NHS Direct & Sitecore: Delivering Digital Health Services
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Slides from the NHS Direct Presentation which was given as Digital Trendspot on 13/10/10.
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NHS Direct & Sitecore: Delivering Digital Health Services
- 1. NHS Direct & Sitecore Roger Donald Head of Digital Delivery 12/10/2010 1 #SitecoreDT10
- 2. What is NHS Direct? 12/10/2010 2
- 3. What is NHS Direct? A health information and advice line (0845 46 47) 14,000 calls a day. That’s over 5 million calls a year Web site alone receives 1 million visits each month 3,400 staff over 1,400 of whom are trained nurses (including dental nurses) National infrastructure, but with regional/local engagement Commissioned by the East of England Strategic Health Authority on behalf of NHS 12/10/2010 3
- 4. The digital challenge 12/10/2010 4
- 5. “The internet has changed the way we shop, find information and access services or all sorts, including health care. The revolutionary effect of the web will continue to grow, and all organizations need to understand how to harness this to achieve their goals. Our patients currently think of NHS Direct as a telephone service. We must, of course continue to be available to patients who just pick up the phone as now. But to ensure we continue to give a service that is highly valued, we need to think about patients who choose to access us by looking on the web first, and then seek phone contact if that is what they need. This needs our full attention.” Nick Chapman - Chief Executive 5
- 6. Public access to health services? Historically... Face-to-face communication only At a time that suits the health professional Organised around geographic locations & communities Some telephone based access (NHS Direct) Our research demonstrated a public demand for digitally delivered health services 12/10/2010 6
- 7. Delivering digital health services The challenge... 40 health & symptom checkers (sometimes called SATs) that are clinically safe That are easily altered by our clinicians & content authors From a single source of clinical algorithms That meet Government accessibility standards Delivered across multiple channels That allow for patient / health professional interactive communication Which capture and pass patient data securely to our systems 12/10/2010 7
- 8. 8
- 10. PCs
- 11. Mobile devices
- 12. iTV
- 13. Gaming consoles9
- 14. The Sitecore solution 12/10/2010 10
- 15. Sitecore was chosen because... It integrates with other Microsoft platforms Specifically Arezzo a clinical decision support tool from InferMed (Prime Contractor to NHS Direct) Easy to implement workflow It versions our content Inline editing out the box An easily accessed web interface An API to syndicate our services to other organisations Delivery of content across multiple channels A proven service used by major organisations 12/10/2010 11
- 16. Over to Michael... 12/10/2010 12
- 17. 13 12/10/2010 Developing the Online Service Michael Edwards Web Consultant
- 19. Not-for-profit registered charity with commercial approach
- 21. 7 years delivering Sitecore solutions
- 23. Job Search
- 24. Health Enquiries
- 25. SATs
- 27. 17 12/10/2010
- 28. 18 12/10/2010
- 29. 19 12/10/2010
- 30. 20 12/10/2010
- 31. 21 12/10/2010
- 33. Contains
- 34. Questions
- 37. Contains
- 38. Questions
- 40. CDE HaSC 26 12/10/2010
- 41. HaSC Process 27 12/10/2010
- 42. CDE Website 28 12/10/2010
- 43. CDE Website 29 12/10/2010
- 44. CDE Website 30 12/10/2010
- 45. CDE Website 31 12/10/2010
- 46. CDE Website 32 12/10/2010
- 47. CDE Website 33 12/10/2010
- 48. The Challenges 34 12/10/2010
- 50. We use a full object model with Sitecore (in house framework)
- 53. XHTML focused
- 54. Uses domain objects as content source
- 55. Open Source
- 58. Compiled rather than parsed
- 61. Full integration
- 62. Flexibility
- 63. Simple
- 64. Uses Sitecore inbuilt caching
- 67. Versioning is typically per item
- 68. The whole SAT must be versioned
- 71. Full Control
- 72. Simple
- 74. 45 12/10/2010
- 81. Time Version 1 Version 2 50 12/10/2010
- 82. Time Version 1 Version 2 51 12/10/2010
- 83. Time /liveguidelines/v001/c001/coldandflu Version 1 Version 2 /liveguidelines/v001/c002/coldandflu 52 12/10/2010
- 84. Summary Produced Health and Symptom Checkers Provided a method to rapidly update HaSC Updates don’t interfere with users already on the site HaSC can be distributed through multiple channels 12/10/2010 53
- 85. 54 12/10/2010 Any Questions ? Michael.Edwards@Eduserv.org.uk Roger.Donald@NHSDirect.nhs.uk Follow Digital Trendspot on Twitter- #SitecoreDT10
Notes de l'éditeur
- Multi-Channel service providing health advice and information out of hours support for GPs and dental services telephone support for patients with long-term conditions pre and post operative support for patients 24 hour response to health scares remote clinics via telephoneCore staff of experienced nurses and health advisors 34 sites across the country. 26,000 calls a day.
- 33 contact centres linked into a single virtual contact centre26,000 calls per day - That’s over 9 million calls a year (including all commissioned services)Health information and advice line (0845 46 47) deals with 14,000 calls a day. That’s over 5 million calls a yearWebsite receives 1 million visits each month and over 30,000 patients access core NHS Direct services through the internet every day
- A key stakeholder in delivering the multi channel future for NHS Direct is our chief executive. Nick get’s what we are doing from a multi channel perspectiver and is instrumental in delivering key internal messages such as this one back into our frontline staff.
- Digital access to health professionals, think about banking in the 1980’s
- 40 online health and symptom checkersCovering 210 clinical algorithms Produced by our Clinical Development Team Clinically safe Mirrors call centre processes Dispositions & explanations (Call 999, Go to A&E, Call-back from a nurse) Distributed via multiple channelsWeb, Digital television, Mobile devices,
- The vision is that NHS Direct feeds into a digital NHS with self service at its core so that tasks that involve a visit to GP, Pharmacy, Hospital done via net books, PCs, mobile devices or iTV to suit patients.
- Top 2 integrate with third party services
- Shows the different components of the site
- These elements are NHS Directs internal inputs. Staff Internal Systems (OES) Arezzo (Clinical Decision Tool)
- External Inputs Third party applications APIs
- Methods of viewing the siteStandard web pages currentPlanned: Via mobile website/ application Embedded on other sites Internet TVEssential that content and presentation are separated to allow for all the different output formats
- All powered by Sitecore
- I am going to discuss the Self Assessment Tools on the site which allows a user to self diagnose an issueIt makes use of the highlighted components
- They are used to self diagnose an issueIt will ask you questions
- Questions can be multiple choice, text entry, dropdowns
- The SAT may from time to time present information instead of questions
- The information returned might be to call 999, see your GP or self care.
- Describes the different elements that go to make a SAT Clinical Teams who design the guidelines and ensure they are clinically safeContent Teams ensure that they questions themselves look correctArezzo is the decision engine that decides what should be presented to the userSitecore contains all the content to present
- Going to run through the process of running a SAT
- The user answers a SAT question that get sent to the website
- We send the answer data to Arezzo
- Arezzo tells us the next set of questions or information to present to the user base on the last and all previous questions
- We then ask Sitecore what content we should display for each question
- Sitecore returns the content we need to display
- The site combines data from Arezzo with the content from Sitecore to return the page.Arezzo decision making process is non-linear therefore we need a content management solution that could handle not being accessed in a linear manner and makes a complete separation between content and presentation. Sitecore allows use to access the content we need when we need it and via a fast API.
- I am going to go through some of the challenges and solutions when developing the SATs.
- Sitecores extensibility means that adding a different rendering method is a fast and simple process. To do this all we need to do was: Create a template to represent the spark files Create a class to create the Spark control at rendering Add one line of configurationSitecore comes with loads of icons out of the box, so we found a cool icon
- We apply workflow to the root item of a SAT.When the want to create a version they submit it, using workflows we lock the entire tree to stop any further editing while it awaits approval. Once approved the SAT can be edited again.Guidelines exist outside the root of the tree, i.e. Not below the home node
- To link to the SAT we have a placeholder page in the site for each SATThis contains a field that indicates which SAT version a user should use when starting a new SATThis is a quick and easy method of switching between the different available guidelines.
- Explain what is meant by clinical integrity, i.e. A publish does not interrupt the current usersGive an example of what this means
- I am going to look at how we maintain a users journey through a SAT and how Sitecores split of presentation and content helps us do that.
- We have a new user to the site who uses version 1 of the Cold and Flu SAT
- As they progress through the SAT the NHS Direct team release version 2 of the SATIt is important at this point that for clinical integrity the user in version 1 of the SAT remains on version 1 of the SAT. When version 2 of the SAT is released they must not be switched to version 2.
- A new user decides to use the Cold and Flu SAT, they access it via the same URL as the original use. They are automatically directed to the new version, version 2.The existing user is still using version 1
- Sitecore allows us to do this because it allows us to complete control the content we choose to render and to which users.We use the same rendering mechanism and same URL but pull different content from the Sitecore CMS.