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December 2010

Implementing the National Learning Management System

Winchester and Eastleigh Healthcare NHS Trust IT Department explains how they implemented the National Learning Management System (NLMS). Overview Winchester and Eastleigh Healthcare NHS Trust (WEHT) provides healthcare for around 240,000 people living in the mid Hampshire region; predominantly within the Winchester, Eastleigh, Andover, Stockbridge, Bishops Waltham and Alresford area. WEHT provides an extensive range of hospital services from accident and emergency, general and specialist surgery, intensive care, rehabilitation, chemotherapy, diagnostic facilities, out-patient clinics to paediatric care. With such diverse services on offer and a highly skilled workforce spread over a highly populated area, there is a constant need to provide up to date, flexible education and learning solutions to all of their NHS staff.

Winchester and Eastleigh Healthcare NHS Trust IT Challenge and Solution The main IT challenge for many Trusts that have chosen to employ a new eLearning delivery platform is to implement the required software in a timely and efficient manner that causes little disruption to a) the end user, and b) to the IT department. The aim was to provide access to the National Learning Management System (NLMS) across the entire network of 2000 PCs within the Trust. A proposed

timescale was agreed starting the NLMS implementation in late May 2010 with the plan to be fully operational ‘NLMS Ready’ during July 2010. During the implementation discrepancies were uncovered by the IT Department due to certain software conflicts which impacted the roll out of NLMS, for instance where different versions of the same software are required by different applications. Below WEHT have provided information regarding the changes to software, including some of the conflicts and solutions.

Helpful Hints Ensuring all PCs running Windows XP SP2 Most PCs were running XP SP2, but a number were not despite the service pack being issued via an automatic update. Those PCs were either not used or were faulty in some way. The problem was they would have to wait until the user reported that they were unable to run NLMS before they could identify and rectify this problem. This is ongoing but the IT Support Team know the procedure to help these users. Please note: In this example the organisation has chosen to ensure client PCs are running Windows XP SP2. Both SP2 and SP3 versions of Windows XP are supported at the time of this publication. Reference should always be made to the latest version of the M-0100 document available on Kbase for advice on supported hardware and software. Internet Explorer (IE) version IE7 is the minimum required version as stipulated by Connecting for Health (CFH) and further information on CFH can be found IE7 is the supported browser for the Electronic Staff Record (ESR) and by default the Oracle Learning Management / eLearning. Java Versions 1 The version of Java that is currently supported for ESR, and was already rolled out to all PCs, is 1.6.0_06. This is the version used by the majority of the software applications we use at present. Although 1.6.0_06 is the recommended and supported version, 1.5.0_11 would also work correctly with eLearning. However, in the future, as the different applications are upgraded at different times, it is likely that they will require newer or different versions of Java from other applications. For example, they anticipate that the next version of Radiology Information System (CRIS), which they will be running from the end of this year (2010), will require Java 1.6.0_13. It is therefore going to be an ongoing challenge to keep all applications available to those users who require access to them. Please note: There is no ‘required’ version of Java for running ESR, however the supported version at the time of this publication is 1.6.0_06. ESR may function correctly with other versions of the Java Runtime Environment, however organisations will need to ensure any issues encountered with ESR on this version are able to be replicated on the supported version. Reference should be made to the latest version of the M-0100 document available on Kbase for advice on supported versions of JRE, including Appendix B that provides advice on compatibility with other applications requiring JRE. 1

Please note that with effect from 4th January 2011 the supported version of Java Run Environment will be 1.6.0_17

Shockwave 11.5 Some of the national course content requires shockwave to run. As this was not available on all PCs they took the decision to roll this software out to all PCs automatically. Flash Player Flash is required the majority of national course content however this was only installed on newer PCs in the Trust. For older PCs this has been rolled out automatically. Internet Settings Some Internet security settings had to be changed so they could include the NHS eLearning address (used to access NLMS) and content servers as trusted sites. In order to do this they used the ‘Group Policy’ function in the Microsoft Active Directory. Firewalls Changes had to be made to their Firewall to ensure a secure connection between our network, and the eLearning content. The Trust firewall was configured to allow access to the relevant sites bypassing our proxy server. Further Guidance Further help and guidance can be found by accessing the comprehensive M-0100 IT and Network Infrastructure document created by the ESR Central Team which can be accessed at the following: ƒ (Kbase) ƒ (eLearning Support)

Solution In order to successfully implement the required software across all of the desired PCs, and to limit the disruption that this may have caused, it was decided to employ the technique of globally deploying all the software automatically across the network. The alternative would be to update each selected PC manually which would have put considerable constraints upon time and resources. Also, to ensure PCs are up-todate when new software is due, or a new version of existing software became available, those dimensions and software specifications were built into the standard ‘image’ build for all new PCs to ensure that they will be set up with the desired software correctly Considerations of using Terminal Services to access NLMS via a single virtual training server was decided against due to the PCs already having the majority of the required software installed. The decision was taken that any remaining required software would be rolled out to all PCs.

Smartcard Challenge WEHT decided during the implementation of the NLMS they would also implement smartcards. WEHT took the approach of training up a small team with tried and tested processes to identify staff to e-Government Interoperability Framework (e-GIF) level 3 standards in creating and issuing of smartcards. As WEHT were an early adopter of the Care Records Service and in particular Cerner Millennium they were familiar with the

preparation of smartcards. This gave them the additional benefit of already having the basic software installed and smartcard ready keyboards.

Smartcard WEHT Solution It was agreed to pilot NLMS (End of Life Care) in 6 wards, as well as implement the relevant NLMS eLearning modules in Audiology and Radiology. The ESR data was used to help them cross-check against staff lists. The following four staff groups were identified: ƒ those staff who had not yet been registered ƒ those who had been registered but they had not created the smartcard ƒ those where the smartcard had been created but not issued ƒ those who were already in receipt of their smartcard (eg regular ESR users) The first 3 staff groups above were communicated to ensure that: ƒ All staff who had not yet registered were contacted via their Ward/Department Manager, who invited them to contact IT to arrange for registration. ƒ The creation of smartcards for those staff where the registration was complete but no card had been produced (including those in the previous category, once they had been registered). ƒ All staff where the smartcard had been produced (including those in the previous category) were contacted and arrangements were made to issue the card either in the office or on the ward, both in normal working hours and out of hours, as required.

Winchester Eastleigh Healthcare Trust Advice to Others and Lessons Learned ƒ ƒ


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If you can roll out software remotely, do so. It is more cost effective to do this, than to employ more staff to visit each PC individually. It is never too early to start registering staff for smartcards. Even though we have been registering staff and issuing smartcards for some time and have publicised this across the Trust, it always takes a long time to register all staff as they may not bring in the appropriate ID, etc. National and Layered Service Provider applications do not all use the same versions of software (e.g. Java). Workarounds may be required for applications that require different versions of the same software. Appendix B of the M-0100 document (available from Kbase) provides advice on JRE specifically as it is recognised that this is a widely used application in NHS organisations. Ensure high user acceptance by training a proportion of staff prior to the system being fully implemented and include both learners and administrators. In relation to technical requirements, have your IT person review the technical specifications to look for any issues at the start. An essential task would be to organise a meeting prior to implementing the system with your NLMS account manager and your IT representative as this will give you time to discuss any potential issues and plan the roll out. If any challenges are raised within these meetings then this gives you time to sort them out without impacting your NLMS timeframe rollout.

Finally it is essential to have good project planning and having a robust communications plan which sets out realistic, achievable and attainable goals to ensure a smooth implementation.