Primary Care News, Secondary Care

Connecting care across Lincolnshire

At the annual InterSystems Joined Up Health and Care conference Liz Jones and David Smith from Lincolnshire STP presented the work in the region to deploy a care portal, a patient portal, and digital care plans using InterSystems HealthShare.

Presenting at the event Liz Jones said  “Back in 2013, led by Public Health, we had a Lincolnshire Sustainable Services Review, because we knew that throwing money into the same services time and time again wasn’t going to work. This review came up with a blueprint, in 2014 that blueprint then led into the Lincolnshire Care Program which then moulded into our STP.”

“The idea of this review was to move care closer to home; to reduce unnecessary admission to hospital and to achieve integrated working. We had to look at what do we actually need to do to enable this change – finance, workforce and what clinical decisions do we need to make. Also, what do our buildings need to look like and what technology do we need. The most striking thing that came out of this review was the frequent comment from staff and patients of “nothing talks to each other, we can’t find the information we need, it would be great to have one system but it is probably not feasible”. We thought, we need to integrate electronic records.”

Since introducing the technology now over 5,000 healthcare professionals can view information from multiple systems in one record. The platform is also providing a patient portal where patients can self-refer in services such as maternity.

Liz continued “There are some real benefits from using this integrated system. We first worked with a group made up of clinicians and healthcare staff to tell us what information they wanted to see on every screen. We can use the system to notify users of key events, such as if the patient has been admitted to hospital and at what time and date, if the patient has been discharged or if the patient has been admitted to emergency rooms, etc. Also, users can access cancelled appointment information, if the patient didn’t turn up and information on in-patient/out-patient/emergency records. We also have a section on community encounters as well.”

“Some of the big wins for us have been including hospital letters, and also discharge summaries. That has made a big difference to GPs and community teams, and there is some evidence that length of stay is being reduced. We hope that is because community services can see the discharge letters and rally round to help them.”

David Smith, Digital Programme Lead, Lincolnshire STP followed and said “The fact that so many clinicians are using the Care Portal system shows how much it’s needed and how keen staff are to engage with it.”

“Some examples of functionality include a bespoke notification that has been set up to support neighbourhood multi-disciplinary working so that whenever a patient aged 75 or over that is registered at a local GP practice is admitted to hospital an email alert is sent, so that the team can proactively in-reach to support the patient.”

“We have a long list of other systems that people want to have connected now that they’re already seeing the benefits of this kind of interoperability. Such as Lincolnshire County Council and mental health services, whilst the project is a first of type for NHS Digital for GP Connect for structured data. We are in the final stages of testing for that. It is challenging in terms of due diligence, because we need information sharing agreements in place with all our GPs. We are also working with maternity and with the ambulance service to surface their electronic record. So, there is lots going on. We are talking to some of our neighbour trusts, to try and pull in some of their patient administration system information.”

The next phase is also about empowering patients directly. The Care Portal democratises data, sharing it across systems – but its impact won’t end at the hospital or practice door. A patient portal has just gone live with maternity services, enabling patients to self-refer. This will be further developed to enable patients to contact health and care professionals and view and contribute to their own records. An electronic care planning module and analytics module will also be rolled out during 2019-20.”