Nebula

Q: What is the NEBULA System?

Nebula is a case management software system designed to cater to the needs of specialist addiction units.  The software is web-based and may be accessed via a standard internet browser.  The system is designed to assist both clinicians and administrators in managing all aspects of client caseloads and also to provide detailed management reporting to enhance the control of services.

Q: For what treatment provision and types of case management is this suitable?

The Nebula system is designed to supplement the management of all types of service user care.  Whether based on the National Treatment Agency’s Models of Care in England whereby provision of care is based on logical Tiers and progress is reported via the National Drug Treatment Monitoring System, or based on the Scottish SMR-25 assessments and The Road to Recovery framework, the Nebula system is ideally designed to support and supplement the work of drug and alcohol services across the UK.  Every type of treatment provision is catered for including substitute prescribing, criminal justice, residential rehabilitation and harm reduction.

Q: Does it require much training to understand how to use the Nebula?

Most software systems will claim ‘ease of use’ or ‘user friendliness’ as part of their feature set.  We think those terms are over used and too subjective to have much real meaning any more, we prefer to make the quietly confident claim that attendees at Nebula training sessions will be happily using the software to record multiple client events within twenty minutes of sitting in front of the system. 

Q: What are the advantages of the NEBULA Event Manager?

The reason that we are confident that attendees at Nebula training sessions will be happily recording multiple client events within a few minutes of using the system, is that the Nebula system is actually designed to lead users through available features such as assessments, keyworker sessions or risk assessments and so on.  We recognise that ‘events’ which are, in general terms, those tasks that an administrator or keyworker needs to record within a client record, do not usually exist in isolation and that several of these usually occur at the same time.  Therefore the system should be capable of taking the user automatically from one event to another without wasting time on navigating between sections of the software.  This greatly speeds up use of the software and means users build confidence quicker.

Q: What security is built into the Nebula to protect client confidentiality?

Clearly, security is a priority in managing caseloads of service users.  Records contain highly sensitive information and people have a right to confidentiality.  At Orion we accord security the highest priority level.  We work with our clients to ensure that access to the Nebula system is open only to accredited personnel and we make use of the latest security measures to achieve this.  Techniques such as Virtual Private Networks (VPNs), dedicated IP addresses, Secure Socket Layers (SSL) and high level encryption algorithms are used to ensure that access is private and protected.

Q: How does the system accommodate differing needs across multi agency partnerships?

Nebula is a multi-user and multi-service case management system.   We recognise that in a multi-agency partnership which may extend across statutory and voluntary agencies, there will possibly be a need to restrict access between certain services.  In practice agencies will have worked out an information sharing protocol between themselves and Orion undertake to reflect this in our software configuration.  An agency may agree to fully share its data with all other partners including the ability to create and edit records, such as assessments and modalities.  A variation of this arrangement may occur where an agency prefers to accord ‘read only’ rights to other agencies or perhaps an agency would prefer its data to be restricted only to its own staff.  Whatever information sharing protocol the partnership has created can be reflected in the Nebula system.

Q: Can the system be customised to reflect local processes?

Very often a partnership will require changes to be made to Nebula to reflect local processes.  An example of this situation would be where a Tier 2 modality is begun, followed by a Tier 3 modality, when the Tier 3 modality is completed and closed, the client can continue with the Tier 2 modality; each of these ‘referral Tiers’ can then have their own start and end dates.  A further example would be where partner services can be configured with their own customised list of possible events and the names of individual events or whole programmes can be customised.  These are only two examples of the types of changes that Orion can make to Nebula to suit individual clients; we believe that software should fit our clients needs rather than impose a rigid framework where at best software only changes periodically and all users are given a new national version.

Q: Can historical data be migrated to the system?

Yes, and Orion have extensive experience of migrating data from legacy systems into Nebula.  Whether data is held on an in-house built system or is contained in a third party branded system, Orion can manage the process of migrating the data to Nebula.  Part of this process will be to help clients ‘cleanse’ the data ready for migration. This means ensuring that each instance of service users data is properly episodic and data conforms with the rules inherent in the NDTMS validation prior to migration.

Q: Can NEBULA batch print prescriptions?

Yes, we provide great flexibility according to clients requirements in managing batch printing. A typical set-up would be offering a choice of FP10-MDA (Blue) or FP10 (Green) scripts, followed by a choice of searching and producing scripts by Service, Keyworker or Pharmacy according to a given data range.

Q: What are the Harm Reduction features of the NEBULA system?

The Nebula Harm Reduction section features a needle exchange which can be configured with individual specifications for needles, barrels, assorted paraphernalia, bins and sex health items.  Issue and receipt of stock items can be managed and reported on, including production of NEXMS compatible report.  In addition to needle exchange a Risk Discussion section allows keyworkers to record conversations with service users across a range of agreed topics such as injecting in high risk areas or mixing stimulants.  Each issue can be dated and recorded as resolved, as a present risk or simply under discussion.  In this way low threshold services can manage ‘sound bites’ of discussions as part of an agreed strategy and report on these in an effort to introduce some structure into what can often be a loosely managed intervention.  Another harm reduction feature is the NX Health section where details of Blood Borne Virus testing and vaccination can be recorded as well as items such as saliva testing, tetanus inoculation and wound care.

Q: Does the NEBULA system reflect criminal justice provision?

Yes, the Nebula system has a comprehensive criminal justice section where all aspects of CJ record keeping are available including Initial Contact, RA Assessments, Activity Forms and Drug Intervention Records.

Q: Can NEBULA record case notes?

Yes, the Event Manager allows case notes to be recorded.  Each note is automatically dated and stamped with the identification of the user.  Casenotes can be spell checked and once the event is saved, casenotes can be viewed and printed, but not edited.  This is a safety feature in the event that casenotes are required as part of an investigation.  It is however possible to add further casenotes to supplement existing notes.

Q: What type of management reports can be sourced from NEBULA database?

It would be true to say that the only limitation to management reporting from the Nebula database is the imagination of the report writer!  Over the years we have built up a stock of management and other reports which are available to our clients.  Of course customised reports will always be required and Orion provides this service too.  From simple columnar validation reports to complex Performance Management Frameworks, Orion can reflect the requirements of line management, DAATs and other local commissioners.  Orion can also provide a reporting service to reproduce any client form such as assessments or care plans.  This means that users are able to print out copies of their individual clients data in a form view, either as a ‘blank’ or fully populated with current client data.

Q: How is NEBULA supported?

There are several layers to the support that Orion provides to supplement use of the Nebula system.  We first of all identify and develop contact with ‘System Administrators’ or ‘SysAdmins’.  These are individuals who have a particularly close investment in the system, and may be a manager, a keyworker or sometimes a clinician.  The SysAdmin will act as an inside contact for all matters pertaining to the Nebula system.  They will often be able to handle simple queries and generally act as a liaison with the project’s management.  We feel it is very important to develop and nurture this relationship because although we like to attend project meetings and make other visits to services, we are not ‘on the ground’ all the time.  A local contact who understands the structure and needs of partnership services is a very useful and productive part of the whole software project. 

Beyond the SysAdmin we provide a telephone support service, with access to trained Nebula technicians, available during business hours or beyond by arrangement.  If local IT permit it, we can shadow users screens and provide direct visual consultation to resolve issues.  We also provide an on-line Customer Portal where issues such as change requests or faults can be recorded and maintained.  For example when a change request is recorded by a client service, this is properly date stamped and the user identified.  Orion will then respond to this and the item will develop with responses being properly recorded.  When both sides agree on how to proceed, the change will be scheduled and the user can then track the item to completion.  At agreed intervals, reports are produced from the system and SysAdmin and project teams can then keep track of historical issues, change requests and faults, with full text and relevant dates.

Q: How is NEBULA updated to reflect to latest NTA NDTMS CoreData Set?

Each year Orion work closely with the NTA in monitoring and subsequently developing the changes required with each evolution of the NDTMS reporting framework.  We ensure that changes are properly understood both by our own developers and also by our SysAdmin contacts within client organisations.  Changes are always in place by the required date and we ensure that subsequent NDTMS extracts are 100% compliant with every client.  To date we have provided these changes to comply with NTA requirements free of charge.

Q: Can NEBULA cater for NHS Scotland (ISD) SMR25 record or Scottish Waiting Times?

For client organisations in Scotland we provide SMR25 a and b versions and a full Scottish Waiting Times framework.  Electronic extracts for SWT can be produced.

Q: How are NEBULA licences costed and over what timescale?

At Orion we understand that client organisations vary considerably in size and structure.  This means that client requirements also vary and we try to reflect this in costing licenses.  A major NHS Trust with multiple partners, operating over a wide area, may have a highly customised version of Nebula which provides all the aspects of case management that a specialist addictions unit would need.  This would contrast sharply with a smaller organisation which specialises in structured counselling and harm reduction.  As such we take this into consideration when costing licenses.  We usually provide a three year license agreement for new clients.  This will generally include a capital fee followed by monthly support and maintenance contributions.  After three years we will negotiate an extension of the license.  We also can also build in increments of licenses, so that where partner services reduce, so the license fee will reduce.  Of course the opposite is true and as partner services increase, so the licensing changes to reflect this.  We always ensure our licensing is highly competitive and fairly reflects the work being done and the service provided for each client.