INFORMATION SYSTEMS
“What you end up needing is two things: one, a clever data collection tool; the other, a mini-systems confi gurator. So we set off on this project, and I had in my head that this was a market gap.
North Bristol NHS Trust is well-known as an IT innovator, and its Clinical Information System Suites, developed in-house, could contribute to making other Trusts more effi cient, argues its Director of Assurance, Information & Technol- ogy, Martin Bell.
F
rontline NHS organisations are over- whelmed with information – and
some of it is even useful. But getting hold of the data and information spread across a number of systems, databases, pieces of software and physical sites can be very ar- duous, and sharing it in an accessible form even more so. And that is before consider- ing the stringent rules surrounding data protection and patient confi dentiality.
But Martin Bell, head of IT at North Bristol NHS Trust, says it is not an impossible task – and the trust now has a number of tools, which it calls Clinical Information System Suites, or CISSes (pronounced ‘kisses’) to show for it.
He explained: “To understand why we developed it, you have to understand the history. When I started in the NHS, I saw a need for two things. The fi rst was that doctors especially, but other clinicians like nurses as well, had lots and lots of these lit- tle databases across Excel, Access, bits of data here and information there.
“The problem with things like that, putting aside the ‘enthusiastic amateur’ side of it, is the fact that they’re not held securely and you can’t share the information. If you’ve got the data on your laptop, I can’t look at it because I don’t have access, for example. So it was partly about having a more effective way to collect that data.
“The second issue is, with that in mind, that however wonderful the large applica- tions are – and we’ve implemented many in Bristol over the past few years with great success – there’s always a bit that they don’t quite do. They are large enterprise applications which might be fi ne for some industries, but doctors especially have their own way of making notes, for example. En- terprise systems aren’t necessarily fl exible in catering for that.
38 | national health executive Jul/Aug 11
“I and Simeon Barron, our head of devel- opment, who’s been the driving force be- hind delivering it, always had in our heads that there was an ‘angle’, a sales opportu- nity with this. As we progressed through, we now have something in the region of what I would 40 to 50 ‘modules’ and sys- tems, the mini data collectors ranging from physiotherapy activity to various clinical data collections. There’s another one about to go live in neurophysiology shortly.
“So, we had a range of clinical-focused and operational-focused mini-systems and da- tabases. What then happened, as this de- veloped, is it was obvious that there were one or two areas were you could build a ‘bigger kit’. So the original principle was lots of small kits, and now there have been a couple of applications in their own right:
full applications rather than ‘applets’.
“The most notable ones are a very nice, slick patient and staff surveying tool, and the other one is to do with outpatient medi- cation prescribing around FP10.
“They are what I call ‘sons of CISS’, so they’re grown-up applications in their own right, but the principle is the same. Al- though they took slightly longer to develop – your average CISS application we’ll often have up and running within about a week. If you’ve got a dedicated doctor in the room with you, you might have it running in a day! So it depends on the size of it. The FP10 and the patients’ survey application obviously took months of development, but the principle is the same, they’re just larger.”
The CISS idea is completely separate from the National Programme for IT, and its specifi c quest to digitise patient records.
Bell explained: “It was a completely inde-
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