Medical records

Sharing patient information

Western Sussex Hospitals NHS Foundation Trust uses patient information in lots of different ways to ensure the best treatment for our service users.

To ensure each new regular use of information is legal, we undertake a Data Protection Impact Assessment (DPIA), which is a risk assessment recommended by the Information Commissioner’s Office (ICO), which is the regulator of the Data Protection Act 2018. These assessments are processed by the Trust’s Information Governance Team and approved by the Trust’s Data Protection Officer (DPO).

To make sure we are being transparent with our patients about what we are doing with their information, we regularly publish and update our most recent list of approved DPIAs.

Following the Trust’s updating its DPIA documentation to meet the needs of the new Data Protection Legislation from May 2018, any DPIAs authorised using that documentation now have a detailed summary of the project it concerns and its benefits.


Recently approved DPIAs

Ratified Project Details
01/10/2019

Adult Seizure Referral Form

 

The process for referring patients suffering a seizure from A&E to neurology specialists has moved from a paper-based to an electronic system hosted on the WSHFT intranet to improve quality of care for patients and enable more effective and efficient working practices for staff. A data privacy impact assessment identified that data submitted electronically is potentially accessible to two small groups that would not have access to information in the system being replaced: administrators of the intranet and the trust’s external web development contractor. The admin group accesses the data only to produce reports for the information asset owner/administrator and to delete it from the server, while the external web developer would access it only if requested in order to resolve a technical issue. The admin group has completed relevant information governance training and is bound by Trust policies and the Confidentiality Code of Conduct which forms part of staff contracts with the Trust. The external contractor has signed a confidentiality/non-disclosure agreement in order to work within the trust’s secure N3 network.

18/10/2019 Skype For Sexual Health Psychosexual Consultations A video consultation provides advantages for patients in terms of accessibility to appointments. West Sussex is a geographically large area and a significant amount of time can be needed to incorporate travel. This can pose difficulties for patients when they negotiate time away from their workplace for a regular appointment concerning a very personal problem.  Approximately 80% of patients seen in the West Sussex psychosexual counselling service are between the ages of 22 and 63 and are potentially affected by this.  Therefore, video consultations may be beneficial for both our patients and also for the local economy.  Currently the service experiences late cancellations for clinics which could be mitigated by offering video consultations instead of the booked face-to-face. It is not likely to appeal to all patients but a subset may find this helpful which ensures that there is less disruption to their therapy and improves efficiencies for the service.  The British Association of Counsellors and Psychotherapists (BACP) provide guidance for online working and the counselling profession and recognise it as a valuable tool5. The Faculty of Sexual and Reproductive Healthcare and British Association for Sexual Health and HIV (BASHH) jointly published standards for online and remote providers of Sexual and Reproductive Health services hence there are frameworks to support this way of working6. Both these documents recognise the need to change the way we work using internet resources.
28/10/2019

Cardiology Image Storage Solution

The reporting and storing systems for cardiac imaging (coronary angiograms and echocardiography) are in poor state across the Trust after years of under investment. Reviewing of images, which is a key part of safety and governance, is made untenable due of defunct storage of tests and unstable viewing software. Reporting of images needs manual double entry of data, which is laborious and makes transcription errors more likely. The purpose of this bid it to provide a 10 year solution for cardiac imaging. The improved access to images will allow cardiologists to review results and explain procedures more clearly to patients. We have undertaken a formal tender process to identify suppliers that can provide an image storage solution which serves the needs of both sites, providing a robust system for reporting and archiving of cardiac images, within the budgetary envelope.
14/11/2019 Docman Connect

BSUH produce over 2000 electronic documents per day to support continuity of patient care. Many of these documents require shared with General Practitioners in a timely manner and this project is to update the method BSUH use to achieve this. Docman Connect is a cloud based document distribution platform which allows the Trust to transmit documents electronically to 97% of GP Practices across the UK. It offers real-time secure delivery with additional functionality to track and return correspondence.

 

The service has be funded by a CCG consortium and will be utilised by BSUH, WSHT and ESHT.

 

The benefits include a single tracked distribution method for electronic documents to GP’s and a single portal for Trust administrators to monitor queries and rejections.

09/12/2019

Procurement Of Finance & Accounting Services

The current contract for outsourced Finance & Accounting Services (inc. Financial System) ends on 12th April 2020. Outsourcing to NHS Shared Business Services has been identified as the preferred option and would involve migration of financial data to a new ledger system. 

 

NHS Shared Business Services is a joint venture between the Department of Health and Sopra Steria, and is a strategic partner to the NHS. NHS SBS is the largest provider of finance and accounting, procurement and employment services to the NHS in England.

 

The previous contract for Finance & Accounting services with Serco, was novated to NHS Shared Business Services in November 2018, and as such all relevant data is already held at NHS SBS.  The project involves the transfer of financial services data from the legacy system, Integra over to the system used by NHS SBS, Oracle.

 

There will be no change in process, however in addition to the migration to a new ledger there will also be a geographical change in location. 

 

The transition will be project managed by an experienced transition and migration team at SBS.

15/01/2020

vCreate Secure Video Messaging In Children’s Services

vCreate is a secure video messaging service allowing nursing teams to send video updates to parents with children in hospital. The aim being to minimise separation anxiety, provide reassurance and to improve communication between the hospital and patient families. The service is NHS Trusted and has passed IG scrutiny in this Trust and others across the UK. The potential information risks have been identified as minimal with clear benefits to families and the Trust.

15/01/2020

Radiology Patient Contact External Website Form

Western Sussex Hospitals is enabling patients unable to attend a Radiology appointment to cancel it online rather than having to telephone or email. By making it easier for patients to notify the department they will not be coming, it is hoped to reduce the did-not-attend (DNA) rates and enable more cancelled appointments to be reallocated to others.

 

A data protection impact assessment identified that data submitted electronically is potentially accessible to two small groups that would not have access to information in the system being replaced: administrators of the Trust website and the Trust’s external web development contractor.

The admin group access the data only to produce reports for the information asset owner/administrator and to delete it from the server.  The external web developer access the data only if requested in order to resolve a technical issue. The admin group has completed relevant data protection training and is bound by Trust policies and the Confidentiality Code of Conduct which forms part of staff contracts with the Trust.  The external contractor has signed a confidentiality/non-disclosure agreement as part of their Service Level Agreement with the Trust.

24/01/2020

OptoMize

Vector have been bought out by Northgate Public Services who also own OptoMize.  The uniface licence for OptoMize expires in April 2020 and therefore the West Sussex DESP will be moving across to OptoMize. 

 

The transfer of data is being managed by the Trust IT Department who have representation on the Project Team to ensure secure transfer within the required timeframe.

 

This is to maintain the current service to the West Sussex diabetic population and there will be enhanced functionality once the Programme go live in March 2020.

31/01/2020

DatixCloudIQ

NHS England and NHS Improvement released the NHS Patient Safety Strategy in July 2019. This strategy provides a greater emphasis and a more focused vision for patient safety in NHS provider organisations, with patient safety planned as a “golden thread” running through healthcare. This strategy aspires to reduce the 11,000 lives the NHS fails to save each year due to safety concerns, with better incident reporting and response alone saving the lives of 160 patients and £13.5 million.

 

With DatixCloudIQ, Western Sussex Hospitals Foundation Trust will enhance existing tools and gain additional tools for aligning daily practice and culture within the organisation with the goals and deliverables of this strategy. This will embed the increasing momentum to develop a just culture and a culture of learning from when things go wrong and increasingly from when things go right. With the advancement of data collection and analysis, DatixCloudIQ is a tool to take a system approach to look at principles, systems, processes, skills and behaviours for incident management.

 

Specifically, DatixCloudIQ will provide an opportunity for furthering a culture of incident reporting and learning from adverse events, with improved interfaces, advanced functionality and mobile accessibility to promote better incident reporting and encouraging engagement.

With a dedicated tool for conducting investigations, this should be a segregated area for deriving learning from when things go wrong. With tools for gaining feedback from patients and all other stakeholders, DatixCloudIQ will also help Western Sussex Hospitals Foundation Trust learn from when things go right.

 

The DatixCloudIQ system will also allow Western Sussex Hospitals Foundation Trust to meet the Care Quality Commission’s requirements around mortality review reporting, with the effectiveness of trusts’ learning from when deaths occur in their care contributing to the well-led part of CQC inspections.

12/02/2020

SOLAR (ServiceLine Opportunities Linked to Actvity & Resources)

The Trust continues to look at improvements to the quality of its patient care, in order to develop both time, cost and quality benefits.  NHS Trusts are required to publish data around its care of patients, and this information can be used to understand both how we provide excellent care as well as make improvements through reduction of variance.  Data that is already collected is used to help this process.  To ensure compliance with data protection requirements, a review has taken place to ensure appropriate usage of data.  As the data is collating information already captured and/or published by the Trust through other channels, no additional risks have been identified following the assessment.

 

09/03/2020

Prophecy Scan

This project is to ensure the secure transfer of pseudonymised diagnostic images from Western Sussex Hospitals NHS Foundation Trust to an external supplier for the production of customised total ankle replacement implants. Images will be uploaded via a secure portal and tracking of the production will be visible to Western Sussex Hospitals NHS Foundation Trust to ensure patients are booked into relevant theatre sessions. The benefits of this scheme are increased security of diagnostic images and to avoid delays in supply chain and theatre space to avoid repeat imaging and the risk of unnecessary radiography.

25/03/2020

Covid-19 Attend Anywhere Video Consultancy

There is a desire to transform the way our patients currently access services at BSUH and WSHT, to offer flexibility and avoid unnecessary travel to hospital especially our higher risk patients during the COVID19. Introduction of this technology aligns to the BSUH/WSHT digital vision and supports the NHS Long Term Plan for patients to have virtual access to advice and healthcare provision.

 

Many patients experience stress or anxiety when attending clinic especially in current climate. This could be minimised if consultation is undertaken within the patient’s home or chosen environment. Due to the nature of their condition, there could be clinical benefits of a patient remaining in home environment.

26/03/2020  Covid-19 Remote Access to PACS

WSHT Generic Image Sharing log on with QVH

31/03/2020

Covid-19 GDm Health (remote care of pregnant women with gestational diabetes)

The Gestational Diabetes management system (GDm-Health) is a prescribed digital therapeutic for the remote management of gestational diabetes at home. GDm-Health is born out of clinical need and is underpinned by a rich source of clinical evidence, gathered as a result of extensive clinical evaluations. GDm-Health is listed on the NHS Digital Apps Library. The GDm-Health system comprises a smartphone App which connects to a wireless blood glucose (BG) meter using Bluetooth or NFC (Near Field Communication). A woman’s measurements along with any text-based commentary she wishes to log, or request for call back is then transmitted directly to a clinical dashboard for the multi-disciplinary team to proactively manage.

 

01/04/2020

Covid-19 Skype For Sexual Health

 

To extend the use of Skype for COVID-19 contingency plans to incorporate all forms of sexual health care.

02/04/2020

Covid-19 independent Sector Radiology Support During Covid-19

To protect the vulnerable high risk CT and MRI patients from CV19 they will be scanned in the IS instead of the acute Trust

08/04/2020

Covid-19 Healthy.io SPOT Tool For Wound Care app

The Healthy.io SPOT wound care app, turns a smartphone camera into a digital wound assessment device. Combined with an integrated, secured shared portal, the app takes time series observations of wounds and uploads them in real-time to a shared portal. This app can be used to analyse and record observations about wounds and pressure sores, generating time series data showing recovery rates.

 

Healthy.io’s SPOT wound care tool will turns the smartphone camera into a medical grade device, providing the following benefits:

Automatic capture of a virtual 3d image of a wound and upload to a shared secure portal

Improved consistency of approach (enabling wounds to be automatically measured)

  • One stop assessment process, creating reduced paperwork
  • A comprehensive digital record with time series data reflecting the wounds size and composition every time it is measured.
  • The secure patient portal will provide a single auditable, searchable secure portal for all wound images and observations across both teams.
  • As part of this commitment, Healthy.io will explore automatic integration with local PAS systems, which will significantly reduce administrative burdens across the wound team.

EXPECTED BENEFITS

The following key metrics are expected outcomes:

  • Reduced visits as district nurses can visit, scan and upload images which tissue viability teams can advise on remotely
  • Significantly reduced administrative burdens
  • Improved consistency of reporting
  • Improved visibility of wounds over time
  • Improved governance as assessments become more visible and volume of data and picture capture is improved
  • Accurate, shareable and contextual quantitative data will be consistently available, enabling the service to analyse more data than ever before

This app can be rapidly deployed within 2-3 days if necessary, to support with reducing visits as part of COVID-19.

14/04/2020

Covid-19 NPEx Implementation

 

To aid in COVID-19 testing NHSx is rolling out a project to connect all Pathology Labs in the country to the NPEx system.  NPEx is a Lab to Lab referral system that lets labs electronically transmit orders and results between them.  This will allow faster transmission of COVID-19 results and allow NHSx to keep track of COVID-19 cases.   

15/04/2020

Covid-19 Microsoft Teams Deployment

NHSDigital has made Microsoft Teams available to all NHSmail users to enable easy and accessible Instant Messaging, Conference Calling, Video Conferencing and collaboration tools. This is to aide communication across the NHS during the Covid 19 emergency.

17/04/2020

Covid-19 GOV.UK Notify SMS/Email Delivery (programmatically) via Notify Service

Portal provides an aggregated view on clinical data from other systems in a single place.

21/04/2020 Covid-19 Medtronics Stay Connected Clinic (virtual pump starts/upgrades for diabetes patients)  
23/04/2020

Covid-19 Affinity Portal – Radiology Requesting

The addition of a Radiology request form allowing clinicians to send a request digitally

02/06/2020

Online STARS Awards Nomination Form

Western Sussex Hospitals is enabling nominations for its annual staff recognition awards (STARS) to be made online, rather than by email. It is hoped that this will make it quicker and easier to nominate a member of staff and that more colleagues can be recognised for their outstanding work and commitment as a result.

A data privacy impact assessment identified that data submitted electronically is potentially accessible to two small groups that would not have access to information in the system being replaced: administrators of the trust website and the trust’s external web development contractor. The admin group accesses the data only to produce reports for the information asset owner/administrator and to delete it from the server, while the external web developer would access it only if requested in order to resolve a technical issue. The admin group has completed relevant information governance training and is bound by Trust policies and the Confidentiality Code of Conduct which forms part of staff contracts with the Trust. The external contractor has signed a confidentiality/non-disclosure agreement as part of its SLA.

02/06/2020

Online Employee of The Month Nomination Form

Western Sussex Hospitals is enabling nominations for its Employee of the Month Award to be made online, rather than by email. It is hoped that this will make it quicker and easier to nominate a member of staff and that more colleagues can be recognised for their outstanding work and commitment as a result.

A data privacy impact assessment identified that data submitted electronically is potentially accessible to two small groups that would not have access to information in the system being replaced: administrators of the trust website and the trust’s external web development contractor. The admin group accesses the data only to produce reports for the information asset owner/administrator and to delete it from the server, while the external web developer would access it only if requested in order to resolve a technical issue. The admin group has completed relevant information governance training and is bound by Trust policies and the Confidentiality Code of Conduct which forms part of staff contracts with the Trust. The external contractor has signed a confidentiality/non-disclosure agreement as part of its SLA.

18/06/2020

Covid-19 Bamboo (for HR staff risk assessments)

To monitor and provide assurance to the trust board that risk assessment and action plans have been

undertaken on any staff member who is pregnant and/or Black, Asian and Minority Ethnic (BAME) and/or vulnerable (including ‘shielded’ employees) as a result of COVID-19

01/07/2020

Sharing the PERFORMS breast screening images

All national breast screening personnel involved in reporting screening mammograms take part annually in the PERFORMS EQA scheme by reading a set of 64 challenging breast screening cases on their clinical workstation and report their decisions about each case using the PERFORMS web-based reporting software. Nottingham are ready to implement the next set of PERFORMS but the ongoing Covid-19 pandemic is severely limiting their access to their offices at the University of Nottingham and currently this is preventing them from sharing the PERFORMS breast screening images via USB drivers or DVDs. To address this challenge, they have prepared a Microsoft OneDrive link, which includes the next set of 64 images, and they would like to share it with our trust. Using the OneDrive link, the images need to be downloaded and then loaded onto the workstation as usual. All images are fully anonymised.

13/07/2020

AccuRx

Many outpatient face to face consultations have been cancelled due to COVID-19. The Trust needs to find a secure and reliable platform for video consultations with patients. AccuRx is being used in Primary Care, and it has been tested in the Trust for video consultations with patients, MDT meetings, and patient groups. Attend Anywhere is the approved platform for video consultations for secondary care and is being used in the Trust, but there are some features like the groups where AccuRx provides a much better performance.

 

AccuRx is an NHS digital approved econsultation system. It is a secure, reliable platform that can be used for video consultations with patients, MDT meetings, and patient groups.

 

Personal data is required in order to correctly identify a patient for a video consultation. Patients will be phoned to agree to a video consultation where their details will be matched with the records the clinician already holds. The patient agrees to take part in the process by clicking on the link to the video consultation. They can dissent at any point by either not clicking on the link to the video consultation or leaving the video consultation.  Necessary clinical information may be verbally collected during the consultation and later added to the patient’s health record.  The IP address of call participants may be stored as part of metadata stored, however no other personal information of call participants is collected or stored.

 

Any health data collected will be retained in line with the Records Management Code of Practice Retention Schedules. The video consultation service is hosted by Whereby who are fully compliant with GDPR. The video and audio communication is only visible to participants while on the call and is not recorded or stored on any server. The connection follows NHS best practice guidelines on health and social care cloud security. 

31/07/2020

e-PGME Attendance System

The Postgraduate Medical Education (PGME) department administers the education and training of doctors in Western Sussex Hospitals NHS Foundation Trust. As part of our remit we ensure that training grade doctors receive the correct amount of learning in order that they can progress in seniority. Currently teaching events have a paper register and paper feedback forms which are them processed by a member (or members) of the PGME team to produce certificates of attendance and/or certificates for teaching. The e-PGME Attendance System will automate this process. A member of the PGME team (or the person delivering it) will set up the teaching event and send an invite link to the group of prospective attendees who then register and receive a unique QR code for each event. Once at the event they will check in by having their QR code scanned by an administration user of the system, some teaching sessions will also require checking out to ensure the trainee has attended the full session. After the event the attendees who checked in will automatically be sent a feedback form and certificate of attendance (people delivering sessions will receive a teaching/faculty certificate).
This system only collects the minimum details required to effectively allow the accurate administration of attendance and certification for training grade doctors. The risk score is extremely low of the data being accessed by anyone other than those intended.

14/08/2020

Carelink (diabetes patient data sharing) – Supplier: Medtronic

CareLink™ System is a service provided by Medtronic for HCPs to upload patient insulin pumps, CGM devices and compatible BG meters.  This enables HCPs to generate reports to assist with patients diabetes management.  HCP’s may create a patient profile in the system and upload a patients compatible device in clinic to see data from their device or request that the patient links their CareLink™ Personal with the clinic so that data patients upload at home can be viewed in CareLink™ System by the HCP (and vice versa, data uploaded in clinic can be viewed by the patient at home).  Greater visibility of patient data helps to facilitate more informed consultations with patients for improved collaboration and improved diabetes management planning. 

14/08/2020

Breast Service Moving To Paperless System

Current protocol requires mammography staff working on breast screening mobile units within the West Sussex catchment area to take patient identifiable records from the hospital to home to screening mobile units for the following day’s work. The Service had an IG incident in January 2018 and there is a risk of a further incident due to loss or theft of patient records in transit to the mobile units.

The Service has developed a paperless system and has purchased the required equipment to implement the new system but reliable internet connection is required for mammography image transfer, worklists and paperless working. DEOS Consultancy Limited will enable worklists to be sent from NBSS to the breast screening mobile units in the community and for the images to be transferred automatically to Trust PACS and Securview.

The files are sent as a compressed image so the new system is very low risk and it is safer than our current system as it will remove the risk of loss or theft of patient records in transit to the mobile units.

16/09/2020

Netcall (retrospective for Appt/Admissions & New For Radiology)

As part of a project to reduce wasted appointments from patients who do not arrive for varying reasons, we looked at a number of ways to help reduce this.  Feedback from both staff and via a patient survey was that text messaging as a reminder system would be beneficial.  It was then decided to set up an SMS Text Project Group to move this forward.

 

The SMS Text Project was set up to create a reminder for patients of their appointment, that would have previously been sent by letter, giving them the option to rebook or cancel if they feel they are unable to attend. 

 

Netcall is a telephonic system that is used in our outpatient departments to include clinic appointments and radiological scans.  Our patient administration systems send information to Netcall who in turn forward as a text to our patients.  The information used is the mobile number provided,  appointment date/time and which hospital site to attend.  In the case of radiology it will include the modality.  

We believe that this will help to reduce the DNA rates as well as giving our patients the best service we can.


If you would like further information about any of these DPIAs or the information being shared, please email information.governance@wsht.nhs.uk.

 

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