Moorfields Eye Hospital - Support Delivery of the Deployment work stream for Ophthalmic EMR

Description

Summary of the work Deliver infrastructure and training workstreams, act as the key divisional contact point for 2 divisions, support divisions during UAT & cutover. Deliver the Desktop Infrastructure Strategy, RAID logs, highlight reports, plans, Infrastructure Audit, deploy new desktop kit, cutover plan to hosting service, the TNA, and delivery of the training workstream. Expected Contract Length 2 years Latest start date Tuesday 1 August 2017 Budget Range (1) 2017/18 financial year - budget range £120,000 - £160,000 (2) 2018/19 financial year - £120,000 - £160,000 (excludes VAT). Note: Trust will, in addition, also employ a permanent cutover/deployment manager and training resources, IT programme manager, IT infrastructure lead Why the Work is Being Done The Trust invested in the development of an Open Source Ophthalmic EMR, OpenEyes. The Trust recently concluded a tender process which identified Hicom as the preferred partner to complete the development of OpenEyes and deploy Hicom’s CareHub product, with the majority of the functionality being delivered in the first 3 years of the contract. The first phase of go-live will be in Q4 2017/2018. The first phase of delivery will include a technical refresh, reporting and migrating to off-site hosting followed by completion of functionality required to support the “Big Three” Ophthalmic sub-specialities; cataract, glaucoma and MR. Problem to Be Solved A fully comprehensive Electronic Medical Record (EMR) solution is required to meet the needs of Moorfields Eye Hospital as a world leading ophthalmic clinical, research and educational organisation and to provide paperless clinical records that will improve the quality of care, and enable administration and operational efficiencies. We treat patients in 32 locations in and around London, which means that we can provide more first-class care and treatment in the community, closer to where people live and work. 30 Sites use the OpenEyes, open source Ophthalmic record. Two sites use another system and they will be migrated to OpenEyes. Who Are the Users EMR users are primarily clinical staff and AHPs including Optometrists, Pharmacy. Some administrative staff including medical secretaries and booking office staff will access the system. All Trust sites will use the system. Currently Croydon and Bedford use an alternative systems which will be migrated to OpenEyes at the end of the deployment. The product will cover all 18 Ophthalmic sub-specialities. The system will be hosted off site by the supplier. Work Already Done OpenEyes is operational on 30 sites but not fully utilised by all clinicans and all sub-specialities and the product is not fully developed. The hicom Carehub product has not been deployed. as historic change management has been inadequate. Initial benefits work book and approach drafted. Change approach drafted in FBC. Clinical hazard log and action plan available for current version Procurement activity is complete. Supplier COTS product not yet deployed. High level functional specifications, including workflow diagrams, documented for all specialities. Genetics and Refractive have very detailed specifications. No SOPS documented Existing Team EPR Programme Team will consist of a range of Authority, supplier and consultancy teams to deliver the EMR solution. This will include the Programme Manager and deployment project leads, change team, test team, data migration team, trainers, technical lead, CIO and CCIO engagement, clinical secondments and other members of the IT department seconded to the project including 2 change leads/analysts and 1 deployment workstream lead. Clinical staff contribute to specification, prototype review and UAT. The trust also has a part time clinical risk lead who is a consultant. Current Phase Not started Skills & Experience • Experience of responsibility for managing EMR workstreams - cutover, training and infrastructure - in a large scale EPR programme in an acute trust • Evidence and experience of producing cutover plans • Evidence and experience of delivering training plan and managing the training resource in a large scale acute EPR programme • Evidence and experience of managing assigned RAID logs • Evidence of approach and methodology to determining training requirements and developing tools • Evidence of approach to supporting cutover and go-live process • Evidence of technical knowledge of desktop and LAN Nice to Haves • Experience – delivery of workstream management for Ophthalmic solution • Experience – analysing, documenting and achieving clinical sign off in Ophthalmic environment. Work Location Main site and base for work - City Road, London, EC1V 2PD. Travel will also be required to other Trust sites across London and the South East (Bedford and Dartford) from time to time. Working Arrangments Most of this work needs to be on site (at least 90%) due to clinical engagement required and wider EMR Team communications. Travel expenses will not be paid unless travel is required between sites at the middle of the working day. Security Clearance DBS required No. of Suppliers to Evaluate 3 Proposal Criteria • Approach and methodology (planning and cutover planning) • Approach and methodology (training workstream management) • Approach and methodology (infrastructure hosting) • Draft plan and timescales • Team structure • Value for money Cultural Fit Criteria • Approach to identifying issues and risks and how they will be managed • Approach to identifying dependencies between EMR programme workstreams and how they will be managed • Approach to and evidence of ability and experience of communication with clinical staff • Approach to team integration with the wider IT EMR team including Programme Manager and IT staff • Approach to QA and ensuring quality Payment Approach Capped time and materials Evaluation Weighting Technical competence 50% Cultural fit 10% Price 40% Questions from Suppliers 1. It is possible to provide a proposal for part of the outlined requirement only? The Trust has advised that no, supplying a proposal for part of the outlined requirement only is not suitable. 2. What desktop architecture do you currently have in place and to what extent is the desktop environment virtualised? What OSs are currently used? Do you have a desktop refresh strategy and if so can you provide a high level view of it? Most clinicians - about 700 clinical end users - connect via thin client VDI / RES service. Remaining desktops (about 1200) are mainly Win 7- which we are replacing 50% with Wind 10 in next 12 months. Desktop strategy under review. 3. Pilot deployments are often advantageous in the roll out, have you already identified a department that may be suitable to perform final extended UAT, or use the LIVE system with additional support for an initial period. First go live will be "Big Bang" as it is tech refresh and impacts all existing users. All subsequent releases will be released to all users however utlisiation of new functions may involve phasing rollout slightly more gradually to smaller satellite sites to accommodate users over 32 sites and focus on main sites. On-site Support will be required for initial period 4. Do you have a tech support team members aligned to this programme to support the roll out at each location. A member of the existing infrastructure team will be assigned to support project but in first year it is anticipated that existing equipment will be utilised. There is a separate team dealing with desktop upgrades. 5. Is the tech refresh including both client and server side hardware? No to desktop. Yes to server side which will migrate to an off site hosted solution which will be managed by the supplier. 6. Will the EPR be viewed on mobile devices, are these included in the refresh? Excluded but desktop strategy will need to review use of mobile devices. 7. Do you use COWS (Computers on wheels), are these included in the tech refresh, how many are there of these to be changed? We only have 24 beds - we are mainly an ambulatory care ordanisation so we only have a handfull of COWS on the City road site. None are planned to be changed. We may decide to add a COW at St Georges 8. If known, how many workstations are required to be upgraded/replaced as part of the programme? What are the technical requirements of the new workstation? Are the updated workstations needed just for the EPR, OpenEyes describes itself as browser based, is new hardware needed just for this. There is a separate programme to replace desktop hardware. The EMR Infrastructure workstream will need to check that the refresh programme is aligned with EMR requirements and ensure sufficient kit is suitably located for the EMR progeramme. 9. You have mentioned the initial scope of 3 main specialities, we have assumed that the EPR is focused on centralising imaging, results and notes for the ease of clinical staff. Is there also a drive to include all stages of the patient journey, from referral to discharge. Will this including scanning of paper records? If so does the system use barcoding, or QR codes to identify the forms and file. Is there a goal to have the EPR facilitate clinical coding? Could you describe the clinicians who have been involved in the programme and what their roles have been. This is an Ophthalmic EMR so priorities include collection of eye related data, integration to Ophthalmic image devices this includes data from referral to discharge. Scanning will be limited and if required this will be to the EDM solution which interfaced to EMR. No bar coding currently. Coding if facilitated within the system and will be updated and refreshed as part of new functions. Coders access the system currently to code. Clinicians primarily involved to date - CCIO and consultants from each speciality. 110 consultants and 17 sub-specialities with the majority of consultants engaging with development and specifications to date. 10. Please could you describe the existing and planned integration that OpenEyes and CareHub has with other systems both incoming and outgoing, anything relevant to what is shown in the record? Is the interfacing HL7 compliant, and which interfacing engine do you use? Who is the interfacing managed by, who actually writes the interfaces? Is mobile/tablet device access currently available for OpenEyes? Does Moorfields EPR data also get sent to other systems, via interfacing, such as GP systems, or consultant systems. Most interfacing HL7 compliant. Orion Rhapsody. There is a separate workstream for interfacing. Interface development and management is outsourced to a third party. Current interfacing is ADT and discharge summaries and OP letters are sent to GPs. Mobile device access to EMR is limited. 11. Do you use elearning, is the system able to identify cohorts of staff based on seniority, location, department or job function? Limited eLearning. Strategy is to fully develop for the solution. 12. Do you have an agreement with the OpenEyes to deliver training, at a minimum to the technical support staff? The contract with the 3rd party supplier provides a training to tech support staff 13. We would expect there to be various tiers of training, some best delivered in person and some more suitable for e-learning Yes 14. What is the typical sign-off route and time scale for formal approval for clinical training, e.g. L&D department, followed by clinical management, then Board. L&D, Project Board then Programme Board