ONE healthcare record system to rule them all..

Kieran Potts | 9 months ago | in Challenge: Getting the basics right

Daring to dream slightly, please forgive the Lord of the Rings quote, but could we ever aim for one system for healthcare records; accessible in hospital, primary care and community care? Avoiding the need for various different sub contracted record systems?

Patients commonly expect us (as Healthcare-professionals) to KNOW their history. Yet, we have arms of the NHS totally locked out of certain records due to poor interoperability.

My dream is that somebody can call 111, arrange an appointment with their local out of hours provider, and that provider can see everything that the patients own GP can see. Likewise for hospital discharges - an ambulance crew can see everything from a recent hospital admission.

Ultimately, this could result in reduction of duplication, a more seamless patient experience, and safer (more informed) clinical decision making.

There are lots of systems out there currently, sub contracted to by NHS Trusts. The only thing these systems have in common is their poor capabilities to communicate with one another.

Sally Morgan 9 months ago

Great idea. Try talking to SECAmb, they’ve done some great work getting shared records started there.

Also need to extend this to sharing files across Health and Social Care - probably the single most important thing we could do to improve child safeguarding.

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Kieran Potts 9 months ago

Thanks Sally. I've been in touch with SECAmb, who have a great system (IBIS). We're looking at a similar system within NWAS. I also totally agree - health and social care sharing is oh-so-important.. Very key point!

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Sam DHSC 9 months ago

Hi Kieran- thanks for sharing your thoughts with us.

The Secretary of State has recently set out his vision for a more tech-driven NHS - you might find his speech interesting - https://www.gov.uk/government/speeches/my-vis...tech-driven-nhs

Thanks

Sam

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Jamie 9 months ago

Agree, trusts should no longer be allowed to do their own thing especially when it comes to IT, why IT departments insist on being as different as possible to each other I will never know.

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Rebecca A'Barrow 9 months ago

Totally agree from a safeguarding perspective this is crucial to protect all children.

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Jonathan Hoeksma 9 months ago

Hi Kieran - one record for the whole NHS is a nice idea but has proved a bit sticky in the not too distant past. There was a fairly recent £12 billion effort from 2003 on that rather spectacularly failed to achieve this.

Better to have specialist systems for hospitals, mental health, community, hospitals and ambulances that can talk to one another. Even better to put patient in control.

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Matt Hancock 9 months ago

Kieran (and all!) – Thanks for being amongst the first to use this site. It won’t surprise you that you’re not the first people to mention this to me. So as Sam mentioned, the lack of electronic join up in health records is one of the things I’m determined to tackle. There is good work to build on in individual trusts, but there is more we can do.

When I was talking to staff at Southmead Hospital in Bristol yesterday, I made clear that in future only systems that talk to each other can be used. I’m going to be publishing robust standards in the coming weeks that IT systems must meet if they’re going to be bought by anyone in the NHS. Do look out for those. Change will come, and not soon enough!

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Jamie 9 months ago

I work at Southmead myself, we desperately need standards/regulations as you mention. Big and small corporations hold the NHS to ransom digitally every day to make as much profit from us as possible, usually by using proprietary formats and closed-off systems that don't work with anything else other than other systems from the same company.

Will this include medical electronic equipment too and will it work retrospectively?
for example a massive problem in the NHS, like my Southmead, is that manufacturers charge many thousands of £'s per machine to allow their ECG machines to electronically transmit sometimes life or death ECG readouts to computers other than their own (which would also cost vast sums of money, likely £100,000's+), meaning we still have to print them out on paper that often gets lost or damaged. I could give 100's of examples like this and I've only been in the NHS a few years.

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Angela Jackson 9 months ago

Great news - iterative route to a Service standard, digital marketplace platform and service assessments gets my vote

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Eleanor Templeman 9 months ago

Can you please consider social care in this also. As there is an ongoing initiative to improve the working relationship between health and social care a shared system would be incredibly useful.
I have lost count of the amount of times that I have had difficulty getting the most essential of information from GP surgeries or hospitals, such as people diagnoses or admission dates. Being able to access a system that has this information and other things such as referrals to specialist services or clinics would cut down staff time and in turn cost immeasurably within social care.

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Matt Hancock

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Devender Khurana 9 months ago

Well said.
To my understanding, NHS records are not more than the data which Google or Wikipedia holds. That data is easily searchable at our fingertips.
A common platform with a single record system for every citizen I.e. NHS no. should be the aim in the interest of “Patient safety” and “Efficiency”. Regulatory hurdle of Data Protection should be made realistic and practical to facilitate this.
Patients should have the ownership and access to all their health records.
Good quality research will be possible to improve outcomes from those records.

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LeonhartUK 9 months ago

Most hospitals have the same software under the different name - it's horribly done by Cerner or whatever they're called. It is obvious that no medical staff was involved in making it.

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LeonhartUK 9 months ago

Well... I wanted a new row but it just posted... Anyway, infrastructure is in place and it's probably very easy for them to communicate with each other. There's another problem, and it's the actual paperwork - on average patient visiting my Trust ends up with 10cm of paperwork inside the file. I'm sure there's literally tones of papers at 5he end of the year and it's only cause we don't use the existing software (doesn't matter how bad it is) and we don't use it. Paperwork are repetitive and so many times irrelevant.

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Nick Venters 9 months ago

One of the difficulties is the massively complex reporting requirements. National vs local commissioning coquins KPIs etc etc. Managing these in one speciality is complex enough let alone using one system across the whole NHS. The suppliers know this and love the complexity as it pushes out new entrants to the market. Currently separate systems with shared standards and ( open source) integration platforms exploiting FHIR seems the way to go. Sadly whilst that can allow viewing of info across the system, workflow etc are a long way off. Also remember that the reporting often significantly influences the tasks we have to ask of clinicians. Many of these divert time from patient care and complicate pathways.

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