HIMSS INFRAM: South West London ICS – SWL Health & Care Partnership

Situation

SWL ICS wanted to measure their Information Technology infrastructure maturity against an internationally recognised benchmark. They engaged with Ideal Health Consultants Ltd, a leading HIMSS Digital Health Technology Partner (DHTP), to conduct Infrastructure Adoption Model (INFRAM) assessments across the six main providers in the ICS. This would be the first ICS-wide assessment of its kind using HIMSS INFRAM.

The ICS wanted more than just a HIMSS INFRAM score for each Trust and had three objectives:

1. Assess the infrastructure maturity of each Trust.
2. Define an improvement roadmap for each Trust.
3. Consolidate the first two objectives at system level and look for opportunities where a limited budget could be used to either level the Trusts up or promote collaborative working and scales of economy.

Requirement

The key activities we supported the ICS with were:

• Supporting the organisations whilst they collated the data necessary to complete HIMSS INFRAM assessments off-line.
• Entering the data on behalf of the organisations in the HIMSS portal.
• Assisting the ICS and participating organisations in interpreting the reports they received from HIMSS.
• Identifying the short- medium- and long-term actions they will need to take at each organisation to reach the desired future infrastructure maturity level (assumed to be HIMSS INFRAM stage 5).
• Delivering organisational level and ICS level reports highlighting the findings, risks, and recommendations.

At the time of the assessments, the Trusts across the ICS had significant BAU workloads, as well as needing to complete a Cyber Security Assessment, and the NHS DMA. Additionally, The Royal Marsden NHS Foundation Trust was mid implementation of an EPR and the Go-Live fell within the window of our engagement. This meant that we had to provide a flexible approach to balance the needs of the ICS against other critical projects.

Approach and Solution

To manage the project, we used our 7-stage approach which has been tried and tested and applies to all the HIMSS digital maturity models.

One of the advantages of this approach is that we provide organisations with the opportunity to resubmit the HIMSS assessment before the final report following an initial baseline score.

This allows organisations to understand gaps and begin to identify the short-term and long-term actions that will have an impact on overall digital maturity, as well as identifying where immediate actions and changes could improve maturity.

Our project team included technical SMEs and consultants who understood the wider NHS Digital environment, as well as being experienced in managing projects with multiple stakeholders across multiple organisations. Being the most active HIMSS DHTP in the UK allowed to us to tap into both our significant experience and the expertise of HIMSS to provide guidance, translation and context setting to save SWL ICS time and effort.

For instance, drawing on this experience, we were able to assist the organisations with identifying the stakeholders that were needed. We know that when compared with the EMRAM assessment, much of the knowledge required for INFRAM sits with one or two individuals within the organisation. This streamlined the engagement process and minimised the impact on BAU.

Translating HIMSS and bringing it to life can be a major challenge. One tool we have developed to assist with engagement is our use of heatmaps, which clarify how the scores across different domains impact the overall score. This was particularly useful for presenting the scores of thirty domains (five at each of the six organisations) across an ICS setting in an easily accessible format.

Our experience of completing the most HIMSS assessments in the UK meant that we were well-equipped to manage the challenge associated with undertaking six INFRAM Assessments in parallel across an ICS for the first time. For instance, our approach taken to writing the final reports was to focus on the elements that we knew would not be impacted by the second assessment phase or inflight projects. Once we had an idea of the key themes that would be in the report, we socialised these with the clients to get feedback on the structure and level of detail to co-design the final output.

Outcome and Benefits

We are proud to have completed the six assessments within the agreed timeframe and budget, along with the corresponding reports. These were tailored reports for each organisation, and a summary report for the ICS. Each of these highlighted actions that needed to be taken to improve scores across the five technical domains of the assessment, and to improve overall digital maturity.

We found common themes of improvement from an ICS perspective, for instance Communication and Collaboration, Datacentres, and Network Transport, as well as also highlighting the variation at individual Trusts that needed improvement. One theme at both Trust and ICS level (which is not unique to SWL ICS) was that the capital was available for initial purchase, but finding the revenue required to install and support the hardware in the long-term was challenging.