Patients and Carers
No. The database is primarily designed for people who take care of the equipment so that all the important documents and information is held in one area.
It is hoped that having the data all in one place and using the same consistent information throughout Scotland will allow us to make better decisions about how much money we spend on medical equipment, helping us to better direct the limited resources to where they are needed most.
Generally, the position is that patient information will be held on systems particularly designed to hold that data: these are patient information systems. This is a medical equipment database. However, this decision still needs to be made by the project board and so there is no firm position currently.
Procurement, Finance and Capital Assets
Yes. You might find that larger HBs get better prices and so the system will indicate when they are likely to replace equipment and you will be able to jointly purchase the required number.
Very little. Most HBs already pay for access to this type of platform and the expectation is that putting in place a national solution will present some savings, but these will be offset against the need to have a new position created for a national coordinator to support the national database. This cost will be proportionate across all HBs using the system.
It all depends on what information you need. You will certainly gain information about all of the assets and details about the inventory e.g. name, model, manufacturer, but we hope to be able to also provide you with information on performance – routine/ non-routine repairs/ costs/ age profile.
Yes. Inventory information along with performance. The system will not allow access to staff information, but most of everything else will be available. There will be a limited number of staff that have been given permission and access rights.
The expectation for this is no, but it really depends on how you make use of your current databases and the interfaces they may be able to support. We are starting our plans looking at how we manage the transition and this will be part of those plans, trying to support you locally in what you want to achieve.
Yes. The prices paid will be part of the inventory information.
Yes. Your local lead for medical physics will be able to provide you with logon details.
Medical Physics & Scottish Government
There are several projects with which there is some commonality, especially related to Global Medical Device Nomenclature (GMDN), Unique Device Identifiers (UDI), Global Location Numbers (GLN) and Global Trade Identification Numbers (GTIN).
Current projects include; UDI / GS1 /Scan4Safety, Medical Device Information System (MDIS), National Inventory Management System (Stock and Consumables Management)
- A national medical equipment database will improve patient safety e.g. in times of a national pandemic, like Covid-19, where oversight of what medical equipment was held in Boards was difficult under the current fragmented system.
- Local data will be mapped and harmonised to the agreed nomenclature system for equipment categorisation, Global Medical Device Nomenclature (GMDN) leading to national consistency and readiness for GS1 barcoding implementation.
- Mapping will also include a field for the European Medical Device Nomenclature (EMDN) equivalent. Although GMDN is currently favoured by the MHRA and used in their Medical Devices Register, it is recognised through the MDR consultation that this has not been 100% agreed on and that EMDN is still a possibility. However, no matter the outcome of that consultation, it will still be prudent to have access to both terminologies.
- At site level location data will be harmonised to a standardised national system and will allow future facilitation of Global Location Numbers (GLN) this will also aid the management of equipment being incorporated from community settings and Social Care organisations.
- Device Product Codes will be mapped to Global Trade Index Numbers (GTIN), although this will not be an immediate benefit, it will in the future, allowing, for instance, easier management of product recall.
- Improved governance both locally and at a national level, clinically and financially.
- Equipment age profiling and obsolescence data, allowing informed forecasting, for the National Infrastructure Board, of areas requiring funding investment as well as scale.
- Also informing National Procurement on categories of equipment likely to require tendering or frameworks.
- Informed analysis of service costs.
- Safety notice information, i.e. scale of equipment affected by SAN’s (Safety Action Notices) or HAZ’s (Hazard Notices) and the ability to check scale of compliance with action.
- Adverse incident investigation. Providing an ability to search for trends when IRIC (Incident Reporting and Investigation Centre) are informed of possible issues.
- Ability to target SAN’s (Safety Action Notices), HAZ notices (Hazard Notices) and MHRA alerts and to support manufactures in targeting these communications more effectively.
- Ability to amalgamate service contracts and reduce NHS Scotland spend by harnessing buying power, with an informed dataset.
- Resolve issues with boards running bespoke in-house databases or using Facilities Management databases that are not designed for medical equipment.
- Data gathering and benchmarking e.g. for inclusion in Scottish Assets and Facilities Report (SAFR).
- Harmonisation and consistency of data allowing for improved benchmarking.
The groups are currently operational with nominations already made. However, consultation will be wide and you can feedback or write directly to us through the Contact Form on this website.
The tender document is incomplete and is commercially sensitive at this stage. It will be publicly available very soon.
Make sure you get all the relevant members of the team together to do the transition plan. This is a key component to get right!
The project team have started contacting each Health Board to start to plan the transition. This will include representation from your local IT departments, but there is no harm in raising their awareness.
As all the departments essentially perform the same broad function of medical equipment management, there is lots of common ground in the what the databases are used for e.g. everyone uses them for inventory purposes, equipment service records, preventive maintenance scheduling, key performance indicators (KPIs) monitoring and analysis. Many also use equipment library functions or for managing safety alerts and Field Safety Notices. However, the detail of the way these functions are implemented is where divergence occurs. Databases are all used to carry out common clinical engineering tasks, but the data used to describe this in the systems is dissimilar and requires interpretation, which can lead to errors in national reporting or analysis.
All funding has been agreed for the project. For the solution, we will not know the costs until we have gone through the procurement process. We would expect the cost of the application to be in line with how much the current yearly cost for each Health Board.
As previously mentioned, data will be initially migrated to attest database to enable business as usual.
How will the data in the new system be standardised to ensure a harmonised system across Scotland?
Some moves towards standardisation are already under way. For example, agreement has been met to adopt the GMDN terms for medical equipment categories, in line with the Medical and Healthcare Products Regulatory Agency (MHRA) Medical Devices Register. It has also been agreed to adopt the national Estates/ Facilities Domestic Services location nomenclature. The mapping of data to Global Medical Device Nomenclature (GMDN) will also include mapping to standard forms of model or product nomenclature. It has also been agreed to use the International Medical Device Regulators Forum (IMDRF) incident codes.
There is still work required to agree harmonised definitions and terminologies for areas such as Job Codes, formats for manually input data such as serial numbers.
Bar Code readers, Unique Device Identification (UDI) and Radio Frequency Identification (RFID) will all eventually contribute to aiding standardisation with asset data. Furthermore, extensive use will be made of drop down menus or look-up tables to minimise free-text options and aid data integrity. There will also be a Database Administrator in place who will be able to gate-keep where required.
There will be a national Database Manager appointed. Their role will include feeding back information to local Health Boards on any changes that are agreed as business as usual, once the National Medical Equipment Management (NMEM) Database is “live”.
Engagement is taking place through various working groups, such as the Nomenclature, Governance Groups as well as the Project Board. A series of on-going meetings have been initiated with Medical Equipment Management leads as a group and one to one meetings have also taken place where requested. The plan is meet with everyone and take cognisance of your database use and ensure, as far as is reasonably practicable, that any new system will not get it wrong and may even improve current operations. The project team have already started to meet with each local Health Board to understand and plan the transition based on their local set up.
There has already been engagement with Boards on role based access and this will work around your department rather than being expected to re-organise. This document will be shared with you once we feel we need to start identifying all the roles that exist in the National Health Service Scotland (NHSS).
All data currently in the system will be transitioned over, including embedded documents.
There is recognition that management of medical equipment requires a national strategic approach, including oversight of NHS Scotland’s asset base. Although local systems may work well, in a local sense, this does not translate well nationally as illustrated during the recent pandemic, where lack of national oversight hampered the ability to respond effectively. Although some functions will become centralised, it is recognised that there is a need for some flexibility to accommodate local practices. The type of functions that are likely to be centralised will be those that maintain data quality such as addition of equipment categories, fault code types etc.
Without national information being readily available, instantly through a national database, we are always playing catch up when it comes to planning. In addition, the manual process of asking each Health Board what they have, with inconsistent inputting to local data causes serious challenges to being able to talk with confidence about the current position. We need common ways of recording and searching so that national bodies get the reports they require to make key financial plans.
Yes. One of the stipulations of the tender is that the system will be required to work with augmented systems such as Radio Frequency Identification (RFID). Remember to highlight all of these through the transition planning – if you don’t you may not have all the functionality you require.
However, as Covid-19 has shown, disruption and delays to projects are not always predictable. At present the project is still on target for the predicted delivery timescale. This is a highly complex project, we will make our best endeavours to meet the timelines, but as you say projects deal with the real world, which has many changes impacting on each one of us daily.
It is appreciated that many of the databases currently perform the function required of them at local level, that will still be the aim at a local level, however some don’t and even where they do, there is little harmonisation between health boards. This has to happen at a national level for the strategic purposes previously outlined. It has been mandated by the National Infrastructure Board with the expectation that all health boards will transition to the new system.
Yes. All medical equipment databases used by Medical Equipment Management services are within scope of the project.
This comes back to the question above where we need to use an access document to identify all the roles that need permission to use the system. These will be agreed through transition.
If it is possible, the intention would be to migrate all asset and service history related data.
The Nomenclature Sub Group is working on this, we will confirm this through our transition planning.
From the outset, it has been made clear, from the project Management Team, that the primary focus of delivering this project is to migrate existing medical equipment databases onto a single platform and that remains the case.
Other disciplines that have become aware of the project have seen the value in this work and have expressed a desire to be part of it. There has been no agreement on this. It has been acknowledged that at some point, at a later date, once the National Medical Equipment Management (NMEM) aspect is bedded in and a proven to work successfully, that there could be value in this and these streams may be evaluated and the system assessed for scalability. However, it would be borne in mind that a key criteria would be that any extension to the primary purpose of the system would not have a detrimental impact on performance of the National Medical Equipment Management (NMEM) aspect.
There are 14 territorial health boards and 1 special board who have Medical Equipment Management departments. Of these 15, all bar one operate a database designed specifically for the management of medical equipment. 9 boards currently use the same one, 1 uses a different system, 5 use an Estates Management database and one uses an in-house system
However, even the 9 boards using the same system operate them differently.
It is envisaged the project will be delivered in 2022/2023.
Currently it is costing the National Infrastructure Board (NIB) over £500,000 to undertake the project.
Asset data will be mapped and harmonised and some additional useful fields added. Once we move the data over, it will go into the “Test” environment. You will have the chance to manipulate and check that everything looks ok, before we go live.
It is hoped all data will be migrated to the new system. However, if this is not possible, for whatever reason, there is a chance that data held in your current database may still need to be accessed until no longer legally required. A methodology of meeting this requirement, while not retaining two licensing agreements would need to be found.
Unfortunately, the answer to this question is similar to the questions above, until we have completed the procurement we would not know what the solution looks like.
Unfortunately, at this stage we do not know which database system it will be. There is a formal Procurement process that must take place to make this decision. The technical aspects of a tender document have been agreed, however, there are still some legal and cybersecurity aspects required. There will be a formal evaluation undertaken of fitness for purpose and value for money amongst other agreed criteria by an agreed panel of stakeholders of which Medical Equipment Management representatives will be key.
There are many and varied. It is one of the reasons why this project is so complex. Staff locally from finance, estates, medical physics, information technology (IT), planning, medical etc. Nationally groups including the National Infrastructure Board, Incident Reporting and Investigation Centre (IRIC), Health Technologies Group and many others.
The project is mandated by the National Infrastructure Board (NIB).
In 2019, there was broad support for a national medical equipment database under the Shared Services agenda however, this was put in abeyance due to lack of funding. The advent of Covid-19 brought the issue back into sharp focus when very quickly it was realised that there was no clear national picture of the key medical equipment required to meet the dramatically increased demand for ICU and other services.
As detailed earlier, Covid-19 put the concept back on the table, however, the National Infrastructure Board has a remit around funding of medical equipment. With limited funding available, it is in theirs, NHS patients and the Health Board’s interest to ensure funding is directed where it is required and where there is greatest risk. The ability to collate, manage and interrogate medical equipment data, at a national level, will allow greater insight and informed investment.
As part of the specification, the company awarded the tender will be required to provide training on all functions of the database.
It is envisaged that a program of phased migration, to the new system, will be agreed with stakeholders before being implemented. It is proposed to start with a smaller health board, migrate the data to a test database to allow testing and minimise impact on business as usual and prevent any data corruption. Once there is confidence in the system, this process will be rolled out on the agreed schedule.
The process can be adapted for any lessons learned as subsequent migrations take place.
It is worthwhile highlighting, as above, once we have your data, during transition, you will be able to test the functionality and that everything is in order in the “Test” environment before the data moves into the “live” environment. Any problems you find will be fixed before it moves to the “live” environment.
It is recognised that staff are constantly under pressure from daily work demands and support will be provided to minimise the ask. For example, as part of the specification, the company awarded the tender will have to provide support to migrate existing data, the data analysts can aid data cleansing and harmonisation, a company has already been engaged to map existing data to GMDN. There is no substitute for local knowledge and it is inevitable that the project will require your support at some point and it is an expectation that, as it is your data, you would expect to be engaged in the process.
This point has been made clearly by the Medical Physics community and we will endeavour to work nationally and locally to mitigate this.
IT and eHealth
At this stage we do not know. Once we have a preferred supplier and we know what their solution is, then we will be able to answer this question. The solution could be “thick” client, could be cloud, we really don’t know.
At this stage we are expecting to award the contract by December 2022. We will then be contacting all HBs to plan a detailed transition plan, both locally and nationally.
Yes. There is likely to be a need to link into other local systems, best to speak to your colleagues in medical physics, they will be best placed to describe.