Creating a secure, cost effective infrastructure for pathology work.
The key to implementing this solution was the ability to support multiple laboratories on a single system and an accessible platform. The platform is accessible to hospital clinicians who are able to see results, General Practitioners in their surgeries and laboratory staff spread over three locations working on specimens.
The architecture was implemented as recommended in Lord Carter’s report outlining the vision for optimising the performance of pathology services and is described as the “hub and spoke” model.
The business challenge is to quickly, cheaply and safely provide diagnostic tools for clinicians in Partnership with the NHS.
Risk Free Transformation
The team worked together to build a new platform constructed especially to underpin the development and delivery of a new pathology service using state of the art technology.
- Accuracy – Accurate test results mean a diagnosis which results in an effective treatment plan.
- Turnaround times – A key aspect of the service is the ability to consistently provide fast turnaround times.
- Costs – Costs per test are kept low by using efficiencies and economies of scale providing a particularly attractive proposition for other Trusts looking to onboard.
“Partnering with CSI enables iPP and Pathology First to focus on what they do best: providing excellent lab services and healthcare, while leaving the IT issues to be handled by experts.”
Deb Packwood, Operations Director, iPP
Integrated Pathology Partnerships (iPP) is part of the wider Synlab group, the leading European clinical diagnostics company that provides laboratory services in 5 continents, 35 countries, employs more than 20,000 people, and performs over 400 million lab tests per year.
In the UK, the combined clinical and outsourcing resources of its subsidiary iPP equips it to be a strategic partner to both the NHS and independent hospitals in the provision of pathology services. It assists healthcare providers and commissioners in meeting the challenges of quality, cost and rising demand in UK pathology services, through partnerships and joint ventures.
The need to reduce pathology costs
In 2010, Lord Carter of Coles’ independent review of NHS pathology recommended that NHS Trusts lower costs by developing a new model for pathology services. Rather than having large labs full of highly skilled staff in each hospital, the review suggested that only emergency and specialist services should continue to take place in hospitals, while simple, high-volume, routine pathology work could be outsourced to other locations for analysis. This would enable large volumes of work to be processed more efficiently and cheaply.
iPP realised that it could help the NHS transform the delivery of pathology services by forming partnerships with NHS Trusts to build and operate new off-site pathology labs, connected to smaller specialist labs in the hospitals themselves.
Seizing this opportunity, Basildon and Southend University Hospitals NHS Foundation Trusts decided to form a joint venture with iPP. This is known as Pathology First, which would deliver this new “hub-and-spoke” pathology model.
The model requires a single new Laboratory Information Management System (LIMS) that would support multiple laboratories (the hub & spoke model). iPP and Pathology First selected WinPath Enterprise from CliniSys. Ultimately, the goal of the IT team was to implement a secure, stable and scalable infrastructure to support the new LIMS, in order to eliminate the risk of any possible technical disruptions to the labs’ vital work in supporting clinicians diagnose and treat patients.
The project was to develop the new hub and spoke laboratory model, implement new ways of working, build the laboratories, invest in new equipment such as analysers, transfer staff to the joint venture and implement a new LIMS – a significant undertaking. Synlab UK appointed IT Director, Charles Lilley in February 2017 who has overall responsibility for technology including the solution used by iPP and Pathology First.
See “Report of the Review of NHS, Pathology Services in England, Chaired by Lord Carter of Coles, An Independent Review for the Department of Health, 26 January 2010” Read report.
Finding the optimum infrastructure solution
iPP and Pathology First (the joint venture with the Trusts) considered a range of IT service providers to find the best infrastructure for their needs. CSI won a competitive tender to deliver the solution at a cost that would help iPP and the Trusts achieve financial savings.
“The fact that both Trusts had worked with CSI before gave us all a great deal of confidence,” says Deb Packwood. “The CSI team has a proactive attitude, which is vital when you are managing both technical and organisational change on such a large scale. We were sure that they would help us find the right solutions to the challenges we faced.”
“We felt that the solution proposed by CSI met our needs in terms of cost-efficiency, security and availability, which are the central requirements of the new hub-and-spoke pathology model.”
Charles Lilly, SynLab Group
Enterprise-class infrastructure as a service
It was critical that the IT infrastructure supporting the three labs would be resilient. Pathology is a 24/7/365 business, and the consequences of a LIMS system failing has significant impact on the ability to care for patients. Physicians and surgeons need the results of lab tests to make the right decisions about how to treat their patients, so delays in lab services are not an option.
For this reason, iPP worked with CSI to design a private cloud hosting model, with dedicated infrastructure located at two enterprise-class data centres in Northampton and Slough.
The CSI team’s previous experience of working with the two Trusts proved valuable when designing and sizing the new infrastructure, and their proactive attitude has played a key role in overcoming any
For example, in the go-live phase of the project CSI provided a 24/7/365 helpdesk, which helped support the team to iron out any teething problems while the new infrastructure was in its pilot phase.
Ensuring resilience and security
The infrastructure at both data centre sites has the same configuration, and ultimately data will be replicated asynchronously from the primary data centre in Northampton to the secondary data centre in Slough.
Currently this is performed in the primary data centre. iPP are in the process of moving to the two data centre model of resilience in partnership with its application and network providers. “The two datacentres are of equal calibre and resilience,” notes Charles Lilley. “Any disruption to our pathology work could affect our ability to support medical staff at the hospitals, so it’s crucial that we have a robust business continuity capability.”
Moreover, the infrastructure is designed to ensure that sensitive pathology data is kept secure. The data centres provide state-of-the-art security and iPP has implemented an industry leading security product, Cylance, from Cyclo. This provides iPP with security at one of the highest levels within the health industry.
Creating a secure, cost-effective environment
The CSI infrastructure as part of the overall IT solution, is already demonstrating benefits in supporting new ways of working, increasing quality, and improving productivity.
Charles Lilley comments: “Partnering with CSI enables iPP and Pathology First to focus on what they do best: providing excellent lab services and healthcare, while leaving the IT issues to be handled by the appropriate people. This project shows that a managed service and cloud approach to IT infrastructure is a viable option – not only for iPP and Pathology First, but for any organisation that is considering a hub-and-spoke solution for pathology or other services.”
Furthermore, the solution is agile and scalable: if the volume of pathology work increases, the CSI team can simply add more computing resources at each data centre.
“In the future, we hope to bring other laboratories to the hub and spoke model,” concludes Deb Packwood.
“This would be easy to do, because the infrastructure is very flexible and can scale up to meet greater demand. And the more Trusts that embrace our shared-services model for pathology, the greater the
savings will be for the NHS as a whole.”