Primary Care News, Secondary Care

Coventry and Warwickshire set to introduce Integrated Care Records

The Coventry and Warwickshire Integrated Care Record programme has announced plans to roll-out its shared care record this Autumn.

The platform will ensure health and care records for patients across the region will be available to authorised health and social care practitioners.

The programme includes GP practices within Coventry and Warwickshire, Coventry and Warwickshire Partnership NHS Trust, University Hospitals Coventry and Warwickshire NHS Trust, George Eliot Hospital NHS Trust, South Warwickshire NHS Foundation Trust, Coventry City Council, Warwickshire County Council and West Midlands Ambulance Service University NHS Foundation Trust. If required the Nightingale Hospital in the region will also be included.

The first phase of the ICR will include the GP practice medical record, basic secondary care and mental health data and radiology and pathology results.

Dr Alec Price-Forbes, Chief Clinical Information Officer (CCIO) for Coventry and Warwickshire Health and Care Partnership, commented: “Our patients have consistently told us that they want their health and care records to be available to the professionals who care for them, wherever they are seen. This means they only need to share their story once, so that the right information is available to enable well informed care decisions to be made, based on their individual needs.”

“By connecting the information which is held by different providers of health and care services, we will be able to improve the quality, and outcomes for those being cared for across Coventry and Warwickshire. This is the first exciting step towards delivering the technology to enable more integrated care across our region, with the long-term aim of improving the health and well-being of our whole community.”

Dr Deepika Yadav, Clinical Director for Integrated Care at Coventry and Rugby CCG and University Hospital Coventry and Warwickshire, said: “This is about patient safety first-and-foremost. In an emergency it is important that the clinician knows as much about you as possible to make the right decisions about how to treat you.”

“But we also hear many times of patients who are frustrated because they need to repeatedly give the same information to people from different parts of the NHS and social care, and delays caused by records not being easily accessible.”

“We have worked hard to create care which is better co-ordinated across Coventry and Warwickshire. This shared care record will support new models of care which form part of the delivery of integrated health and social care services that are central to the NHS Long Term Plan.”

HTN recently discussed with Dr Alec Price-Forbes some of his learnings and reflections from the past few months:

Dr Price-Forbes, said: “On reflection, to me the most critical factor from COVID-19, is that the health and care space was not prepared from a technological perspective for what was a population health crisis. This wasn’t an organisation or specialty challenge. We needed a holistic approach.”

“I’ve spent the past 12 years trying to implement solutions to change the way we work within a hospital setting. My experience in working in healthcare for nearly 25 years informed a simple vision for Coventry and Warwickshire; “to become the healthiest community in the UK”. This would move us towards that holistic view of person-centred care. This would also, however, be dependent on creating an appropriate modern infrastructure, by harnessing the power of the technology revolution which has transformed our daily lives.”

“The COVID-19 pandemic, has exposed the fundamental shortcomings in our healthcare system, particularly around communication with patients and the lack of such integrated patient portals. The Government have tried to do track and trace; but the reality is that the NHS doesn’t have the required, modern infrastructure in place. We don’t have even simple things like current and up to date email addresses or mobile numbers, for our customers. These are fundamental, basic requirements for any other commercial aspect of society; those organisations we interact with for banking, shopping, entertainment etc have all those details. In fact, in this modern age you can’t really run a business without that information; but the NHS runs a business either without those details or where they do have them, there are multiple versions and it’s often incorrect, outdated information. Given how critical data is to providing and sharing information currently, COVID-19 has also exposed a lot of poor quality data. One example comes from ‘Operation Shield’; we had more than 50 different databases of patients from which we had to source data; 6 months on we are still identifying patients who were either missed nationally from datasets or locally. Organisations who had modern integrated EPRs were able to perform the task of identifying highest risk groups of patients in hours/day.”

“You have to choose the right technology, implement it properly, test it and train people to use it the way it’s designed to be used. The challenge of where the NHS is at right now, is that lots of fragmented technologies have been deployed in response to COVID-19 as tactical solutions. If you look at video consultations as an example, there are many platforms being used, but still very few consultations actually take place via video. The vast majority of interactions have been by phone in healthcare, as opposed to video for social connection during lockdown. Part of the reason is habit; we are all used to picking up a phone and speaking to people. It’s comfortable and intuitive to answer the phone. Despite the advent of zoom, many still don’t have the IT literacy to use apps/video conferencing solutions. We need to get the right technology in, but be strategic and ensure we test and train staff and patients to feel comfortable using it, just as they are using their phones. Otherwise, technology gets in the way of delivering healthcare.”

“The biggest take home is that we need to change the approach. We need a longer term strategic strategy to ensure we deploy technology which has the power to enable us to transform and reimagine the way we both focus on health and wellbeing, as well as deliver healthcare when it’s needed. This has to be done at a population level using the boundaries created by STPs.”

“Only 6 months from now, all STPs will need to become Integrated Care Systems (ICS). But integrated care requires integrated information. Digital, therefore, has to be the golden thread which flows through and enables these new ways of integrating care. Modern, fit for purpose integrated digital platforms will be critical to provide both the real-time, high quality data and functionality required, but centred around the whole person. At the heart of these new ICS, there will therefore need to be a single source of truth, which a single integrated EPR solution can provide. From there, the strategic vision should enable all health and care organisations to use the same information platform to move towards creating an ECR.”