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New national sexual health IT system is rolled out by NHSScotland

AxSys Technology : 22 April, 2008  (Application Story)
As part of the National Sexual Health Strategy for Scotland, NHSScotland is currently rolling out its new National Sexual Health (NaSH) IT System.
The aim of the system is to provide a common IT platform to support specialist sexual health services for 12 NHS Boards across Scotland to help improve the quality; range and consistency; accessibility and cohesion of the delivery of these services to patients. To oversee the procurement and implementation of the system, the NaSH Project Board was set up in 2006 and in 2007 the NaSH system contract was awarded to AxSys Technology.

Based on AxSys' Excelicare product, the NaSH Project Board's Reference Group, working with AxSys, has designed and developed the NaSH system which is due to 'go live' at NHS Lanarkshire and NHS Ayrshire and Arran in March 2008. Following this the system will be gradually rolled out across the remainder of NHSScotland.

The NaSH system is a key component of the National Sexual Health Strategy - 'Respect and Responsibility: A Strategy and Action Plan for Improving Sexual Health', launched in 2005. The strategy sets out a framework for improving sexual health in Scotland by enhancing access to information and services whilst enabling flexibility for local services to respond to local requirements. It also highlighted the need to be able to review existing data and develop a data collection framework to provide a more accurate picture of sexual health and wellbeing in Scotland, in terms of both sexual ill health and behaviours and attitudes.

To support these objectives the new NaSH system will provide a national solution to incorporate all sexual health services that are currently being delivered in both primary and secondary environments including Family Planning and Genito Urinary Medicine (GUM) and will be used in other areas where sexual health clinical encounters occur, such as acute HIV, community gynaecology, counselling, community pharmacy and General Practitioner services. Once fully rolled out the Sexual Health System will support between 1200 to 1500 clinical and administrative staff working across 200 sexual health clinical sites treating over 400,000 patients, which is expected to grow by 20 to 30 percent over the next five years. This means delivery of a modern country-wide, multi-agency service and as information can be shared between the various clinical disciplines this will create the first steps towards developing a sexual health electronic patient record in Scotland.

Dr Alison Bigrigg, chair of the NaSH Board and Director of The Sandyford Initiative in Glasgow commented: 'To meet the objectives of the Sexual Health Strategy, it was clear we had to overcome the inadequacies of the existing sexual health information system. Before NaSH there was no standard approach to the gathering of information from the range of sexual health services; there was a distinct lack of IT systems and support within the clinical environment and there was little or no integration between the traditional specialities of family planning and genitourinary medicine. This meant that statistical, clinical, patient and administrative information across sexual health services was hard to obtain and share and holding paper records in isolated locations was not conducive to delivering a fast and convenient healthcare service.

'With a growing population of sexual health patients with increasing expectations, continuing to operate non-integrated paper based clinics across Scotland simply could not be sustained. The NaSH project was therefore set up to help address these issues by developing a robust IT system which would improve communication and co-ordination across all sexual health services; improve standards of service delivery and patient care and provide the building block upon which the intended Sexual Health Service could grow.'

The NaSH Project Board and its Reference Group includes wide ranging representation from clinical, managerial, technical and administrative stakeholders from across NHSScotland to ensure that the new system meets the needs of all elements of sexual health services. Its key objectives have been to find a solution that follows a patient centric process; streamlines clinical, operational and financial processes to enhance service provision; reduces administrative time used by clinicians; improves patient access to all sexual health services and relevant information; facilitates clinical governance and audit; integrates with screening laboratories; enhances multidisciplinary and multi-organisation collaboration and is scalable with the ability to accommodate a minimum of 10 years online data without affecting performance.

Following a formal European Union procurement exercise AxSys Technology were awarded the National Sexual Health (NaSH) system contract. The winning bid was a tailored version of AxSys' Excelicare product. The outcome of the NaSH contract is a system that will be made available to all NHSScotland organisations.

'As current suppliers and with their familiarity of existing IT infrastructures across NHSScotland this was a key element in our decision to choose AxSys. Plus the fact we knew the Excelicare solution could integrate with the national Scottish Care Information (SCI) products such as SCI Store and SCI Gateway,' stated Dr Bigrigg. 'The flexibility and functionality levels of Excelicare were also critical. It is easy to use and intuitive and the reporting prowess enables crucial information to be collated on a local, regional and national scale. We also needed a solution that could be developed specifically to suit our requirements and AxSys worked closely with clinicians to ensure the system would fit with the objectives of the National Sexual Health Strategy. The development of NaSH provides an excellent example of a truly collaborative process, not only between the Project Board members, but all parties involved.'

Once fully rolled out the NaSH System will provide a joined up Sexual Health Service where patients have easy access to efficient local, community-based clinics. Working at site, Health Board and National levels it will also provide a National Sexual Health database which will result in more effective information on which to base public health initiatives. The NaSH system will be capable of providing all mandatory Scottish National Returns for the Sexual Health Service and produce agreed reports relevant to the Key Clinical Indicators for Sexual Health in Scotland.

'Within sexual health services accessibility, choice, efficiency and confidentiality are all key requirements for the patient. NaSH aims to provide this and will deliver significant benefits,' further comments Dr Bigrigg. 'The new system will create a truly joined up service whilst streamlining the operational day to day process of running individual sexual health clinics. Automating the process of data collection will dramatically improve data quality which will have a positive bearing on audit and clinical governance and patient turnaround times. The system will also enhance the efficiency and productivity of screening as clinics will be integrated with the laboratories so results can be delivered electronically. It also means we can communicate and deliver results to patients via e-mail, phone or text and protect patient anonymity if requested. Eliminating paper records and manual systems will just make the whole process much smoother for staff and patients and by creating integrated care records this will provide clinicians with reference material at the point of care.'

Dr Pradeep Ramayya, chief executive officer AxSys Technology said: 'With so much emphasis nationally on the importance of creating greater consistency and convergence of IT applications and infrastructure the NaSH project is proof that this can be achieved. However this is not just about technology but about how it can facilitate the creation of a nation-wide system that can deliver a patient centric service at a community level. With the national roll out of the Sexual Health IT System this will demonstrate once again the benefits of facilitating multidisciplinary collaboration and effective sharing of information and the creation of electronic patient records.'
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