CIO Q&A with Tracey Scotter – Sheffield Teaching Hospitals IT director

Tracey Scotter is the Director of Informatics at Sheffield Teaching Hospitals, one of the UK’s busiest NHS trusts, running five hospitals in northern England, employing some 15,000 staff, and each year treating roughly 960,000 outpatients, 107,000 inpatients, 100,000 day-case patients, and 143,000 accident and emergency visits.

With an annual income of £909.5 million, Sheffield Teaching Hospitals offers a full range of hospital and community services, as well as specialist care for cancer, spinal-cord injuries, kidney ailments and more. Sheffield Teaching Hospitals has been awarded the title of “Hospital Trust of the Year” in the Good Hospital Guide three times in five years, and it’s placed in the top 20 percent of NHS Trusts for patient satisfaction.

Tell us about your top projects. We’re implementing a digital health record, which consists of an electronic patient record (which will be the main clinical system in the hospital). It’s going to be supplemented by an  electronic document management system, which will take care of all of our legacy paper — a big task, since we have more than a million paper patient records.

We’re also implementing a clinical portal. Some of our key systems are specialised clinically; we’ve got things such as renal systems, sexual-health systems and dental systems. We won’t put all of that data initially into our electronic patient records. Our portal will sit on the top and link all of our patient information.

How is Sheffield Teaching Hospital contributing to the NHS’ plan to save £20 billion over four years? Every trust is involved in that. Our project will reduce real estate, reduce printing and reduce paper — all of which will make a big contribution to our hospital’s portion of that savings. It will also help staff work more efficiently.

But at the same time, isn’t the number of patients increasing? Yes, and that’s difficult. But that’s a challenge of the NHS in general: Despite increasing demand, we have to make savings. In fact, no matter how much was invested in the NHS, I don’t think there’d be enough money in the whole country to cover what the growing demand is likely to be.

So somewhere along the line, there have to be lifestyle changes, prevention — the whole public-health agenda. There’s also been talk from the government about individuals making a contribution to their healthcare. We could have a system that at some point in time isn’t free at the point of need.

One thing we’re doing now is reducing length of stay. That will enable us to see more patients without adding to the financial equation. But reducing length of stay is also a technology issue. How much can the patient do before he or she comes into the hospital? There might be a pre-op assessment that you could do online, or registering for certain things. Then, at the end, some things could be done by the patient from home.

That’s also why we need a single patient view. Today, it’s quite easy for a patient to go from one section to another, with nobody having a holistic view of that patient each time he or she moves into the care of a different clinician. Actually having somebody responsible for a patient throughout the pipeline would help us make sure that it’s as quick as possible.

How do you use data to drive decisions? From the micro to the macro, we use data all the way through. The biggest category of data for us is the human genome project. The idea, broadly speaking, is that we’ll be able to have much more prediction about people’s health. They’re talking about it coming down to being £10 a report. I don’t know the exact timeframe, but it’s within our lifetime.

We also use data for running the organisation. For example, we do predictions in terms of seasonal fluctuations. So, in the winter, what can we expect in terms of colds and the flu? Also, our clinicians use data collected from patients to monitor their condition. For example, patients’ blood, glucose levels, or adherence to their medication.

What are you doing to ensure patients’ privacy? There’s a big emphasis on privacy in the NHS. We have to follow a number of specifications on that, such as information governance toolkits and standards to protect patient information. For example, we can’t store patient data outside of Europe. That limits what we can do with the cloud.

Looking forward, I think the next big challenge is on mobile devices. Right now, we only support our own devices on our networks. But we want to open that up. Our junior doctors already have devices, so it’s pretty pointless for us to buy them another. If we can accommodate their devices, that would also save us money.

How do you align IT with the rest of the trust? We have about 70 technicians participating in a “back to the floor” exercise. They work on the ward for at least one day each year so they can see the challenges our other departments face. It’s important for our IT technicians to understand how vital their services are, what it actually means for a clinician when a printer or PC goes down. Unless you’ve experienced that, you really don’t know.

About this article:

This interview first appeared in the report about the CSC Global CIO Survey, 2014-2015. Visit www.csc.com/ciosurvey

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