St Helens and Knowsley COIN speeds up comms

Tags: Community GP GPs Informatics Liverpool PCT Security

28 Feb 2008

Over 7,500 staff working across 160 GP surgeries, health centres and acute hospitals in St Helens and Knowsley, Merseyside, are now connected to a new Community of Interest Network (COIN), enabling healthcare information to be accessed and shared across the region in real time.

Deployment of the £4.2m COIN began in July last year and was completed towards the end of 2007.

Faster treatment, reduced waiting times and better use of NHS resources are some of the improvements patients in parts of Liverpool and Merseyside are experiencing from the new COIN, according to the trusts involved.

Using Cisco technology, health workers across the local trusts now have instant access to records, stored in two separate data centres, which host the area’s clinical applications and data.

Neil Darvill, director of informatics at St Helens & Knowsley Hospitals NHS Trust, told E-Health Insider: “As a shared informatics service for the whole health community, this COIN has meant that we have been able to work on one IT strategy for the whole region on the one budget. As each trust goes live, information is made available for sharing as appropriate, with full security measures included. For example, it has meant we have not had to order separate order comms solutions for GPs and the hospital as the one system is on the same network.

“From the support perspective, we can resolve 80 – 90% of faults remotely and have systems back up and running straight away without helpdesk engineers having to go out. As we expand to cover more GP practices, and most recently Halton PCT which merged with St Helens PCT, it means that we are immediately available to help all the time and information is available instantly, so patients are not kept waiting long.”

The trust say this is helping to reduce the time patients wait to see consultants and specialists, and is also helping to make the job easier for locum doctors because they have immediate access from any location to records of patients they may never have seen before.

Dr James Heath, managing director of Aston Healthcare, which has a network of 10 GP surgeries caring for 33,500 patients in Knowsley, said: “Being able to access records of drugs and treatment not just from a GP, but any health centre or hospital, and have that information available wherever it’s needed instantly is a huge asset to improving healthcare.

“In the past, our GPs were carrying out various medical tests, and results were getting to consultants a week later. With the Cisco network, information is being shared much faster, and we have seen waiting times for consultant appointments cut to days, if not hours in some cases.”

Using Cisco Unified Communications and Cisco Unified Contact Centre, which provide IP telephony and contact centre capabilities to hospitals and individual GP surgeries, telephony costs have also been reduced. The trust can now make cost free telephone calls over the network to other sites on the COIN.

The trusts say that as a result of switching to the COIN structure, local GPs are seeing treatment and hospital waiting times cut to days instead of weeks. Patients in the Liverpool and Merseyside area are also experiencing faster treatment, reduced waiting times and better use of NHS resources.

Cisco’s UK and Ireland sector manager for healthcare, Terry Espiner, told EHI: “The use of Cisco technology as part of their new COIN is creating huge benefits for the health professionals in St Helens and Knowsley. GPs can find and enter information from any healthcare settings, and can then receive test results in a matter of hours, as opposed to days. Information is available where and when it is needed and making it quick and easy for patients to contact a doctor or specialist wherever they are located.

“The network is providing them with better, faster and more effective patient care in real time. Using our equipment, the community is running over high bandwidth from ntl: Telewest Business and the extension ability of the network means they can take information with them wherever they travel. It’s a lot more useful than the usual high-stress, high-risk and data-intensive environments that are often dominated by paper-based processes and characterised by inefficient workflows.”

Links

Cisco

ntl:Telewest

Reader's Comments

Another local success

28 Feb 08 07:02

Another example of local progress. Well done!

Now the inevitable question: Is this because of (or in spite of) the National Programme?

Nice bit of gloss but.....

28 Feb 08 10:02

I guess it is good news....

However, many GPs can get pathology results in 'hours rather than days' without the specific need for a COIN.

Equally, how come my partner (who works in a practice serviced by this COIN) can't get a printer fixed after 2 months and three visits from the PCT IT team?

I suppose the email registering the fault gets to the 'This isn't as sexy as a COIN' Inbox a little quicker.

I feel sad about these 'stories of success' from techies about techie things. It's about as interesting as M&S telling us they have linked up a number of stores. When did I last see a press release from M&S about that.....?

In the absence of significant clinical application developments, I guess this is a positive achievement at least.

Is this because of (or in spite of) the National Programme?

01 Mar 08 17:03

This COIN is a wires-only N3 Customised Service which reflects the way in which N3 is beginning to evolve to offer more flexible services under genuine local ownership. Let's hope this is a harbinger of better things to come under other NPfIT contracts.

Printers ...

01 Mar 08 17:03

"Equally, how come my partner (who works in a practice serviced by this COIN) can't get a printer fixed after 2 months and three visits from the PCT IT team? "

Maybe your partner, who presumably is an independent contractor and not part of the NHS, needs to put his/her hand into their pocket and buy a new printer?

Re: Printers

03 Mar 08 15:03

No; it doesn't work like that. Providing and maintaining kit in Practices is a PCT responsibity.

Data Sharing and Security

07 Mar 08 09:03

So now we have a multitude of NHS organisations, all sharing personal and sensitive personal data across a network that CfH says shouldn't be considered secure

See “Network Infrastructure Security Recommendations For PACS Patient Identifiable Data (PID)”(Doc Ref: NPFIT-PAC-DES-0030.08) states at paragraph 4.12

4.1.2 N3, Trust WANS and Coins

N3 is a private but insecure network infrastructure and should be treated accordingly.

PID must not be transmitted in the clear across N3.

Trust WANS and Coins should also be viewed by default as being constructed from insecure links, unless further investigation and associated risk assessments of those component links prove otherwise. Guidance on how these links may be assessed and secured can be found within PACS and RIS Network Security Model Guidance, DocRef4.

I appreciate this refers to PACS but if it's not secure for PACS it's not secure for any other PID.

I would like to know how the data has been secured against unauthorised processing (which includes viewing). Who owns the network. Individual organisations are responsible for their own security but how can this be so if the COIN the backbone of the WAN. Also, who's responsible if there's a data breach.

I don't like central systems as, in my experience, NO-ONE wants to take responsibility for them.

Data Sharing and Security

gushartley@aol.com

07 Mar 08 14:03

Agree witht he comments, on COINs to the North these issues have been addresed by; exch to exch TLS encryption, utilising bespoke encryption, and of course NHS mail where appropriate.

COINS - reselling N3

07 Mar 08 17:03

So CfH fined BTN3SP for being late, and accelerated putting the wrong connections into sites in a hurry, and now the NHS is spending vastly more money for BT to rework all this into COINS.

I really don't get the benefits of COINS, other than for BT to resell and rework. Mind you, there is little to N3 that represents a service rather than a monopoly opportunity for B£.