The following critical appraisal case studies have been sourced from recent exemplar implementations and cover a range of business capabilities. They provide an opportunity for CIOs, CCIOs, IT teams and others to study and learn from detailed analysis and research carried out on a variety of national and international exemplars.
Bradford & Airedale Integrated Digital Care Record [New]
The Bradford & Airedale Integrated Digital Care Record (IDCR) allows care professionals to access citizens’ information when and where they need it.
The region has a long history of joining up health and care information, enabled by digital technology, having been one of the first areas to work with the SystmOne integrated record.
SystmOne is a major component of the IDCR but it is part of a wider interoperability landscape and a digital vision which relies on information flowing between systems and organisations, and across boundaries.
The Connecting Care Programme has implemented a read-only shared care record across Bristol, North Somerset and South Gloucestershire. The record is used to share information across a range of health and care settings and support the provision of integrated care.
The solution uses the Orion Health technology platform.
The Cheshire Care Record is an integrated care record solution that shares information across a range of health and care settings. The record is used to support clinical decision making and transfers of care. The former West Cheshire Record was extended across the whole of Cheshire in 2016.
The Cheshire Care Record uses Graphnet CareCentric v.3 software.
Dorset Care Record [New]
The Dorset Care Record is helping Dorset re-engineer the way it delivers health and care across the region.
The record currently draws data from three acute hospitals and the majority of Dorset’s GP practices. Data sets from other partner organisations will be added soon. A wide range of providers, including social care and mental health, can view the record. Access for the South Western Ambulance Trust is in the pipeline.
The solution, which uses an Orion Health technology platform, is one of the key digital enablers of Dorset’s Sustainability and Transformation Plan.
The east London Patient Record (eLPR) shares ‘read-only’ patient records across health and community organisations in the 5 London boroughs of Waltham Forest, Newham, Tower Hamlets, Hackney and City of London, as well as with GPs in West Essex.
The Health Information Exchange (HIE) has been implemented to facilitate continuous improvement in the delivery of direct patient care.
The Greater Manchester Academic Science Network Partners (AHSN) have implemented a Lumira data sharing solution to support the devolution of health and care services to Greater Manchester. This is part of the regional interoperability programme called DataWell. At the current scale, the solution enables sharing of pathology information between healthcare organisations, viewable through mobile devices.
The solution implementation is in progress with a final Go-Live date of May 2018.
The Hampshire Health Record (HHR) is a shared care record that shares information about 1.9m patients across a range of health and care settings. The record is used to support clinical decision making and transfers of care. A second database was deployed with the solution which uses pseudonymised data to support research and population health planning.
The Hampshire Health Record uses Graphnet’s CareCentric software.
The Lancashire Person Record Exchange Services (LPRES) allows sites to share patient documents with participating sites. LPRES also developed an online information governance tool for managing information sharing agreements between sites.
The solution deployed is a HIE Tiani Spirit Exchange platform and it connects 9 sites and 228 GPs.
Leeds Care Record [New]
Leeds Care Record is described locally as a city wide multi-agency integrated record. It contains a rich data set, supplied by a variety of settings, including mental health and adult and children’s social care, and is used exclusively to support direct patient care
Leeds Care Record is a bespoke solution developed and hosted by The Leeds Teaching Hospitals NHS Trust (LTHT). It is a component of the Leeds PPM+ enterprise platform. A strong focus on engagement, collaboration and understanding what people want has been key to the programme’s success.
Lincolnshire Health and Care (LHAC) have deployed a shared care record solution that currently shares information from 3 of their acute hospital trust’s systems. The Lincolnshire Care Portal will be used to support the delivery of integrated care through multidisciplinary teams.
The Lincolnshire Care Portal uses InterSystems’ Healthshare Solution.
London North West – Care Information Exchange (CIE) [New]
The North West London Care Information Exchange (CIE) provides patients – and the health and social care professionals involved in their care – with secure online access to their medical records.
Initially funded by Imperial Health Charity, the programme is led by the eight CCGs which form the North West London Collaboration of Clinical Commissioning Groups. The portal solution is being rolled out initially to patients receiving treatment for particular conditions, including Rheumatology, Renal and Oncology. It uses Patients Know Best technology.
Medications data using a CareConnect #FHIR API [New]
Bristol, North Somerset & South Gloucestershire (BNSSG) Connecting Care
Clinicians often struggle to retrieve a patient’s medications history to prepare a list of collated medications as the data is, typically, stored across a number of systems.
In Bristol, the Connecting Care Programme has developed a solution which involves adopting FHIR to address the needs of medication reconciliation.
The initial aim is to avoid substance misuse (specifically opioid substitution therapy drugs) within Bristol but there are far wider future aims.
Midlands Your Care Connected [New]
Your Care Connected (YCC) is an information sharing programme, hosted by Birmingham Cross City CCG on behalf of the other CCGs in the region. It uses the Medical Interoperability Gateway (MIG) to enable secondary care clinicians to view information recorded by the GP. In the next phase, the ambulance service and out of hours providers will gain access, and other organisations will follow.
YCC plays a role in the Birmingham Intelligent City programme, which aims to deploy a city-wide infrastructure to meet the evolving demands of its citizens and support new models of engagement.
Connected Nottinghamshire is the interoperability programme for Health and Social Care in Nottinghamshire. The programme has implemented a Medical Interoperability Gateway (MIG) solution to share information from primary care with 9 other health and community organisations.
Connected Nottinghamshire has also implemented a solution for information sharing and risk stratification known as eHealthScope.
Rotherham Health Record [New]
The Rotherham Health Record (RHR) is an integrated IT portal which presents the information health and care workers need to make clinical and operational decisions with confidence.
It provides aggregated views of key data at the patient level, and features a set of dashboards which show how the local healthcare system is performing.
The RHR is a bespoke solution developed by The Rotherham NHS Foundation Trust. It is managed by the Rotherham Health and Care Interoperability Group.
Salford Integrated Record [New]
The Salford Integrated Record (SIR) is an IT portal designed to improve care for Salford patients and promote research which benefits the local population.
SIR is a key enabler of the Salford Together partnership’s vision for integrated care. The solution currently provides hospital and mental health clinicians with a view of the GP record, and it is being expanded to encompass social care as a priority. Salford’s real depth of experience lies in its use of SIR for research purposes, and it has developed communications and governance approaches which support this aim.
Surrey Care Record [New]
The Surrey Care Record is the shared integrated digital care record for Surrey Heartlands and East Surrey CCG. It uses Patient Knows Best (PKB) technology to deliver a professional-facing portal, which will be launched in July 2018.
In Phase 1, GP, acute and pathology records will be made available to GPs and A&E professionals across four CCGs. Soon after, Phase 2 will see the record extended to cover mental health, social care, community, ambulance, and later pharmacy. Shared care plans will also be introduced. The solution includes a data warehouse to support analytics.
West Essex My Care Record [New]
The local programme team describe My Care Record (MCR) as a shared care record “model” rather than an IT solution. Their implementation approach reflects this, and they have invested heavily in branding, engagement, and governance.
MCR was designed by West Essex CCG, and is being adopted across the Hertfordshire & West Essex STP footprint. It currently allows hospital clinicians to access information from the GP record, and vice versa. Mental health, community, ambulance and social care will be added in time. The solution uses Graphnet and the MIG.
Wirral Care Record & Health Information Exchange [New]
The Healthy Wirral Population Health Programme is delivering two key solutions to reduce variations in the health of local people and improve care.
The Health Information Exchange (HIE) is a shared care record that provides access to real time patient information. Along side it, the Wirral Care Record (WCR) supports targeted intervention and prevention based on a set of wellness and condition registries. Both solutions use Cerner technology to draw data from 51 GP practices, community services, the acute hospital, and cancer centre. Further data sets will be added in time.
New York City
The Health and Human Services (HHS) –Connect programme was established by New York City to transform the city’s health and human services. The programme implemented a shared care management system to break down information silos between social care providers.
The platform shares citizen information between 10 different agencies and provides citizen access, to improve services for families.
Singapore’s Ministry of Health Holdings (MOHH) initiated the National Electronic Health Record (NEHR) program to improve healthcare quality and patient safety, lower healthcare costs and develop more effective health policies.
The NEHR currently enables patient health records to be shared across the nation’s public healthcare ecosystem.