS/RIS

Casemix

Order Comms Theatre

Audit

Web

Clinical Mgt

Middleware

Primary Care

Pharmacy

MPIIntegration Engine

LANTIS

Master Patient Index

PAS

MPI(SQL Server)

Biz TalkServer 30 + systems

• Patient Identification

•NHS Number

•Hospital Number

•System Number Migration

•“Back room” system but the most system critical

•40,000 per day

• 1.8 million records in MPI

Delivering the benefits …..

• Patient– There details follow them across the Trust

• Business– Reduced CNST payments – Clean set of patient demographics

Praxis example

Draw architecture of PRAXIS

Delivering the benefits …..

• Patient– Know what is happening– Information

• Clinician– Speed of access of referral– Integrated into record

• Administration– Rich source of data

Integrated PACS/RIS project

Architecture of PACS

Switch Fabric

SAN SAN

Temporal Temporal Temporal

Web viewer

DICOM Message Handling Validation and Integration

MultipleModalities

andManufactures

DICOM / Integrationof all existing modalities

DICOMConformance

“Compliance” or “Conformance” to a standard doesn’t always mean

that it will work

Metrics

• 5.4 Million images since May 04

• Estimate 8.5 Million Radiology p.a.

• 3,582 users, approx 1,400 concurrent

• Hardware– 48 Tb stretch SAN - HP– Fx Channel Disks– 2 Gbps average access rate from SAN

Delivering the benefits ……

• Patient– Quicker access to diagnosis– Quicker through the system

• Clinician– More than one clinician can access the same

picture– Delivery in all clinical environments

• Business– Financial

Mermaid …….

Integrated into

PathologyRadiology

Clinical Notation

•Becoming the clinical front end

•3,000 letters per day

•Future

•Link to clinical document archive

•Integrate Digital Dictation with Telecoms switch

National Programme ……

• Vision & Values

• Delivery …… ?

• Only 40% of Trust systems – Version 2.x ………. Not going away !!!

• Inter operability …….

The Future ………