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Information Management

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Introduction to SPAMMIS

"The challenge for the NHS is to harness the information revolution and use it to benefit patients"

Rt Hon Tony Blair, July 1998

Information can provide a powerful tool for change. The capturing and analysis of information is an integral element of the Supplies service in equal measure to the other services. Supplies utilises a number of systems, which have the opportunity of generating comprehensive and quality information, for customers and the organisation as a whole. SPAMMIS has been designed and developed by the LTH supplies information section to provide a single central integrated system for supplies management information. Please click here for more details about the SPAMMIS system (PowerPoint presentation)

Within the Leeds Teaching Hospitals we use a variety of order processing and inventory control systems including:

These are examples of online transaction processing (OLTP) systems, which usually have many users working on the system simultaneously.

We also have to record details in Supplies concerning

Data Cleaning

Data are gathered from the different, cleaned (made consistent) and loaded into a SQL Server data warehouse.

The SPAMMIS system can be defined as a database that includes all Supplies data for the organisation that can be accessed by users. The Trust has a large amount of purchasing data stored at different times and in different locations from different systems (Oracle Financials, RESUS, WESSIS etc).

The SPAMMIS system extracts the data from the different systems and converts them to a standard format. The data consolidation is provided in several steps:

  1. Data Assembly
  2. Data Cleaning
  3. Quality Assurance of Data

Data must be assembled from the various systems. In this process data is extracted from the various sources, converted to an intermediate schema, and moved to a temporary work area in SPAMMIS. Procedures are then run to extract exactly the data required within SPAMMIS.

Data Cleaning ensures the integrity of the data to be stored in SPAMMIS. For example, data cleaning must be done on incorrect entries in data fields, such as deliver to addresses or incompatible data fields used to define the same date fields from Oracle and RESUS. The SPAMMIS system has a series of procedures for this data cleaning process.

An example will help explain the process of data cleaning more clearly. Both the AllSource catalogue from GHX and the system item table in Oracle store the unit of measure. In the first database this attribute is defined as CHAR(2) and the data values are BX and EA. The same attribute in Oracle is defined as CHAR(10) and the data values are box and eac. The sources are correct but for SPAMMIS, you must clean the data, that is represent the values of the attribute in the same way.

The last part of data consolidation is the quality assurance of the data. This involves a data validation process that specifies how the end user will want to view and access the data. For our example above it is vital that the data is cleaned in SPAMMIS before it is used in a live environment. This is due to the fact that the correct unit of measure must be transmitted via e-Commerce as this data is input direct to the ERP system of a supplier.

Users have a simple browser based interface from which they can generate standard reports or execute complex queries. The system is used to track historical data for all data regardless of source and can be used to make comparisons between data gathered in different time periods.

All supplies customers are sent a monthly activity report that accompanies their budget report. Finance managers have password access control to all this information that is held on a networked SQL Server system allowing data retrieval without the possibility of corrupting the source information. The further development of information within supplies will add experientially to the department’s ability to generate savings and add value.

Tenders and Contracting

Contracting must concentrate on delivering best value through managed procurements. This requires focus on procurement influence and effectiveness. The Cabinet Office and subsequently the Executive require a minimum of 3% savings to be delivered. This will be possible in certain areas, but prove extremely difficult where markets are mature and contracts have already proved to be successful.

The challenge for Supplies will be to move away from the traditional view of contracting, and move up a pace into a truly commercial arena. This requires staff to increasingly have an understanding of clinical and business processes. Purchasing needs to move ‘upstream’, into the planning process and challenge some of the principles that procurements are based on. Significantly Supplies has an opportunity to develop sophisticated procurement models which reflect pathways of care and outcomes for our patients. If new methods of working are not adopted, and price not cost represents the departments focus it will fail to deliver the required savings.

A standardised system for the management of all tenders and quotations has been agreed within Supplies. Standard documentation has been introduced for all tenders and contract files, with information held centrally within the Supplies Department.

The data set is now fully managed by the SPAMMIS database (Supplies, Purchasing and Management Information System). Contract notes are also recorded allowing the reader a simple explanation of the contract process adopted. This will aid with the audit process and in particular the review process of the contract for Supplies staff.

The contracts database is the most forward looking module of the SPAMMIS system developed in the department. Each contract, whether local or national is included in the database and is linked to orders placed so providing information on contracts, maverick purchases etc.

All contracts are now managed using the SPAMMIS database. The database is used to maintain the following information

The database is linked through to Oracle via the system item table. Further development is taking place in linking item categories to the database

Approved Suppliers

An approved supplier database is under development. This will analyse data from a range of sources and will in time become the precursors for Suppliers wishing to contract with the organisation. Information will include

These tables are linked through data extracted from the Oracle database.

System Item Table Developments

The master item catalogue is held in SPAMMIS in a SQLServer database and holds details of the items in our major Supplies systems:

SPAMMIS is used to clean the data from these sources. The data is then consolidated and validated according to strict quality assurance standards. The Oracle system item table can be considered a sub-set of the SPAMMIS item catalogue data.

The item catalogue contains:

Demand Management

Demand Management is primarily concerned with the processing of requests into purchase orders. In key areas this process is carried out by professional supplies staff to reduce the amount of time spent by clinical and nursing staff in the requisitioning process. In other areas we have identified our major customers who would benefit from remote electronic requisitioning. The aim is to segment our customer base according to need.

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Materials Management is essentially where customers agree that Supplies staff will manage their regular product requirements. This involves the maintenance of stock within a ward or department at agreed levels. Supplies staff requisition, put-away and rotate stock at regular intervals.

Demand Management is a further development and includes

Inventory Control Systems

Computerised inventory control systems are in place in key high value areas within the Trust, such as the Catheter Labs and Radiology. These systems are integrated to Oracle Purchasing through the requisition Interface table, from which Requisition Import creates requisitions. The requisitions are imported with an approved status as they correspond to stock requisitions in the inventory control system. The systems currently in use within the Trust include:

It is likely that we will work towards fully integrating our purchasing systems into EPR systems in the future. This will allow true cost per case costing to be carried out.

Remote Electronic Requisitioning

This function is key because it represents the link between negotiated contracts and the actual procurement against the contract. This element of the Supplies Service determines that the Trust achieves the five key principals that drive purchasing:

Where contracts exist for goods then this process has been automated wherever possible and placed under the control of the customers. Progress in implementing this process had been restricted with the use of the inherited set-up of the Oracle 10.7 system. Since the introduction of a new more powerful Oracle server and the availability of rapid application development skills in Oracle programming, we have been able to develop sophisticated routines in Oracle 10.7.

Where a contract exists, the processing element is an unnecessary overhead and the Supplies Department has been successfully working toward reducing this intervention and facilitating ownership of this process by the customer.

All customers are important within the organisation. Certain Departments can be segmented to provide a differing service configuration, which will most appropriately meet the customers needs. These are primarily those areas that generate either significant numbers of requests / requisitions, and, or significant values of purchases throughout the year. Where the customer fits both categories then the Supplies Service must respond with the contractual focus and the operational Supplies solutions so that the customer can be as independent as possible.

This group of customers includes the following departments: -

Other customers would also fit into this category but will receive a different response strategy. These tend to include the busy clinical areas such as Theatres, ITU/HDU, A&E and acute surgical wards: these customers tend not to have a dedicated member/s of staff dealing with Supplies. The most appropriate response in these areas is the provision of a Materials Management service, which is described elsewhere in this document.

It is important to provide customers who do not have the advantages of materials management or inventory control with access to the remote requisitioning within Oracle 10.7, and a managed range of contracted goods and services. This will provide the customer with full control of their contracted product requirements. It will also provide an opportunity for Supplies together with the customer to review their total product usage. The convenience of placing orders directly for contracted goods and services will provide customers with the impetus to expand this range, and enjoy the benefits of direct control over the timing of purchases.

Additionally the increased use of Oracle 10.7 remote requisitioning provides the organisation with better information through SPAMMIS, control over receipt, and an opportunity to capitalise commercially from the data collected.

The use of demand management is vital to the transition of the Supplies department from a processing department to a professional purchasing department. Supplies add little added value to inputting standard requisitions to the system.

Further development of Spammis for the NHS

The unique Spammis system has already played a major part in Leeds Teaching Hospitals' winning of the 2003 HSJ e-technology award. It is now in the process of being developed to enable it to be implemented in any NHS Trust in the UK. Its already extensive functionality is also being increased still further to incorporate such features as web requisitioning and the ability to share information across multiple Trusts - for example all Trusts (both acute and non-acute) within a Strategic Health Authority.

The new SPNet system is to be installed initially in Leeds Teaching Hospitals itself in December 2003 and will then be available to other Trusts from January 2004. It is being developed by the Healthlogistics-Sybase joint venture, and Leeds Teaching Hospitals will continue to be responsible for the development and testing of future functionality. For further information contact Healthlogistics.co.uk on 01865 487185.

 

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