What they learned and gained
Stakeholders see the benefits of a national collaborative approach to cancer intelligence
Chemotherapy Electronic Prescribing and Administration System (CEPAS) procurement
IHDP facilitated conversations across cancer networks and with the CEPAS supplier (ChemoCare®) to ensure engagement, and support networks to jointly negotiate the specification for upgrading to ensure as much harmonization as possible going forward (see SCRIS impact story: Developing National Systemic Anti-Cancer Therapy (SACT) reporting).
ChemoCare® is an electronic chemotherapy prescribing and patient scheduling system known in NHS Scotland as CEPAS.
ChemoCare® provides support for safe prescribing and administration, giving each patient a single electronic chemotherapy treatment record that is accessible to designated members of the multi-professional team across the pathways of care and from multiple geographical points of service delivery.
Information governance in health and social care data
IHDP brought stakeholders together across sectors to simulate national debate on challenges and how to overcome them, providing a springboard to consensus building.
- Implementing Treatment Summaries across Scotland
A national scoping of the examples of, and evidence for, treatment summaries provided the basis for implementing this commitment from the 2016 Scottish Government cancer strategy. A national approach to delivery will ensure consistency for patients and those involved in their care. Developing National Systemic Anti-Cancer Therapy (SACT) reporting
Having national comparative reporting of chemotherapy data for the first time will allow the identification of any inappropriate variations in treatment and prompt corrective action (see SCRIS impact story: Developing National Systemic Anti-Cancer Therapy (SACT) reporting).- Modernising the cancer registry
SCRIS dashboards were developed with extensive stakeholder and user feedback across Scotland. By helping to shape SCRIS, users such as clinicians and service managers can ensure it meets their needs and helps them to provide better cancer services.
A collaborative approach can expedite progress and lead to swifter outcomes (e.g. procuring an upgraded CEPAS, above). Working collectively for a national approach can, however, require significant investment of time but have greater gain. For example the work to create a national view of SACT data has taken place over 5 years to date, yet the benefits of having national comparative data far outweigh any derived from quick-fix local workarounds. (see SCRIS impact story: Developing National Systemic Anti-Cancer Therapy (SACT) reporting).
Improvements in data assets, better access to data and more useful intelligence from data
- Public Health Scotland staff have enhanced and extended datasets available for analysis, which are more easily accessible.
- The analytical and intelligence service accompanying SCRIS has been expanded to optimise use of national cancer data.
- Nationally comparable SACT and radiotherapy data enable identification of unwarranted variation in treatment.
- The North of Scotland Cancer Alliance (NCA) cancer teams can more easily access and update patient information in Trak – in real time.
- Regional intelligence systems are aligned with national mechanisms. For example, IHDP supported the South of Scotland Cancer Network (SCAN) to align their new data architecture with SCRIS.
- Tools developed to report patient outcomes and experiences will enable the patient voice to be expressed and captured in tangible ways, and used by clinicians in the ongoing management of their care (see Cancer Innovation Challenge impact story).
- Implementing Treatment Summaries across Scotland will empower patients, as they feel more confident in their ability to manage their own health. It will also streamline communication between hospital and general practice, ultimately leading to better care.
- Recognising that ‘failure’ is due to current context (e.g. technical environment, data sharing agreements) can provide a rationale and evidence for change (for example: see IHDP programmes of work overview: – ‘Experimenting with cognitive computing’; ‘Improving cancer intelligence in the North of Scotland’).
- Sharing learning over what does not work can prevent others from investing resource in similar endeavours, and refocus efforts on more useful areas (for example: see IHDP programmes of work overview: – ‘Improving cancer intelligence in the North of Scotland’).
- Confirming where change would not add benefit prevents investing efforts in developments that would not add value (for example: see IHDP programmes of work overview: – ‘Exploring technical options to automate data entry’).
Spotlight on the North of Scotland
IHDP worked with NHS Grampian to improve the organisation of care for cancer patients.
The North of Scotland cancer intelligence project set out to streamline the process of data management and reduce the manual efforts involved in tracking patients:
- Test and develop a system to improve patient tracking.
- Develop a business intelligence repository to store relevant data in one place.
- Develop tools to improve use of data for planning and reporting.
After 12 months of testing, it was clear that the Trakcare Referral-To-Treatment module being used in these developments was not viable for cancer tracking.
Using the knowledge gained through this exploration, effort was refocused on developing more appropriate solutions to support pathway management:
- A reduction in the manual processes involved in patient management was achieved, making it easier for staff to do their jobs.
- Information can now be captured and shared electronically to form part of the patients’ electronic record, making it visible to help clinicians, admin staff and ultimately patients.
- More reliable intelligence is available to support service planning and improvement.
- By widening the project scope, solutions were pursued which will have benefits beyond cancer care.
In keeping with the IHDP approach, learning has been shared:
- With Health Boards.
- Regional collaborative networks have been established to continue the sharing of knowledge and expertise.
- Alignment with SCRIS.
Key steps
Work collaboratively to identify where national approaches can meet local needs, and expedite solutions that can work for all parties.
Consider where greater investment at the outset may lead to greater gains in the longer term.
Take a ‘test and learn’ approach and support exploration and learning from ‘failure’.
Share learning about what doesn’t work or add benefit, to prevent others from investing resource in similar endeavours.
Impact Stories
The ways in which IHDP’s approach and activities contributed to improved outcomes and impact are shown through impact stories.