Office of the Chief Information Officer

P

Delivering eHealth Ireland

Maternal & Newborn Clinical Management System

(MN-CMS)

Caroline Cahill, Programme Manager

Overview

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• Live in 4 sites • CUMH Dec 2016

• UHK Mar 2017

• Rotunda Nov 2017

• NMH Jan 2018

• Healthlink • CUMH June 2018

• Other TBC

• Gynaecology module in design phase

• Planning for Phase 2 of 4 phases

Starter Question

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Who wants this?

If Senior Management & Senior

Clinicians are not fully invested in

implementing an EHR then don’t do it. “A “technically best” system can be brought to its knees by people

who have low psychological ownership in the system and who

vigorously resist its implementation”

(Lorenzi and Riley 2000)

Challenges

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Snr mgt. adoption & leadership Clinical adoption & leadership

Resources – National; Local; Vendors Governance structures

Communication Device deployment

Change Management Shared Domain

Patient Portal Workflows

End User Training Scope Creep & Costs

System adoption - Sustaining the change Single sign on

Super Users & Champions DCW’s

3 P’s - Principled, Pragmatic, Pessimistic Uncharted waters

Benefit measurement & realisation Data Migration

Change & Transformation Order Comms

Support structures – National; Local; Vendors

Key recommendations - People

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• Commitment from NWIHP; EMT & Clinicians

• Clinical Nurse/Midwifery Managers as Superusers • empowers them at go Live

• creates a positive, supported atmosphere for staff.

• Involve future sites in the go live • opportunity to experience all that is involved

• Resources • well below typical international levels for large scale EHR

implementation.

Key recommendations - Process

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• Governance Structures • Board; NPT; NBO; LPT; LBO; CAB;CAG; IG; Joint MN-CMS – MedLis group • In place, established meeting intervals, right resources

• Communications & Engagement • NPT-LIT; External stakeholders;

• Rigorous scope review • Post contract changes costly

• Training • Commitment clearly explained & understood • Play domain • Ongoing strategy

• DCW’s • Bootcamp on completing DCW’s

• Consider Go-Live as a project in itself

• Sustaining change • Adoption & Optimisation

Key recommendations - Technology

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• Device Procurement & Deployment • Never too early

• Opportunity for staff to get used to technology

• System login methodology • SSO solution such as swipe card

• Domain management • Robust cross programme governance

• OoCIO I&T • Assign I&T resource to work with each project

2017 Ireland eGovernment Awards

Health & Medical Award, Winner: MN-CMS

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2018 Tech Excellence Awards

Public Sector Project of the Year Winner: MN-CMS

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Local ICT - Infrastructure

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• Power • Are there enough power sockets in the right areas?

• Is there space in the wards & corridors to charge carts?

• Has each area got enough capacity to handle extra power

demands?

• Wi-Fi • Is it in place and providing good coverage in all locations? • If not, how much time and money are required to bring it up

to standard?

• Facilities Department • Do they have capacity to mount equipment?

Local ICT - Procurement

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• National standard for equipment? • Does “one size fit all” when choosing hardware?

• How are local requirements catered for?

• Suppliers • Will they comply with tender specifications?

• Can they deliver on time?

• Can they install on time? • How responsive are they post go-live?

• Physical storage • Is there sufficient storage for early delivery? • Does that leave any workshop space for configuring?

Local ICT - People

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• IT Training • Do you have enough staff?

• How do you get them trained? “Clinician built – IT enabled

system” so IT training is limited

• When to schedule training? Needed at the busiest period

• General staff training • Where to host multiple training rooms for prolonged

period?

• How do you “re-locate” all other training & events?

• External assistance • How effective are the national team?

• How useful are any “management consultants”?

• How responsive is vendor support?

MN-CMS – EPR Lessons Learned

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Q & A

Thank you