Bradford & Airedale Integrated Digital Care Record

Introduction BackgroundSolution

Our digital journey to a fully interoperable electronic health record is at the heart of our planning, and is central to our overarching principle of People First - Digital First

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.

Maturity
Level 4 - Sharing three or more care settings, with write capability
Scale
Medium - 5-10 Organisations

Local Context

  • The IDCR was developed out of a successful bid for the NHS England Safer Hospital, Safer Wards Technology Fund. The project aimed to deliver a future proofed technology platform which allowedmultiple organisationsto realise the benefits of an integrated care record.
  • SystmOne was chosen as the basis for the IDCR solution due to its widespread use in the area, which reduced the need for additional investment, and the fact that the product’s functionality met the requirements of the organisations involved.
  • However, despite the prevalence of a single system, the region is clear that its strategy has always been one of interoperability. Bradford Teaching Hospitals NHS Foundation Trust (BTH), for example, chose Cerner Millennium as its electronic patient record, with a view to exchanging data with SystmOne via Cerner’sHealth Information Exchange (HIE).
  • BTH went live with Cerner Millennium in September 2017. Work is ongoing on the HIE component, which is due to be implemented later in 2018. The integration will mean users of Cerner Millennium will see a combined view of data sourced from SystmOne in a tab in the hospital record. Similarly, SystmOne users will be able to see a summary of BTH data in their records.
  • Peer To Peer Model IDCR is based on widespread SystmOne usage in combination with other interoperable clinical systems.
  • All organisations are committed to open standards.
  • BTH uses Cerner Millennium as its EPR. The HIE component of the solution is being implemented to allow data exchange between Cerner and SystmOne.
  • SystmOne is used in a mobile capacity, both online and offline, across the region, supporting flexible and collaborative working arrangements.

Business Capabilities

Individual Patient Care
  • The majority of the IDCR user base uses SystmOne, including all 85 GP practices, community and mental health services, adult social care teams and Airedale NHS FT.SystmOne is an integrated clinical system, which was designed on the premise of “One Patient One Record”.
  • The fact that so many teams contribute to SystmOne makes it an exceptionally rich and clinically valuable resource.Care professionals input their side of the story into the same record (although the information can be viewed and filtered in different ways).This gives a much more comprehensive and accurate insight into a patient’s current care status than would otherwise be achievable with separate records.With access to the bigger picture, care professionals can make decisions with confidence.Patients benefit from a better experience and staff save time because they do not have to chase for information.
  • Care professionals add information into the record through a variety of means, including clinical templates, forms and care plans, which are coded in the background.These structured methods of capturing information facilitate data sharing and comparison.Bradford and Airedale teams have spent considerable time developing standard templates.
Care Planning and Coordination Governance
  • The richness and level of integration of the SystmOne record, as well as the range of collaborative tools and in – built communication methods that it offers, makes it a powerful resource for care planning and coordination.
  • IDCR has enabled a number of innovative shared care initiatives which allow staff from different teams and organisations to work together to deliver coordinated services.Examples include :
    • Palliative Care
    • Integrated District Nursing
    • Integrated Health Visiting
    • Respiratory
    • Nephrology
    • Telemedicine Hub
    • E-Consultations
    • Virtual Ward
    • Bradford’s Healthy Hearts
    • Bradford Beating
    • Diabetes
  • When the HIE component of the BTH Cerner project goes live, there will be further potential to join up care between BTH and the other partner organisations.Hospital users will get a view of information from SystmOne, while GPs will have access to patient management plans, future scheduled investigations, outpatient appointments and blood test results to help them provide continuity of care.
Research
  • The IDCR enables the collection of anonymised data at scale in support of research, such as the pioneering Born in Bradford ( BiB ) project, via a “black box” solution.
  • The Bradford Institute for Health Research , The University of Bradford , and the Digital Health Enterprise Zone are key stakeholders leading Bradford’s health research agenda.
  • The prevalence of a single system (i.e.SystmOne) has benefits when it comes to data aggregation because it allows for more seamless data linkages to be made.
  • Future plans include extending the research portfolio, and using IDCR data for population health management.