Friday, May 04, 2012

An Interesting And Already Working Alternative To The NEHRS And Cheaper Too.

This very interesting article and report appeared from the UK a little while ago.
Here is the news report.

Cumbria steps up record sharing

23 April 2012   Rebecca Todd
GPs and community services in Cumbria are streaming live into a shared patient record that can be viewed in some out-of-hours providers via Healthcare Gateway's medical interoperability gateway.
NHS Cumbria hosted an interoperability day last week to showcase its work on sharing patient information between services.
NHS Cumbria chief clinical information officer Dr William Lumb said the area’s population was ageing and suffering from more long term conditions.
He said paper processes could support the old way of doing things, but could not support the modernised NHS structure and methods for delivering healthcare.
In 2008, he embarked on an IT project in Cumbria with a number of aims. These included migrating services to EMIS Web and developing an interoperability network involving community services, acute trusts and out-of-hours services.
Dr Lumb argued that as 85% of healthcare is provided by GP or community services, it made sense to start there when moving to an electronic patient record system.
Two thirds of GPs in Cumbria have an EMIS system and one third of those have upgraded to EMIS Web.
Three quarters of community services in Cumbria are also live with EMIS Web Community and all are now streaming information to a shared record via EMIS Connect.
This record can be accessed via a button on the clinician’s normal screen view with the patient’s consent.
Those organisations not on EMIS can view a shared record via the MIG. This pulls data from EMIS and INPS practices and creates a read only view of the patient record.
Lots more here:
Associated we have a more detailed article.

Breaking down borders

NHS Cumbria has forged ahead with an ambitious interoperability project. EHI Primary Care reporter Rebecca Todd went to a conference at the Rheged Centre in Penrith to hear about progress.
23 April 2012

NHS Cumbria has a vision of an interoperable healthcare system – in which all the clinicians involved in the care of a patient can see their relevant health data.
Leading the project to make the vision a reality is NHS Cumbria’s chief clinical information officer, Dr William Lumb.
He believes that while paper processes could sustain old ways of doing things, a digital record is needed to support the move towards a modernised NHS structure and new ways of delivering healthcare.
His “grand plan” for IT services in Cumbria started to take shape in 2008. The aim of the project was to migrate services to EMIS systems and have the majority of organisations streaming information via EMIS Web.
It also set out plans to invest in a community of interest network; develop a hosted GP system; and develop an interoperability network involving community services, acute trusts and out of hours services.
Two thirds of the area’s 91 GP practices are now streaming via their EMIS systems, while the remaining INPS practices stream via Healthcare Gateway’s medical interoperability gateway, which provides a view of the patient record to other organisations such as out-of-hours providers.
The system only provides a clinical view, so people can not alter the shared record and certain information, such as sexual health, is automatically blocked.
At a recent conference to outline progress, Dr Lumb said there were just a few practices that had not signed up to share their data.
“You can’t take a group of GPs in a single line together, so work with the one third who wants to work with you, get things going, and then work towards critical mass,” he advised an audience member who said GPs in his area were against the idea of data sharing.
Write records with care
One GP who was on board from the outset, and who now leads the project in Carlisle, is Dr Alan Edwards. “I can’t see how we can deliver on the agenda of the NHS without this information sharing; that’s what we told our primary care trust and that’s how get got a project manager’s time and my time,” he explained.
Much more here:
Both these articles are well worth read to see the level of thought that has gone into getting to where this area now is.
What it also shows is that there are some really interesting ways of ‘skinning the (important) information sharing cat’ that really can make a difference and be implemented with the support of both clinicians and patients.
Given all this has been underway since 2008 there is no reason to assume that the NEHTA/DoHA boffins should not have been considering such approaches before rushing into the NEHRS. Just where is the strategic options document / benefits options analysis that should have been produced before all that money was committed? I wonder was it ever written and why it has not come to light.
We all know the public consultation has been desultory at best and despite the efforts of many submitters very little in the way of change actually happened.
I would argue the facts and evidence on health information sharing have been evolving rapidly and despite that none have gone the NEHRS route for a good reason. That there are better ways of reaching the same end have been obvious for a couple of years - before the kick-off of the PCEHR - and yet we just push on. Who was it who asked “When the facts change I change my view, what do you do sir?”
We are seeing better and simpler approaches working in the UK, the US and NZ at least and so far we seem to be struggling. There is still time to sort it out before all that has been done is wasted. I hope someone sees that and gives it a go.

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