Assignment: Strategy

Submitted By: Abhaysing Bainade Student # 6034632 Norwich Business Scchool

2011

Contents: 1. Background.......................................................... .................2

1a. Requirement, opportunities and challenge of IS in NHS......................2 1b. Opportunities associated with precise IS of NHS................................3 1c. Challenges associated with precise IS of NHS......................................3 2. The key components of the NHSs external information strategy.........3 2a. Patients........................................................................ ......................4 2b. Five Key Information Exchanges within patients and NHS...................5 2c. Suppliers....................................................................... ......................5 2d. Five Key Information Exchanges within Suppliers and NHS..................5 2e. Stakeholders................................................................. ......................6 2f. Five Key Information Exchanges within Stakeholders and NHS.............6 3. Implications of External components on Information System of NHS.....7

3a. Demonstration of Implications of external components on IS..............7 4. References.................................................................... ........................9 5. Glossary of Terms........................................................................... ......10 6. Appendix 1................................................................................... ........10 7. Appendix 2................................................................................... ........11 Figures:
1.

Figure 1: Flow of Information within Internal and External Components of NHSs Activities..................................................................... .................4 Figure 2: The components of the Information System (IS) and their role while implementing the Information process..........................................8

2.

NHS (NATIONAL HEALTH SERVICES)

(1) Background 1:

NHS is worlds largest publically funded healthcare organization with over 1.7 million employees which includes 1,20000 hospital doctors, GPs more than 40000 , ambulance staff of around 25000 and more than 400000 nurses 1 In 2009 NHS received the funding of more than 100 billion. NHS also caters to almost 1 million patients every 36 hours. And looking at the

vast number of people; processes happening through all the departments; NHS needs to have a robust Information system in place so as to deliver high quality healthcare services. (1a). Requirement of IS, the opportunities and challenges in NHS (Internal and External Components of NHSs Information System): NHS represents interesting and massive system model of vast services and huge amount of information flow; to and fro within below mentioned working groups
1.

Policy makers and Stakeholders: Department of Health, NHS Trustees, Strategic Health authorities Professional Bodies: GPs, Nurses, Pharmacists and paramedical staff, Clinical research and pharmacovigilance department, Ambulance staff

2.

3. Education and training departments

4.

Administrative Departments: Logistics, property administrators, maintenance, waste management department, Security Department, Finance and accounts Legal department, Marketing, Public Relation etc. Suppliers: technology, Medical devices, equipments, power and electronic equipments, materials. Most importantly the recipients of NHSs services; the patients

5. 6.

7.

While all these working group function in order to deliver the NHSs objective; the large pool of data and information is exchanged and generated; the challenge is to effectively maintain, transform, build analyse and store the data in a systematic manner and thats where the role of effective and systematic Information Systems (IS) is important and needed. Considering the Value chain2; Information system of NHS should involve vast number of processes so as to fulfil requirements of government, regulators and law, Strategy and planning, structure and performance

management and Infrastructure and IT Management. The value of all these processes is realized only when the intended services are delivered to end users. During the entire cycle of process; there are several steps; value of which can not be realized immediately but they are of importance (e.g. data handling) However it is important to eliminate un-necessary processes than non value adding process. E.g. instead of putting large staff on data management it would advisable to build the effective technological structure for data management. It would help to reduce the unnecessary costs. (1b). Opportunities associated with precise Information System (IS) of NHS:

Possibility of creating a Technical information System: Better delivery of the services by means of effective process and advanced technology

People empowerment with prompt solutions, effective flow of information through NHSs organizational structure so as to develop and progress the motive of the firm and develop new effective processes Enhancement in transactional and transformational capabilities Chances of inventing new effective processes (1c). Challenges associated with precise Information System (IS) of NHS:

To establish; how management, public and clinical needs be met effectively

Integration of IT, Healthcare services and social responsibilities Confidentiality, Security and control of data Cost effectiveness 2. The key components of the organisations external information strategy should include its customers i.e.

patients and Public, stakeholders (Government, Policymakers) and suppliers. As per my understanding about the NHS (From the official website of NHS) I have developed/assumed the model in which the flow of information occurs across the Information System components i.e. Peoples, Structure, Technology and process. (2a). Patients: Patients i.e. end users or beneficiaries remain the cornerstone and Centre of the NHSs organizational activities and the value of the organisational purpose are only realized by means of delivering effective healthcare services to patients. The Information System strategy of NHS should include need based secure access of their own healthcare record to the patients (e.g. Robust Storage space would be required) and seamless access to the records such as patients past illness record documents, Investigation records such as radiographs, blood tests other diagnostic evaluation records, prescription and past surgical procedures records etc. As it can be used by both Healthcare professionals and patients too. Access to basic healthcare information such as preventive majors, healthy life style Access to data and directory of phone numbers, address of Ambulance trusts, NHS Trusts, NHS Walk Ins, NHS Direct, mental health trusts, emergency and acute care trusts, near location GPs, Pharmacies, Dentists It is a two way process in Information system at NHS that the information exchanges occurs at both ends. Doctors, paramedical staff gather the key components of the Information system involving Human elements are People & Structure. Now with respect to NHS; people means patients (The external key component), the employees such as management; doctors, paramedical, staff Human resource etc. Figure 1: Flow of Information within Internal and External Components of NHSs Activities

CENTRAL DATA

SUPPLIERS
(M edical Equpiments; Power & Electronic equpiments; Technology; Telecom etc)

NHS
(M anagement; Empl oyees such as doctors; Paramedical Staff; Admi nistration; Logisti cs; Researchers; Trai nees;Legal)

STAKE HOLDERS
(Govt; Policy makers)

PATIENTS

EPIDEMIOLOGY DEPARTMENT

(2b). Five Key Information Exchanges within patients and Organization i.e. NHS 1. Patients report the healthcare need to the healthcare professional (First point of contact) 2. Responds to the questions posed by healthcare professionals 3. Interaction and information exchange with paramedical staff, laboratory staff, pharmacy etc. 4. Information exchange in terms of completion of formalities, consents etc 5. Follow-up Visits with the Healthcare professional and addition and updating of the previous data Requirements: (2c). Suppliers:

The next set of external important component of NHSs Information system should be suppliers which includes System Suppliers, Technology vendors, National service providers such as National Network for NHS; NHSmail, Telecom Service provider (BT is the National Network Spine for NHS)

External component Suppliers can again be divided as National Suppliers and local suppliers depending upon the service area. In order to acquired the cost effective supply of the essential services and commodities it is essential to develop the output based specification of the requirement2 (2d). Five Key Information Exchanges within Suppliers and Organization i.e. NHS
1. Suppliers respond to the published need (using Electronic

interface) of the requirements and further brief understanding about the need (First point of contact: response to requirements) 2. Information about the products and services offered by the supplier are exchanged from supplier to NHS (response to requirements by means of quotation) 3. NHS responds to suppliers after evaluation (Negotiation phase) 4. Suppliers respond to negotiations 5. Information exchange between supplier and NHS after the services are finally in place, exchange of information will take place later regarding problem reporting, maintenance. (2e). Stakeholders: Stakeholders are individuals and organizations actively involved in the project or whose interest might be affected as a result of project execution or project competition 4 In case of NHS Stake holders are Government, Policy Makers, department of Health, etc. It is essential to update stakeholder with advanced performance reports such as Quarterly performance reports, annual reports, and advanced data analysis. All this can be achieved with the support of advance information system (2f). Five Key Information Exchanges within Stakeholders and Organization i.e. NHS

1. Stakeholders

i.e. Healthcare department communicate and exchange information regarding public health need and public health policies as per the current need of the time 2. Government provides the required financial support based on the needs communicated by NHS 3. NHS implements and delivers healthcare services as per the protocol devised and informed by Healthcare department and communicates with the stakeholders in the form of status reports of the implemented processes, performance reports, financial reports (Monthly/quarterly/annually) 4. Stakeholders review the input information and communicate necessary feedback 5. Information system is devised, reformed, upgraded based on the next cycle of communication/information exchange between NHS and stakeholders

3. Implications of External components i.e. Customers (Patients), Suppliers and Stake holders on Management Information System of NHS: In order to achieve the high performance Information System (IS) NHS should posses 10 below mentioned critical features5:
Technology

1. Advanced Information Technology And 2. Free of defect processes and delivery Processes 3. Accelerated cycle timings 4. Instant transfer of knowledge 5. Innovation to be encouraged People and 6. Alignment of incentive 7. Interventions based on the community requirements Structure 8. Organized system for care

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9. Consumer and purchaser education 10. Accountability

(3a). In order to demonstrate Implications of previously mentioned external components on Information system and across two subgroups of components of Information System can be described as below:

Assumption: Customer and the Healthcare professionals are the central focus (i.e. People) (External component and Internal component) Example task : Deliver instant electronic information to patients regarding their specific or general healthcare issue, support information for self care and allowing them instant access to their own healthcare records and; for the healthcare professionals deliver the case histories including prescriptions, procedures and other patient records so as to offer the best services

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Figure 2: The components of the Information System (IS) and their role while implementing the Information process

.Reporting

.Fulfilling requirements of government, regulators and law Strategy and planning

and performance management People management Infrastructure and IT management

Once the need is identified the mobilization would occur among NHS management, IT Staff and necessary system would be placed in order (Information Exchange at People and Structure level) and this interface also poses the challenge at Technology and Process level Implementation of the Information system (i.e. data gathering updating- collection and collation of data retrieval and use and application of data) group involved would be Healthcare professional, Patients, data maintenance staff, statisticians, data analyst (Reports and finding) Use of the output i.e. the usable source of information in terms of patient records online; both by doctors and patients (customers), Reports and analysis would account for performance measurement and success of the process implementation across people and structures.

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The large pool data analysis report would enable Policy makers, stake holders to identify the scope of improvement in current healthcare policies if required which may in turn result in introduction of new policies, up gradation, development in current Information system of NHS (Components involved: Stakeholders, Policy makers etc) Reference to academic literature

4. Reference to academic literature

1.

Overview of NHS from the official website of NHS; can be viewed at http://www.nhs.uk/NHSEngland/thenhs/about/Pages/overvi ew.aspx, viewed on 11/4/2011. Gabriele Piccoli (2008);Information systems: Definition, Information system component; , Value Chain (2)page 2529 Gabriele Piccoli (2008);Information systems: Definition, Information system component (2)page 25-29

2.

3.

4. Baltzan and Philips (2009); System Development and Project management, Business driven information systems,(11)page 413-414
5. 6.

7.

Coye MJ, Detmer DE. Improving the quality of health care. Quality at a crossroads. Milbank Q 1998 ;(76)75968. Don E Detmer(2000); Information technology for quality health care: a summary of United Kingdom and United States experiences; Special article, page 184-187. Can be viewed at http://qualitysafety.bmj.com/content/9/3/181.full.pdf viewed on 11/4/2011. Alasdair Liddell, Stephen Adshead and Ellen Burgess (2008) Technology in the NHS; Report on transforming the patients experience of care, page 14-15. can be viewed at http://www.kingsfund.org.uk/publications/technology_in_th e.html ; viewed on 11/4/2011

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5. Glossary:
1. Epidemiology: (Department which maintains the data

about population such as diseases incidence; age gender distribution; and evaluates the need for special healthcare needs) 2. pharmaco-vigilance: science relating to the detection,
assessment, understanding and prevention of adverse effects, particularly long term and short term side effects of medicines

6. Appendix 1:

The NHS is divided in two sections: 1. Primary Care 2. Secondary care.

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Primary care: Initial point of contact External component and is delivered by a wide range of independent contractors, including GPs, dentists, pharmacists and optometrists Secondary care: Includes acute requirements, elective care is also the part of Secondary care Source for Appendix 1: About NHS can be viewed at http://www.nhs.uk/NHSEngland/thenhs/about/Pages/nhsstructur e.aspx ; viewed on 11/4/2011 7. Appendix 2: Information objectives supporting the key groups

1.

Source: Don E Detmer (2000); Information technology for quality health care: a summary of United Kingdom and United States experiences; Special article, page 184-187.

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Can be viewed at http://qualitysafety.bmj.com/content/9/3/181.full.pdf viewed on 11/4/2011.