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HTN Feature: Digital Social Care

In a two part series we explore some of the programmes and technologies supporting social care digitisation. In this part one of the series we speak with interoperability specialists Healthcare Gateway to explore data sharing, to hear about their work with the Local Health and Care Record Exemplar (LHCRE) programme and to discuss some of the challenges faced when delivering interoperability projects.

Matt White asked Liam King, Director of Customer and Commercial Experience at Healthcare Gateway a few questions:

Since we last spoke, what has been happening in the realm of data sharing?

We have continued to do what we do which is the rapid deployment of real time integration between systems; In Cumbria we have extended the reach of our programme to include connectivity with adult social care. It’s an exciting project for us as a business to be working alongside health and care providers in the county and our partner Liquidlogic to provide a connected Health and Care community.

The project is the reciprocal sharing of health and social care information embedded into systems in use by health and social workers. By having a complete picture of an individual’s health and social care, clinicians are better prepared for challenging situations, preventing escalating social care needs and are supported in safeguarding work.

We are also in advanced talks with organisations in the midlands to provide social care data to healthcare settings; which will provide the same benefits as Cumbria, but with a different set of clinical systems.

What are some of the challenges with connecting health and social care?

One challenge is for care homes and domiciliary care to share information; it’s suggested that up to 70% of the records are on paper. The challenge is how do we create and make that available digitally. Our teams are working with health and care colleagues to define what that data looks like in paper form, digitised, and then how it can be best shared in real-time with clinicians and healthcare workers involved in a patient/citizen’s care.

The social care dataset we provide is available in structured and HTML format, which means the consuming system has flexibility of how the data is integrated, to allow for optimum use and benefit.

Could you tell me about one project during Covid that has made an impact?

In the early stages of the pandemic we were asked by the OneLondon Local Health and Care Record Exemplar (LHCRE) programme to support a rapid expansion.

The system was quickly expanded in less than six weeks to support healthcare teams across seven major hospital trusts with access to information on vulnerable patients with COVID-19 symptoms. This meant urgent care staff across London could access around 8 million GP records, this was information they could not access to before, but vital during the situation.

Is data sharing across regions and borders becoming more efficient through development of the MIG?

MIG can be used to provide simple connectivity between multiple settings. Regional sharing across multiple systems and settings in a local health and care economy is also supported.

What we have seen more recently, is the drive to connect health with care, the regional shared records have become much bigger and one of the outputs from that is how MIG deal with the cross boarder challenge.

No matter where you draw your boundary; patients will cross them; therefore, the connection of regional data sharing initiatives to one another has been incredibly important. As a scalable solution MIG can be used locally, regionally or nationally.

What are the challenges that you’ve faced in creating interoperable systems across regions?

The challenge is getting systems to talk to one another and standards or language of connectivity, this is something the MIG has always done. We translate one data language into another in order for that to be understood across systems.

Over and above the standards, a challenge has been defining the data to be shared. ‘What information should we share in a specific care episode’ to ensure we are giving clinicians the right information and not everything ever recorded for a patient. For example our EMIS GP Journal View Dataset displays a 12 month timeline of all coded and free text entries, giving clinicians that valuable deeper insight, allowing everyone involved in a patients care that finer detail, it’s paramount for patient safety.

Another is information governance, the legal framework of sharing. The COPI notices released during the Covid-19 pandemic, have helped to speed up this part of our delivery. It will be interesting to see if we roll back to a more rigid data sharing model; customers have suggested that this may remain in place after Covid-19. Governance is also a challenge, Healthcare Gateway governance experts have been working through this challenge with our care home and other third party sectors involved in a patient’s care.