An introduction to the NHS CUI programme
As part of its commitment to supporting the NHS, Microsoft is investing £40 million in the Common User Interface (CUI) programme.
This is a partnership initiative with NHS Connecting for Health, the agency tasked with delivering the ten-year National Programme for IT in the NHS.
The project has two main objectives: helping the NHS to get the most out of its investment in information technology and helping to improve patient safety by creating a common look and feel for NHS systems.
In November 2004, NHS Connecting for Health (CfH) signed a nine year `enterprise agreement' with Microsoft that set out the terms on which the NHS would buy up to 900,000 licences for its software.
The agreement included a commitment to the Common User Interface (CUI) programme, which has two main objectives. The first is to help the NHS get the most out of its investment in IT, by making it easier to roll out, maintain and use day to day.
The second is to help lay the groundwork for a common look and feel for the applications that are used across the health service, which should have major benefits for staff and for patient safety.
Getting the most out of IT
There are two aspects to helping the NHS get the most out of the IT it has invested in. The first focuses on infrastructure and desktop (PC and laptop) management.
Charlotte Eastham, who leads on this side of the project, says that while different NHS organisations have different IT set ups and levels of IT support, many IT departments spend most of their time fire-fighting.
Trusts may have no centralised way of rebuilding their desktops, for example. So whenever a PC needs upgrading, moving or fixing, a "man in a van" has to go out and do the job.
A lot of advice already exists on how to make life easier. But NHS organisations may not have the time to find it, or the specific skills needed to use it. "We have been looking at the guidance that exists and trying to make it more relevant to the NHS," says Ms Eastham.
"Part of this is about telling people that there are alternatives...and part of it is about training."
A new, web-based Interactive Navigation Guide will also be launched shortly to help IT managers find the guidance most relevant to them. And another online tool is being created to help them identify the IT they need and work with partners to create it - or deploy it themselves.
Microsoft Office with added NHS-ness
Another strand of the CUI project has been looking at how to put "NHS-ness' into the Microsoft Office software suite.
Thousands of clinical and administrative staff are already using Office, but Microsoft's Carl Nolan says that detailed research for the CUI project found that many are not using all of its functions or not using them as well as they could.
"For example, we found people were creating really big documents and then using email to share them," he says. "That can put a big strain on IT systems. So part of this is about telling people that there are alternatives, such as using Windows SharePoint Services, that they are already licensed for, and part of it is about training."
The Office part of the CUI project has also created new resources for the NHS that should make the work of frontline staff much easier. For example, it has put resources such as the British National Formulary into the research pane, so they are easier to access.
"At the moment, if a medical secretary needs to look up a drug name, she will probably have to go through a dictionary on her desk that might well be six months out of date," says Mr Nolan. "With this resource, the information she needs will be available instantly; and it will be the most up to date information available."
Similarly, an NHS Abbreviations Manager has been created that will automatically ask the user exactly which condition is covered by an abbreviation that they type and encourage them to code it correctly. And Microsoft is looking at whether adding an NHS spell checker is viable.
Improving patient safety
The other big aim of the CUI project is to help create what Andrew Kirby, the CUI programme's director, describes as a "consistent user interface" for the NHS - therefore enabling healthcare applications to become more standardised, easier and safer to use.
Again, there are two aspects to this part of the project, the first of which is called Design Guide. This will determine the user interface standards that clinical applications should use, whatever supplier actually builds them.
In other words, the Design Guide will describe how things that need to be done across the NHS should be done. For example, it will specify how a medication should be described, how the dosage should be displayed, and even how much space should be left between the different elements on a label so it can be read clearly.
"The whole project is about helping the NHS to get more out of the technologies and the tools that it has."
The second aspect of this part of the CUI project, the NHS Software Development Kit, or `toolkit' takes the Design Guide and turns it into software. Microsoft is developing a set of software components that other NHS suppliers will be able to use, free, in their own clinical applications.
This should have benefits for developers and NHS organisations, because applications will be easier to develop and deploy. And over time, it will make clinical systems look and feel familiar, whether they are installed in hospitals in Cornwall or Northumberland.
This will help NHS staff, because consistent software is easier to learn and to use. And it should help to reduce mistakes. At the moment, for example, dates can be recorded in many different ways, such as 11-12-07, which is potentially confusing.
Eventually, all dates generated by NHS systems will use the format 12-Nov-2007, which is not only clearer but much safer, given that a missed treatment could have life-threatening consequences.
Next steps
The design guide and toolkit are based on extensive research in the NHS. At least 130 clinicians, from different professions and different types of organisation, were involved in this work, and many are still involved with advisory panels.
The initial batch of the first guidelines will emerge in March, and Microsoft will continue to work on the CUI project until 2008-9, by which time the programme hopes there will be a large number of standards embedded into systems across the NHS.
The Interactive Navigation Guide and other tools for IT managers should also be available by the end of March, while frontline staff should start to see the new Office functionality later this year.
"The whole project is about helping the NHS to get more out of the technologies and the tools that it has, so its staff are able to use them better and they can spend more time on what they want to do, which is caring for people," says Mr Kirby.
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