Friday, February 03, 2017

The UK Is Making Some Progress In The Use Of Shared Care Records To Co-ordinate Care.

This appeared a little while ago.
Special Report: Shared Records

Shared records starting to make headway

Sharing records between care settings is starting to become much more commonplace, but is viewing patient and clinical data enough to deliver joined-up care?
Vivienne Raper revisits some of the pioneers of information and record sharing, and examines how they are beginning to use shared records to change how they interact with patients.
In 2013 NHS England set out its vision for trusts to achieve a “fully integrated digital care record [IDCR] across all care settings by 2018”.
The vision first set out in Safer Hospitals Safer Wards: Achieving an integrated digital care record, defined an IDCR as the ability of users in local health and care services to view patient and clinical data in a joined-up manner.
According to Markus Bolton, joint chief executive of shared records specialist Graphnet, real progress has been made in achieving the target. He estimates that around 35% of health communities in England now have what he describes as large-scale solutions.
“We already have 12 million patients on our systems on CareCentric [Graphnet’s shared records software]”, he says. “And we’re expecting to double that in nine months – it’s really picking up pace.”
Bristol builds momentum on Connecting Care
Bristol was among three IDCR exemplars named by NHS England in 2014, building on locally-led developments. Today about 2,500 users share records across GP surgeries, three acute trusts, community providers, mental health and adult social care via a portal supplied by Orion Health.
“We’re still in growth mode,” says Andy Kinnear, Connecting Care programme director. “The plan is to get up to about 10,000 users, and it may go beyond that in due course.”
Most of Bristol’s efforts over the last year has been growing the functionality of the shared record by, for example, allowing document sharing and so-called context launching from within native applications. So, for example, a GP can launch the shared record from inside EMIS rather than logging into a separate system.
Connecting Care is due to add children’s social care this month, and has begun conversations with third sector charities and the police.
Kinnear believes having IDCRs across NHS England by 2018 is entirely plausible. “But I think it depends on how you go about it,” he says.
“I think the areas where it will be more challenging are where the people haven’t yet started, but they can be successful if they join neighbouring programmes and adopt solutions that have worked elsewhere.”
Bradford now able to share records at scale
Bradford, another IDCR exemplar from 2014, now has the potential to share most data of 600,000 citizens. The area’s GP practices, acute trust, adult social care and community services all use TPP Systole and can share information across different modules of the same TPP SytmOne system.
“We have the potential to share everything with those agencies,” says Andy McElligott, medical director and Caldicott guardian at Bradford District Care NHS Foundation Trust. “That functionality simply didn’t exist two to three years ago.”
However, Bradford relies on explicit patient consent to share information on a case-by-case basis. “We’ve still got some work to do in getting the information governance exactly right so we’re confident in a wider sharing model,” McElligott says.
Overcoming information governance challenges
In general, the barriers to IDCR are about people and not technology. There are multiple different stakeholders and organisations who must work together, and agree information governance. In Bradford alone, there are close to 100 GP practices, all controlling data.
“Many people in health and social care think and operate at an organisational level,” says Kinnear. “To make programmes like this successful, you need people to think and act system-wide.”
Lots more here:
What I found interesting was the approach being adopted of hastening very slowly and of ensuring explicit individual consent for all the information that is to be shared.
It seems to me this approach, where wrinkles are identified and incrementally addressed, rather than mass, unconsented enrolment has to be much more sensible, and interestingly seems to be working at this point.


Anonymous said...

Life after Tim looks a good target, guess we just have to wait. The UK efforts of late are worth looking at especially around FHIR and clinical interoperability in general

Bernard Robertson-Dunn said...


Totally agree with your comments.

My observation is that in the UK they are sharing data in local, point of care record systems. In Australia they have built a government owned, duplicate, un-reliable, un-trusted, privacy risking, data linking, very expensive, benefit free data bucket.

The UK's system is so totally and absolutely different from PCEHR/MyHR that the only comparison is that the first works, the other stands no chance.

Terry Hannan said...

David, nice comment. "It seems to me this approach, where wrinkles are identified and incrementally addressed, rather than mass, unconsented enrolment has to be much more sensible, and interestingly seems to be working at this point". A fundamental set of principles for those systems thta have had success. Terry