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Unity Business Continuity

January 14, 2018

Unity will replace and extend existing clinical IT systems. The scope covers all clinical services in the Trust. It sees the digitisation of substantial parts of the clinical record, handovers between departments, ordering of portering & transport, prescribing and dispensing. It continues the digital use of existing clinical documents, orders and results, patient flow, bed management and others but combines them in a single system.Trust business continuity plans must describe how we will continue to treat patients should Unity become unavailable. This could be because of:

  • Routine scheduled maintenance
  • Major incident  declared
  • Power failure
  • Unity systems failure
  • IT network failure
  • PAS failure (a separate but dependent IT system)
  • Cyber attack

In a lot of cases the return to normal operations may not be known and could end up being hours or days. For example recent cyber attacks have left the Trust without fully functioning IT systems for 7 – 10 days. This represents a worst case.

IT Solution

The Trust will have 200 PC (known as 724 PCs) that will store 30 days of current information for patients separate from the main Unity system. In the case of a business continuity event the records (e.g. drug charts) can be printed out. Informatics will ensure there is a printer available with an uninterrupted power supply. One PC can service a maximum of 5 wards however it is more appropriate to have one per ward. These PCs provide IT service continuity – they enable the business to run but do not say how.

Business Continuity Process

Typically business continuity will go through the following steps once the process is activated. The exact process will depend upon team business continuity plans:

Move to Paper

Each department will move to the paper alternative, e.g. CAS cards in ED, paper prescription charts if outage longer than 24 hours (the printed copies suffice for this long). The 724 laptops will be used to print initial records for the patients. During this step it will be important that:

  • Paper records can be made available quickly
  • Staff are trained in their use (not a problem now, but after a few years the knowledge will disappear)
  • The logistics around the management of records in the department (end of bed folders, records trollies) is in place.

Depending upon the business continuity event, handovers between departments, drugs administration, orders and results will be managed through paper at this point.

Sustained Operations

Depending upon the length of the business continuity event the Trust may need to move to sustained operations using paper. This means considering the management of paper records when transferring between departments, sites and when discharging patients. Should a single area or site be affected then it will be necessary for elements of records to be transcribed into the EPR as part of sustained operations. This may require additional staff or time. We may also need our scanning partners to be able to cope with increased demand.

Recovery

During recovery the paper records will need to be transcribed into the EPR. This broadly focuses on medication and can be done across the Trust at the same time. Where patients have been discharged a decision would need to be made as to whether to transcribe the records into the EPR or scan them into the casenotes system.Once transcription is complete, the paper records, trollies, etc. would be put away.A full understanding of the order of uptime activities is required. For example, ED will need to prioritise there upload of information of attendance and complete full depart process for all patients that are admitted. In –patient activities can then commence.

Further Information