Are shared care records just a pipe dream?
With the introduction of LHCREs (Local Health and Care Record Exemplars) in 2018, there was a sense the NHS was finally on course to overcome long time challenges to sharing health records. They were created to promote regional collaboration for hundreds of thousands of people – ensuring that wherever someone receives care, the health or care professional has access to the right data.
To date, progress of shared care records across health and social care has been mixed and it’s fair to say we are still learning what works and what doesn’t. What is widely agreed however, is that when different local organisations work together, patients get better and more joined-up care that is tailored to their needs and helps avoid unnecessary stays in hospital.
A shift from LHCREs to Integrated Care Systems
Perhaps this is why the NHS has shifted focus from LHCREs to ICSs (Integrated Care Systems). At ReStart we question whether the current top down approach will work for these regional partnerships where priorities lie in sharing data between neighbourhoods (30 – 50,000 people), places (250 – 500,000) and systems (1 to 3 million). The initiatives around shared care records have changed, but the ambition has not.
The shared care record ambition
In short, if sharing records is about making crucial patient information accessible to clinicians to help them make informed decisions at the point of care, it will ultimately save lives.
The shared care record’s value lies in the ability to have the right data presented at the right time along a patient care journey. Clinicians do not really care where the data comes from so long as they can trust what is being provided.
If information is entered once, and shared immediately across care settings, the efficiency gains are incredible – clinicians save time, reduce duplication, and improve patient experience in one fell swoop.
The problem with shared care records: interoperability
Whilst it sounds contradictory – how can interoperability be a problem for sharing records – it is a bit of a red herring.
A truly integrated record is one which provides a care professional with the data necessary to treat an individual and make informed decisions. It is reliant upon the data held in individual systems being managed correctly to display in the right format at the right time, rather than relying on having all the systems ‘talk to each other’.
In our experience, ICS’s need to spend their efforts on releasing benefits quicker through incremental integration rather than wasting time and money on striving for full interoperability. The top down approach of LHCREs working with multi-million-pound procurements can be unpredictable and challenging. A neighbourhood, place or system simply will not have the resource or budget.
Scaling shared records, step-by-step
A different approach to sharing patient information is via an interoperable clinical record such as IMX. It extracts data direct from source systems and simply presents that data to the user at the point of care. There’s no attempt to exchange data across the source systems because it displays the data and provides an indicator for the provenance of the data. In turn, this allows the end user to make decisions based on both the data and their knowledge of the source of the data. Staff are not reliant on stored data which may be out of date.
This innovative approach can be built incrementally to initially focus on areas of urgent need, such as avoiding inappropriate A&E attendances, or reducing delayed transfers of care. And because it doesn’t rely on vast data storage, and additional clinical programmes for source systems are independent, record sharing can be continuously developed and scaled across care settings.
Don’t delay digital transformation
The challenge of trying to deliver full shared care records is distracting from the wider aim of achieving transformation. Clinical and digital transformation is often lost in the rush to implement a clinical portal or patient portal, and if these technologies fail to deliver expected benefits, digital transformation will take longer.
Transformation is about people, process, and technology. If clinical staff run out of patience when it comes to failed promises, and finance staff are no longer willing to endure the impact of costly over-runs and failed ROI, then momentum suffers.
If we are to see shared care records as anything other than a pipe dream then we must start to look at other ways of working.
IMX Clinical Record – the incremental way to share records
IMX Clinical Record promotes collaboration across care settings with the creation of a single-source of patient information. It enables health and care staff to make informed decisions about patient care with confidence that information is up-to-date.
For a demo of IMX, speak to a consultant today on 01392 363888 or email hello@restartconsulting.com to arrange a quick Teams call.
This blog is an updated version of our consultant’s article written in 2018.