The six Caldicott principles, applying to the handling of patient-identifiable information, are:
Information Governance is an approach to the way the NHS handles all organisational information – in particular the personal and sensitive information of patients and staff. It allows organisations and individuals to ensure that personal information is dealt with legally, securely, efficiently and effectively, in order to deliver the best possible care.
It provides a framework for bringing together the requirements, standards and best practice that apply to the handling of information. It has four fundamental aims:
The framework currently encompasses:
The aim of the new clinical commissioning system is to design the most efficient and cost-effective way of providing excellent commissioning support activities.
For some support activities, CCGs may choose to appoint their own internal staff while for others they will have a choice of using new NHS commissioning support units (CSUs) or other sources of commissioning support, for instance from the independent or voluntary sectors.
CCGs are likely to need support in carrying out:
Transformational commissioning functions, such as service redesign Transactional commissioning functions, such as market management, healthcare procurement, contract negotiation and monitoring, information analysis, and risk stratification.
EMR – Electronic Medical Record
The EMR is very medically focused and usually focuses on a particular medical domain for example orthopedics. EMR can be for a particular department in a hospital or a collection of patients medical information from all departments in a given hospital site. Rarely the scope of EMR extends outside a hospital even when it does it is usually for a organization which has multiple sites but never between two hospitals which belong to different organizations. This is a widely used term in N.America and Asia-Pacific and not commonly used in European countries.
EPR – Electronic Patient Record
This is a term which has its origins in the UK and essentially has the same definition as that of EMR. However the definition of EPR by NHS as “an electronic record of periodic health care of a single individual, provided mainly by one institution” makes EPR definition more patients centric. NHS has classified EPR into 6 levels
Level 1 – Patient Administration System and Departmental Systems
Level 2 – Integrated patient administration and departmental systems
Level 3 – Clinical activity support and noting
Level 4 – Clinical knowledge, decision support and integrated care pathways
Level 5 – Advanced clinical documentation and integration
Level 6 – Full multi-media EPR on line
EHR – Electronic Health Record
Electronic Health Record (EHR) is described as the concept of electronic longitudinal collection of patient’s health and health care – from cradle to grave. It combines information from different care settings held in different systems and in some instances aggregates the data and shows them as a single record.
The Committee for European Normalization provides the following definition for EHR:
“A repository of information in a computer readable format regarding the health of a subject of care “
The Australian National EHR Taskforce, defined EHR as
“an electronic longitudinal collection of personal health information based on an individual or family and entered or accepted by healthcare professionals .It can be distributed over a number of sites or aggregated at a particular source including a hand held device. The information is organised primarily to support continuing, efficient and quality healthcare.”
ASI – Appointment Slot Issues
AMU – Acute Medical Unit
DNA – Do Not Attends
CARR – Coding and Activity Relative Risk Report
Episode – One consultant throughout the sickness/ illnesss
CCG – Clinical Commissioning Groups
CDS- Commissioning Data Sets
CSU- Clinical Service Units (used in our reports etc , used in our context)
CSU – Commissioning Support Units (as general in the context of NHS)
CIP – Cost Improvement Plan
CTC – Community Treatment Centre or Cardio Thoracic Center, Basildon
CSS – Clinical Support Services (previously Integrated Core Services) (one of the Divisional Directorate Trust)
DGH- District General Hospital
DNA – Do Not Attends
DTA- Decision to Admit
DTOC – Delayed Transfer Of Care
EBITDA – Earnings before interest, taxes, depreciation, and amortization
EM – Emergency
EMR – Electronic Medical Records
EPMA – Electronic Prescribing and Medicine Administration
EPR – Electronic Patient Record – BTUH is using Medway EPR
FCE- Finished Consultant Episode
FFCE – First Finished Consulatant Episode
HDU – High Dependency Unit
HRG – Healthcare Resource Group
KPI -Knowledge Performance Indicator
IST – Intensive support Team
Local code for specialty used only in BTUH
LOS – Length Of Stay
MARS – Mortality and Activity Review System
MRSA – Meticillin-Resistant Staphylococcus Aureusis
Main specialty code is a specialty code, there is also Treatment Specialty Code / Treatment Function Code
http://www.datadictionary.nhs.uk/web_site_content/supporting_information/main_specialty_and_treatment_function_codes_table.asp?shownav=1
NHSID – Nationality code for specialty used all over the NHS in UK
NCAA – National Clinical Assessment Authority
NICU – Neonatel Intesive Care Unit
OPWL -Outpatient Waiting Lists
PLICS – Patient Level Information and Costing Systems
Provider – Care Centre can be hospital or other care centres
PTL – Patient Tracking Lists
RPRT – Right place Right Time
RTT- Referral to Treatment
ROTT – Removal other than treatment
SHMI – Summary Hospital level Mortality Indicator
SLA – Service Level Agreement
SSNDS – Specialised Services National Definition Set
HSMI – Hospital Standardised Mortality Ratio
Spell – The whole stay in hospital is called a spell. A spell can have multiple episodes
SUS – Secondary User Services
Treatment Specialty Code / Treatment Function Code are two specialty code, there is also a main specialty code
Symphony-Ascribe Symphony (A&E) Emergency and unscheduled / Software/IT System
UNIFY2 -main online data collection portal to collect and share performance information, aggregate data and statutory returns.
VTE – venous thromboembolism
The Referral to Treatment (RTT) operational standards are that 90 per cent of admitted and 95 percent of non-admitted patients should start consultant-led treatment within 18 weeks of referral. In order to sustain delivery of these standards, 92 per cent of patients who have not yet started treatment should have been waiting no more than 18 weeks.
Complete guidance
RTT Calculation guidance:- http://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-guidance/
This is the part of a PATIENT PATHWAY covered by Measured Referral to Treatment Period.
There are 17 RTT statuses, they are listed here
Other links:- http://www.ruh.nhs.uk/Training/support/Millennium/RTT/index.asp#3
The main RTT data collection return (unadjusted data) has three parts:
Part 1a – Completed RTT waiting times for admitted patients – i.e. RTT waiting times for patients whose RTT clock stopped during the month with an inpatient/day case admission
Part 1b – Completed RTT waiting times for non-admitted patients – i.e. RTT waiting times for patients whose RTT clock stopped during the month for reasons other than an inpatient/day case admission
Part 2 – Incomplete RTT waiting times – i.e. RTT waiting times for patients whose RTT clock is still running at the end of the month
The adjusted RTT data collection return has one part: Completed RTT waiting times for admitted patients on an adjusted basis – i.e. RTT waiting times for patients whose RTT clock stopped during the month with an inpatient/day case admission including adjustments for legitimate clock pauses
The RTT data collection has ISB approval. It also has Monitor approval, which means that the data collection is also mandatory for NHS Foundation Trusts.
http://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2013/04/RTT-FAQs-v10-Oct-2012.pdf
The UK Department of Health’s online data collection tool which is used to submit statutory returns to create a data warehouse. All trusts have access to screens enabling them to enter statutory weekly, monthly, and annual returns—e.g., 18-week targets.
Guidance on the submission of community and mental health Friends and Family Test Unify submission FFT with screenshots
Choose and Book is now NHS e-Referral Service. It went ‘live’ on June 15th 2015. Choose and Book was switched off for all users at 19:00 on Friday 12th June.
If you have been referred by your GP for an appointment with a healthcare provider, you may be able to book your appointment with NHS e-Referral Service, which replaced Choose and Book in June 2015. Most services are available via NHS e-Referral Service. You can choose the date and time of your appointment and your GP may be able to book your appointment there and then.
NHS e-Referral Service will also give you the ability to:
Papooze 