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Quote Of The Year - Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

Friday, June 13, 2014

Health Information Sharing In The UK. A Very Useful Set Of Experiences And Ideas.

This appeared a little while ago.

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Information sharing to support more integrated health and social care is back on the agenda. EHI will be running a series of case studies over the summer looking at the approaches that healthcare communities in England are taking. To start the series, Lis Evenstad and Lyn Whitfield look back at the long history of information sharing initiatives and ask what lessons can be learned from them.
3 June 2014
Encouraging the different organisations that make up the NHS to share information, and to create a ‘seamless’ journey for patients in the process, has been a long-standing goal of NHS IT policy. 
Before the National Programme for IT was set up, the Information for Health strategy tried to create ‘lifelong’ electronic health records to achieve this; and ran some Electronic Patient Record Development and Implementation projects to show what could be done.
NPfIT itself aimed to create an integrated care record service, with a Summary Care Record to provide access to key patient information to any professional, anywhere. 
More recently, the idea of information sharing has been given new impetus, with NHS England issuing guidance on creating an ‘integrated digital care record’ last summer, with tech fund money to back it up. 
Three IDCR ‘exemplars’ were announced at the end of bidding for the first round of tech fund money; while both councils and trusts can bid for IDCR projects in the second round of bidding that has just opened
From a slightly different direction, the idea of information sharing has also been revived with the government’s revived interest in integrated care; in the specific sense of getting health and social care to work together. 
Care minister Norman Lamb, who the NPfIT years arguing for interoperable systems to support local information sharing, has found cash to support 14 integration ‘pioneers’ – some of which put plans for shared records in their proposals.
Doing IT for themselves 
As national interest in information sharing has waxed and waned  some healthcare communities have got on with their own projects.
The result is a patchwork of initiatives, some of which have made more progress than others, while coming up with different answers to key questions, such as who should hold the record, and what technology should be used to provide access. 
In Liverpool, for example, the iLinks programme has spent a decade giving an increasingly wide range of clinicians access to patient information based on GP records, using the EMIS Web-based portal that evolved into the Medical Interoperability Gateway. 
Access is covered by information sharing agreements, backed up by patient consent, and has been used to support initiatives ranging from the development of new community services to giving some hospital clinicians access from their own systems. 
Next in line is a much wider project across health and social care, says Kate Warriner, deputy director at Informatics Merseyside; the information exchange programme, which will launch at the iLinks conference in July. 
“We’ve had lots of experience in relation to data sharing. In the last ten months, we have been using that to create what we are branding iLinks information exchange programme, which is about sharing patient information across the health and social care economy,” she says. “The goal is to give clinicians a full view of an individual.”
Another information sharing project that has made use of the MIG is the Oxford Care Summary although, unusually, it has grown out of the acute sector, rather than from primary care. 
The OCS was created by Oxford University Hospital’s IT team, and is hosted on the trust’s ‘case notes’ system; a clinical intranet that holds results and documents. 
GPs have been able to use the OCS for 20 years to view pathology results. But over the years, its scope has widened to include demographics, allergies, medications, encounters, care plans and investigations; with information delivered to acute, community and GP staff on a ‘read only’ basis with patient consent.
Shared records and portal projects  
Other healthcare communities have taken a very different approach, creating their own shared records. In Hampshire, for example, different organisations have been working since 2005 on the Hampshire Health Record, using Graphnet technology.
The record includes demographics, medication, allergies, GP diagnoses, care encounters, blood and radiology results, clinic letters, discharge information and some social care information. It can be accessed by a wide range of staff, including clinicians at University Hospitals Southampton NHS Foundation Trust.  
Read the rest of the saga here:
What a fantastically useful summary of the UK experience and the lessons learned.
Compulsory reading.
This article really needs careful attention from those trying to work out what to do with the PCEHR post the Review.

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