EHI PC Interview: INPS

Max Brighton, managing director of INPS

Add up the column inches devoted to GP system suppliers on EHI Primary Care and elsewhere and you would probably find that they were dominated by two names – EMIS and TPP.

One of these companies is the biggest GP system supplier in the UK and the other has had a high profile entry to the market over the last decade.

Yet over that same period, another company, INPS, has not only maintained its position as the second biggest GP IT supplier in the UK but has also seen its customer base grow every year.

It now has about 20% of the English market, 30% of the market in Scotland and Northern Ireland and just over 50% of the market in Wales.

It has also been quietly been getting on with projects that it now hopes will give it in an edge in what is a highly competitive marketplace.

Looking all around

First among these is Vision 360, a secure data hub which gathers information from Vision 3 practices and other sources and makes it available for sharing.

Russell Blackmore, INPS’s product development director, says Vision 360 has been in development for several years. It is being worked on from the company’s Dundee office, where around 50 staff are involved in the development of the system.

He says: “The strategy is to move from a practice-based system to a patient centric system with a centralised patient database and access to records from other healthcare settings.”

Vision 360’s biggest deployment to date has been in Tayside, Scotland, where the vast majority of the 60 plus practices use Vision 3.

The aim is for Vision 360 to collect information from practice systems, the local hospital patient management system, NHS 24, laboratory and radiology systems, and disease-specific systems, and to make it available to view via Tayside’s Clinical Dashboard.

At the moment, patient summary functionality is being rolled out although the portal will not be live for a few more months.

Blackmore says Tayside has a long-standing record of close working between primary and secondary care, illustrated by the fact that the e-health clinical lead is a shared role between a GP and a consultant.

This has enabled Tayside to work closely with clinicians and a number of software application providers to develop its portal technology, which it hopes will eventually support several hundred thousand patients.

He adds: “Vision 360 is a central vehicle which gives a unified view of the patient record and having access to that will provide added value for acute staff and practice staff.”

In use across the UK

INPS feels it has been able to develop in Scotland as a result of its Vision 360 product. The company now has 30% of the Scottish market – a sharp contrast with four years ago, when the home-grown GPASS dominated with an 85% market share.

INPS and EMIS were selected by NHS Scotland in January as preferred suppliers to replace GPASS and Brighton believes that, when the current board-by-board procurement process is finished, INPS will have about 50% of the market.

Outside of Scotland, Vision 360 is also being used in shared record projects in Westminster, the Isle of Wight and Carlisle in England. Primary care trusts in these areas are using Vision 360 for a variety of sharing initiatives, such as providing access to GP data out-of-hours and sharing data with community users and diabetic teams.

In Wales, INPS was the first GP system supplier to commit to the country’s Individual Health Record project, which is based on proprietary systems.

Vision 360 is being used by 19 practices in Pembrokeshire to make information available to out-of-hours clinicians using Adastra software. The next community of live users is scheduled to be Cardiff, which will start using Vision 360 for the IHR later this summer.

Simon Fanthorpe, INPS IT director, says Vision 360 gives GPs a virtual private database. Practices retain a lot of control of their own data and can ensure that only the information they want to add to their record from other settings is incorporated.

Blackmore adds: “Local communities have different attitudes to sharing and Vision 360 can offer local choice whereas working with the national services in England doesn’t really allow you that.”

Vision 360 as a GP system

Max Brighton, INPS managing director, says the intention is to seek NHS Connecting for Health accreditation for Vision 360 as a GP system – just as EMIS is currently doing for its next generation system, EMIS Web.

However, Brighton also pledges that the current customer base of 2,314 practices will not be forced to move from the current Windows product Vision 3. He says that Vision 3 will continue to comply with new requirements so that practices are not left using less functionally-rich software.

Vision 3 was the first of the GP systems in England to meet CfH standards for hosting – about a third of all INPS practices are now in a hosted environment – and is also compliant with GP2GP, the SCR and EPS Release 2.

The other data sharing initiative which INPS is focusing on is its 50:50 joint venture with EMIS. The two system suppliers have set up a separate company, Healthcare Gateway, to implement their Medical Interoperability Gateway.

Brighton says there are lots of places where both EMIS and INPS practices are common and that the MIG offers them an opportunity to share data. He says the new company sees particular opportunities in areas where boundaries are less distinct, such as in London and other metropolitan areas, where there is a demand for community-wide IT solutions.

He argues that the gateway will provide an alternative to building links into a range of different systems, covering everything from social care to hospitals and community providers. He also says third party suppliers are interested in the MIG as a way of adding value to their existing product.

The MIG has already passed CfH testing for interoperability toolkit standards for discharge summaries, in a consortium with Infoflex. The company hopes the first implementation of the MIG will happen in the third quarter of this year.

More opportunities

INPS was bought by French-based Cegedim, a healthcare IT and information specialist, 12 years ago. It supplies different GP IT systems in other parts of Europe and also owns Cegedim Rx, suppliers of the pharmacy software used in 50% of UK pharmacies.

Brighton says Cegedim Rx also reports to him and says there is an “obvious opportunity” there for joint working with INPS. However, he argues that information governance issues with UK community pharmacies will need to be further developed before data sharing in this environment gets going.

INPS also has ambitions to develop its business overseas, which Brighton says would be driven by success at tendering opportunities or buying existing companies.

Overall, Brighton is optimistic that the current economic squeeze will be good news for suppliers like INPS. In England, he hopes to see “greater agility” introduced into the local service provider contracts, with money spent on making better use of the IT systems the NHS already has rather than replacement programmes.

He adds: “More austere times might not be a bad thing for us and I welcome the change to the approach. The things we do are cost-effective and we have always been prepared to work with other competitor partners. I am excited by the future for us and for the health service in general.”