PCN clinical director and primary care IT specialist Dr Neil Paul offers tips on developing an IT strategy for your network
Given the direction of travel in primary care is for contracts and targets to be directed through PCNs, it makes sense for your Network to have an IT strategy.
IT is critical to everything we do – for the planning, delivering, monitoring and evaluation of care as well as for claiming income. In addition, it seems likely PCNs will be given notional budgets for IT and an approved framework and software, so it is important for PCNs to be ahead of the game and know what IT solutions they want.
Here are my tips for developing a strategy to identify and deliver the best IT solutions for your PCN.
Firstly do a stock take, asking yourself:
You may find a need to level up practices in a PCN, which means initiating conservations with your members about helping the worst-off.
If like me you work in an area where all the infrastructure is provided by the local Commissioning Support Unit (CSU), you will benefit from having this paid for and maintained for you. The size and scale of the operation also brings advantages in terms of professionalism and resources, but this can also restrict choice and any system failure can take out large numbers of practices in one go.
Where possible you may want to look at alternative suppliers, such as X-on, to give you more choice of services and flexibility – for example, additional support during extended hours.
It is important to review your clinical system software too. Are you all on the same systems and if not, why not? A historical legacy or attachment to a particular vendor is understandable, but there can be advantages to moving to one supplier. Doing this at PCN level can support collaboration while still giving practices some control. It also makes sense for practices to be using the same add-ons, such as digital dictation. For example, most practices in our GP federation, which covers three PCNs, now use Lexacom’s digital dictation – this gave a discount, enabled staff to use a familiar system across different practices and made training and support easier.
Think also about whether having all on the same triage tools or app systems would help. Locally we are looking at whether to have one video consultation and SMS solution across the patch.
Look at your people and do a stock take of skills. Each practice will usually have one or two staff members with efficient approaches to automating appointments, searches or protocols. For example, one of our pharmacists created an EMIS protocol to automate generation of controlled drug prescriptions for palliative care patients, which other practices across the PCN have found invaluable. Consider organising practice visits or exchanges to share processes like these.
Similarly, there may be tools or app functions that could be shared; we recently recommended an outsourced dictation typing service to a neighbouring practice manager whose secretary was off sick.
Look at harmonising processes for administrative work such as coding of incoming letters and summarising notes: having consistent coding across a PCN will help quality of care and make population health management analysis more reliable. Other process such as information governance, shredding and IT training could also be standardised.
There are a number of business intelligence (BI) tools practices can use to analyse member partners’ activity and quality of care, such as Apollo or Graphnet Health for patient data and the pharmaceutical focused tools AnalyseRx and Eclipse.
The Apex tool, which I helped develop, extracts data on population health, access, capacity and demand from your clinical system in real time and presents them in accessible formats.
Putting a robust data sharing agreement in place will save a lot of time. Know what your practices are comfortable sharing at a practice, PCN and wider level and write that up once. This avoids lots of paperwork each time you test out a new piece of software or do a cross-practice search or audit.
Hiring an IT trainer for the PCN can be a cost-effective way to level up skills and knowledge across practices. My PCN did this for three months and it really improved IT knowledge among the reception and administrative staff as well as clinicians, in particular where employees had missed original training on software, or new functionality or features had been added. The IT role could also include reviewing each practice’s IT disaster recovery plans to create one plan or share resources.
Encourage your teams to develop their own IT skills, through training or self-supported learning through tools such as the free www.how2.training resource, which has a range of training videos on software we use in primary care aimed at different roles.
Dr Neil Paul is a GP partner in Cheshire and Clinical Director of SMASH (Sandbach, Middlewich, Alsager, Scholar Green and Haslington) PCN
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