Provision of a whole-system Digital Shared Care Record including Patient Portal, Analytics and Electronic Care Planning system.

Description

The Lincolnshire Care Portal is a 24-7/365 system hosted by United Lincolnshire Hospitals NHS Trust and currently implemented by the Lincolnshire sustainability and transformation partnership (STP). The system is used collaboratively across health and care settings and organisations. Clinicians are able to look at data from any connected systems which contribute to a Patients Local Shared Care Record. The Lincolnshire Care Portal is a catalyst for clinical transformation based on the following 4 capabilities: - - Unified Clinical Care Record; - Patient Portal; - Analytics function supporting - dynamic patient cohorts, clinical alerts, risk stratification and population health management; - Electronic Care Planning; Underpinned by: - - a robust information governance model; - Custom RBAC model; - comprehensive auditing; - a set of eLearning modules; The Lincolnshire Care Portal has Information Sharing Agreements (ISAs) with all Lincolnshire STP Provider organisations, GP Practices, Social Care, NHS organisations on the STP borders and a number of 3rd Sector care organisations supporting approximately 9,000 users. The digital solution, currently provided by InterSystems is due to expire on the 30th June 2021 and needs to be extended until 31 March 2024, to avoid de-stabilising our system during the global pandemic, pending a review in 3 years' time when the STP may transition to the East Midlands LHCR platform. The current contract is underwritten by Lincolnshire CCG. Lot 1: This contract is being procured under the Health Systems Support Framework Lot 2b via a Direct Award. The Lincolnshire Care Portal digital solution comprises multiple components including: Unified Clinical Care Record (the care professional system), Patient Portal, Analytics function supporting - dynamic patient cohorts, clinical alerts, risk stratification and population health management; Electronic Care Planning. It also includes a set of eLearning modules. The Lincolnshire Care Portal digital solution data sets, functionality and user interfaces have all been developed and customised by InterSystems to meet Lincolnshire STP specifications of the service's unique requirements, including support for a distributed data architecture which can be deployed across all partner organisations to support individual partner organisations local IG requirements. All aspects of the solution have been delivered via a jointly resourced development life cycle involving STP specification of requirements, InterSystems technical design with STP review and sign off, InterSystems development and testing, STP and partner organisations user acceptance testing and sign off, and InterSystems release from the development and test environments, through to the verification and live production environments. The IT solution in its current form has involved on-going system development and multiple releases over a 4 year period. The associated eLearning modules have also gone through similar development life-cycles. In addition to base product deliverables, the STP's contract with InterSystems has allowed for the development of additional functionality via the contract Change Control Note (CCN) process. A total of 29 CCN's have been implementated to deliver specific additional functionality to the base product IT solution, including support for Patient Demographic Service, Summary Care Record, Child Protection Information Service and customised alerts, GP Connect (Access Record Structured and HTML), Pathology WebV interface, EMAS FHIR interface, TPP S1 Community interface, RiO customised Event work-flow, in-house Electronic Discharge Documents, in-house Outpatient Letter Documents, Servelec Mosaic 2-way integration (including 'deep' integration within Servelec Mosaic), Medusa SIREN integration, End of Life Palliative Care, multiple Remote Monitoring systems, NHS Login integration, custom eReferral Templates, multiple Electronic Care Plans and integration, generation of Dynamic Patient Cohorts etc. Due to the highly customised nature of the Lincolnshire Care Portal solution, it would not be possible to replace this with a common-off-the-shelf (COTS) solution. Based on the experience of developing the current solution, it is estimated that it would take a minimum of 2 years to develop and test a replacement system from scratch with the associated STP and partner organisation resource time and effort, and that of their suppliers, in order to replicate the functionality we have now. Clearly any such replacement would also have implementation and training implications and the associated disruption to all existing care professionals and patients across the Lincolnshire STP domain, whilst a replacement system was being implemented. The STP strategic objective is to continue to develop the existing Lincolnshire Care Portal solution over the next 3 years in order to extract maximum benefit for our patients and staff during the global pandemic, and then to review the capability of the East Midlands LHCR platform during 2023, with a view to migrating to this platform if it meets our requirements. If not, then this would trigger a tender process for the Lincolnshire Care Portal solution at this time. Additional information: Award of a contract under the direct award procedure under the NHS Health Systems Support Framework Lot 2b Due to the highly customised nature of the Care Portal digital solution, it would be very difficult to replicate using a common-off-the-shelf solution, without incurring significant service degradation and disruption. Based on the experience of developing the current solution, it is estimated that it would take a approximately 2 years to develop, test and release to a live production environment a comparable replacement system with all of the associated STP resource time and effort required to support such a development. Thereafter, within 12 months of completion, we could then be facing a further change as we consider a transition to the Regional LHCR platform. Clearly the prospect of having to change twice within a 3 year period is very unpalatable in terms of resources (costs, staff to support, training) and disruption to services which would likely yield little no advancement/benefit in the meantime. We would effectively be expending a huge amount of resource to simply stand-still over a 2 - 3 year period. The STP strategic objective is to continue to develop the existing Lincolnshire Care Portal solution over the next 3 years, not to de-stabilise our system as we emerge from the global pandemic and transition to a period of service restoration; in order to extract maximum benefit from our existing investment for our patients and staff, and then to review the capability of the East Midlands LHCR platform during 2023, with a view to migrating to this platform if it meets our requirements. If not, then this would trigger a tender process for the Lincolnshire Care Portal solution at this time. (Suppliers may be interested in bidding for the LHCR Platform referred to above. The ITT for this is expected to be released on 1st June 2021.)