Coronavirus (COVID-19) digital health and care response: 2021 update

Continuity of Service

The digital response to the pandemic has demanded significant shifts in priorities and unprecedented demand on digital resources.

However, the need for delivery of major digital programmes of work that were underway prior to March 2020 is undiminished, and work has continued to move these programmes forward within this new context. This includes:

CHI and Child Health Programme

The programme to replace the national patient demographic system and the national child health systems has continued. Outside of the programme, a parallel workstream was initiated to put in place a separate instance of the new CHI EMPI (enterprise master patient index) system, specifically to facilitate the timely provision of demographics data for vaccination scheduling.

Within the programme, the start date for the availability of the new CHI EMPI was brought forward to provide the facility to look up and validate basic demographic details in support of the COVID-19 response. A core component of the Child Health system is the functionality to schedule and record vaccinations. The digital response to the pandemic has resulted in significant new national capabilities to support the vaccinations process, including self-booking.

GP IT Reprovisioning Project

The programme to provide access to modern GP systems has continued to be delivered during the response to COVID-19.

HEPMA National Implementation Programme

The implementation of Hospital Electronic Prescribing and Medicines Administration (HEPMA) has been ongoing for a number of years. HEPMA has been successfully implemented in four Health Boards across Scotland and all remaining Health Boards are on track to roll it out within the next three-to-five years. COVID-19 has delayed HEPMA implementation progress and has been included in Board recovery plans.

National eRostering Programme

A national eRostering solution is to be deployed on a 'Once for Scotland' basis. This solution will provide a single source of real-time workforce demand and fulfilment data that NHS Scotland has not had access to in the past. This will be hugely informative for strategic workforce planning and a provide business critical support in any future pandemic situation.

PACS Reprovisioning Programme

The national Picture Archiving and Communications System (PACS) has continued to make progress towards procurement.

International Engagement and Knowledge Exchange

The International Engagement Team's remit is to seek out and maximize opportunities for engagement and collaboration with international stakeholders to support the development and delivery of digital health and care services for the people of Scotland. The team works closely with national and international organisations from: health, social care and housing, third sector, policy and academic sectors to develop sustainable digital health and care services.

Throughout the period March 2020 to June 2021, the team continued to make connections between the current knowledge base and policy, in relation to the digital health and care response to COVID-19.

Contributions to the COVID-19 response

• In partnership with the LGDO Digital Telecare and TEC Telecare, South Norway and Andalusian Telecare teams, obtained funding from Digital Health Europe, for a twinning project about transition to digital telecare.
• In partnership with the Near Me team and the Basque Country, obtained funding from WE4AHA for a knowledge exchange twinning project focused on 'scaling up video consultation'. These twinning activities were conducted during the COVID-19 response and provided a forum for exchange and discussion about the impact of COVID-19 on service delivery.
• In June 2021 the team hosted a virtual Digital, Health, Housing and Care Learning Network. The programme provided an opportunity for the Scottish and international stakeholders to share their experiences of delivering services during the COVID-19 pandemic.
• Shared Scottish TEC experience in response to COVID-19 via tailored international knowledge exchange sessions, including:
  • Southern Denmark – Video Consultation Roll-Out in Primary Care
  • Maccabi, Israel – TEC Response to COVID-19
  • Ontario Health – Telecare, Remote Health Pathways and Near Me
  • American Health Information Management Association Masterclass – Scottish Digital Response to COVID-19
  • UK Digital Leaders Lounge – Digital Health and Care Leadership during COVID-19
  • European Connected Health Alliance (ECHA) – Pop-Up Ecosystem Webinars on COVID-19-related issues.
  • New Zealand Telehealth Network – Scottish Digital Health and Care Response to COVID-19
  • Norwegian Welfare Tech conference – Transition to Digital Telecare
  • Europe - Africa Healthcare Federation Telehealth Summit – New Models of Healthcare in response to COVID-19
  • European Health Telematics Association – Hybrid Healthcare: New Healthcare Models.
• Responded to horizon scanning request from Scottish Government colleagues on international examples of digital inclusion initiatives.
• Provided support to Scottish stakeholders through targeted knowledge exchange activities related to COVID-19 and vaccination programme.
• In December 2020, delivered DigiFest2020. More than 1,600 speakers and delegates participated in a nine-day virtual programme of digital health, housing and care content with Scottish, UK and international speakers and delegates.
• mPower – the Interreg VA-funded project redirected almost all their efforts to support the scale-up of digitally enabled services, including support for national Remote Health Pathways, Mental Health and Digital Access. mPower staff provided video connectivity and digital training to care homes' staff and residents in their localities and staffing support for community helplines was provided.
• Building on our international relationships, mPower supported the training and helpdesk function for the HSE eHealth Ireland Video Consultation service, which benefitted from the expertise of Near Me in Scotland.
• The EU Health Programme funded SCIROCCO Exchange Knowledge Transfer Programme undertook a specific COVID-19 response knowledge exchange session with speakers from Denmark and Scotland. The session showcased the National Wellbeing Hub and the mental health and wellbeing support provided for staff in response to COVID-19.

Telecare

The provision of technology-enabled support for people at home, ensuring connectedness for those who may be frail or vulnerable came into sharp focus during the past year. From the initial COVID-19 response, and the review of urgent priorities, the TEC Telecare programme in collaboration with the Telecare Lead and the Local Government Digital Office Team (LGDO) have continued working together to support Scottish Telecare service providers on the essential work with local authorities and Integration Joint Boards (IJBs) to:

• Establish remote working.
• Continue to support the analogue to digital transition.
• Facilitate continuity of service for Telecare providers.
• Identify opportunities to provide proactive/wellbeing calling for people who use Telecare.

Contributions to the COVID-19 response

• COVID-19 Telecare Service Continuity Information.
• COVID-19 Telecare Updates.
• Telecare Outbound Calling Report.
• Publish a report on the Proactive Telecare Services Study.
• Produced a report on: Delivering Telecare Services during the COVID-19 Outbreak.

The Telecare team have worked with Third Sector partners, Alzheimer Scotland, to review technology enabled support for individuals and families living with dementia to better support them during the COVID-19 pandemic. This provided opportunities to:

• Refresh and relaunch the new Purple Alert App.
• Work with Telecare Call Handlers accessing the Alzheimer Scotland for specialist support.
• Produced a report on the use of consumer technologies, based on learning from the About Digital and Me (ADAM) case studies and, to further develop the About Digital and Me online assessment tool.

The transition from Analogue to Digital Telecare workstream is a critical work programme led by the Local Government Digital Office's Digital Telecare team. Work on the transition has continued while navigating the COVID-19 response across Local Authority areas. For more on this work go to the TEC website.

Proactive Telecare Test of Change, led by TEC, working with the Digital Health & Care Innovation Centre and the Care Inspectorate (accelerated in response to COVID).

• Four funded sites are developing and testing proactive outbound calling as an enhancement of an existing telecare service.
• Linking and sharing expertise with the Connect Project in West Wales, and the Andalusian Telecare Service.
• Publication of FarrPoint's Proactive Telecare Services report, which focuses on the practicalities and benefits of proactive calling and is informing the tests of change.

The team is also working with the University of Strathclyde on a research project to investigate telecare services users' experience of the COVID-19 pandemic. Further information about the Telecare work is available on the TEC website.

Transforming Local Systems – Pathfinder Projects

The Transforming Local Systems four pathfinder projects were selected for the programme from April 2019. The objective of the projects is to use the Scottish Approach to Service Design (SAtSD) to facilitate local partnerships to design – with and for citizens – preventative and digitally enabled services.

The approach of working in equal partnership is crucial to the programme which is being progressed in different geographic areas and with different groups of people. A national model of support has been developed and each of the pathfinders have adopted the SAtSD in different ways.

The programme is being delivered as a collaboration between the Scottish Government's Digital Health and Care Directorate through the TEC Programme, Healthcare Improvement Scotland's ihub, the Office of the Chief Designer, Scottish Government Mental Health and Social Care Directorate, and the Digital Office for Local Government.

The pathfinders are:

• Aberdeen City – Exploring, define and co-designing multi-agency services for people who experience domestic abuse.
• East Ayrshire – Enabling transformation health and social care provision for people living with long-term conditions.
• Highland – Exploring the end-to-end life circumstances and journey for people who experience respiratory symptoms.
• Midlothian – Improving the experience of people with frailty, their families, carers, and staff.

Contributions to the COVID-19 response

During the COVID-19 response, the team have continued to support digital adoption while ensuring the co-design principles and engagement continue to shape the programmes. Support work has included critical friend and individual coaching support in service design and provided additional capacity to the pathfinders.

The impact of the pandemic for each pathfinder area has varied. The biggest challenges have involved the redeployment of some staff and the inevitable barriers presented to organising citizen engagement activities. A shift to redesign virtual engagement has been required.

The learning from the TLS pathfinder projects and the methodologies used will provide insights which will be valuable in the recovery and remobilisation of services.

Further information about the work and a webinar recorded about the TLS project is available to view on the TEC website.

TEC in Housing

The aim of the TEC in Housing (TECH) programme is to raise awareness across the housing sector about the potential of TEC and to increase the use of digital technology to deliver services and support their tenants'/customers' health, support and wellbeing. The TECH programme shares cross-cutting areas of delivery with the Telecare programme.

During the response to COVID-19 the team have:

• Increased the number of signatories to the TECH Charter.
• Further developed the TECH Community network to share good practice and support housing providers to further develop their contribution to TEC and provided one-to-one support as required.
• Identified and promoted TECH opportunities with academia.
• Improved understanding of the levels of digital readiness across social landlords in relation to the transition from analogue to digital telecare and identified appropriate support for the sector.
• Provided support to the new Digital Telecare Housing Transition Manager.
• Delivered, in partnership with the Digital Telecare team, a series of Analogue-to-Digital events for the housing sector.
• Ensured the ongoing integration of housing into established digital health and wellbeing programmes.
• Supported the expansion of Near Me use with housing providers to facilitate people to make use of online consultations.
• Continued to deliver TEC training to Digital Champions.
• Commenced Phase 1 of the Healthier Homes initiative.
• Supported the 'Reimagining Telecare', Telecare procurement framework activity.

Further information about the TECH programme is available on the TEC website and the Scottish Federation of Housing Associations TEC in Housing website.