Torbay and South Devon NHS Foundation Trust (TSDFT)
THIS FORWARD-LOOKING TRUST IS AIMING TO EXPAND THE USE IT MAKES OF INFORMATICS TO INCREASE EFFICIENCY AND OPTIMISE THE PATIENT PATHWAY.
- Generates workflow and worklists automatically
- Enables information to be shared and accessed easily
- Easy to evolve in-house as data requirements change
- Facilitates remote monitoring and supported self-management
- Reduces paper, van rounds and postage costs
Facilitates patient safety
- Manages safe, structured handovers of responsibility when shifts change (Hospital@day and Hospital@night)
- Minimises information held on paper (writes documents straight into the EDM system)
- Enables workflow, not just data capture and sharing
- Highly flexible and configurable by Trust IT&M staff
- Based on modelling and templates, it does not require programming skills
- Can handle detailed clinical needs to complete any gaps in the patient record
- Fully supports remote monitoring and supported self-management
“When we procured Digital Dictation, we went with InfoFlex because unlike other digital dictation systems at the time, it enabled us to look at workflow at the same time, which meant it didn’t need someone to be manually managing it as such. InfoFlex with its workflow abilities has really become essential to the day to day running of the Trust.”
CCIO and Lead Breast Cancer Surgeon, TSDFT
As an integrated care organisation, Torbay and South Devon NHS Foundation Trust covers Acute, Community and Social Care for the area. It is one of the most forward looking trusts, using informatics not just to share information, but also to drive workflow.
InfoFlex has proved invaluable to this strategy. Not only does it capture and share information, but it is one of the few pieces of software which can manage workflow intelligently, without requiring manual input. TSDFT use it to track cancer patients and to facilitate structured handovers when shifts change for hospital@day and hospital@night. In fact, hospital@day was one of the very first uses of InfoFlex when it was set up here in 2007 and it is still used for this today. Some other systems are available for scheduling but not in an intelligent way, lacking the ability to, for example, automatically schedule further appointments and tests needed around existing appointments. This manual management of workflow is very intensive and prone to human error, whereas a digital system like InfoFlex, which manages workflow automatically, can greatly reduce workload and increase accuracy.
Risks are minimised because everything is on a timed workflow. For example when a patient is due a check-up, a letter is sent from InfoFlex to the GP and then forwarded to the patient as a reminder.
When a patient calls the health helpline, InfoFlex captures this communication event and creates worklists. Staff then have access to call records and events, from which they can check the worklists daily and forward as relevant.
“InfoFlex is a system we can use when our other systems won’t do it. There are always gaps where we haven’t actually got anything. The more bits of system you put on InfoFlex, the more available that information is and the more complete that record becomes.”
IT Programme Manager
South Devon Health Informatics Service
Across the Trust, InfoFlex manages information from physiotherapy to endocrinology, from outpatients to admissions to follow up. With such a wide remit it is impossible to list all its uses here but implementations include:
Correspondence Design / Digital Dictation – started rolling out across departments in 2013, with Endocrinology the latest to come on board in September 2017. Overall, InfoFlex has been responsible for over one million letters. Digital Dictation reduces paperwork, makes information more accessible and, with InfoFlex, prevents the confusion which sometimes occurs when interim drafts are sent out. This is because with InfoFlex, the system will not produce a paper copy until the clinician has verified it. InfoFlex then sends letters straight to the Trust’s electronic document management system, making information readily accessible to authorised users across the Trust, breaking down silos.
The ‘o’ drive – This is the Trust’s colloquial name for patients who are expected by the hospital but who have not yet arrived, coming for example from the GP or A&E. InfoFlex produces a consolidated list that clinicians can review as part of the workflow / patient planning required.
Trackers – InfoFlex runs a number of trackers including the PSA tracker for Prostate Cancer. This improves the patient experience and hospital efficiency by avoiding unnecessary hospital visits while still maintaining specialist care through remote monitoring.
Outpatient appointments – All outpatient appointments are on the system and InfoFlex is handling thousands of letters, which are securely emailed to the GP. Before InfoFlex, they had to be printed and delivered by van, which was more expensive and took much longer.
Patient referral – InfoFlex can send patient referral letters onto other specialties such as occupational therapy and TSDFT use it for inpatient referral to other specialties.
Design & implementation
“We use InfoFlex for so many things now. If you took it away from the hospital, it would pretty quickly grind to a halt. We’ve had it for 10 – 11 years and it would take us a long time to replace, and I’m pretty sure there is nothing else like it on the market. Where people need a database and workflow – who it is, what needs to be done next and what was done in the past – InfoFlex is our go-to system.”
CCIO and Lead Breast Cancer Surgeon, TSDFT
With a trustwide licence, InfoFlex can be used on any computer in the Trust, regardless of function, and now has hundreds logging on each day. Initially it was used for hospital@day, to see how busy junior doctors were, in line with the European time directive and for care plan summaries.
“Once you take the five-day course you can build anything to do with reporting. It’s only when you work with it that you fully appreciate what InfoFlex can do. We are still finding functions and actions we didn’t know existed.”
Software Developer & Change Analyst
Information Asset Support Team, TSDFT
InfoFlex has been designed specifically for the modelling of information and workflow processes across departments and organisations. The flexibility and configurability of InfoFlex has been called its greatest asset by this Trust. Required data sets are constantly changing and InfoFlex can readily change with them.
Future InfoFlex implementations include interfacing e-prescribing information. When patients are discharged from hospital, the prescriptions they need will automatically go into the care summary, reducing duplication and the risk of errors. A lymphoedema system is being developed with the local hospice to manage their patient pathways. The Trust already uses InfoFlex for Cancer MDTs and is now looking to build an MDT that any specialty can use, replacing less reliable and accessible spreadsheets.