Report highlights five recommendations for interoperable health records

The Institution of Engineering and Technology (IET) has published a new report that focuses on interoperability of health and care records.

The document – entitled ‘The Digital Advantage – Realising the benefits of interoperability for health and social care in England’ –  highlights five new recommendations needed for a new, national initiative to achieve interoperability.

Authored by Liz Heron, an independent writer, the report was reviewed by members from the Academic Health Science Network, suppliers, NHSX (at the time), PRSB, All-Party Parliamentary Health Group, Innovate UK, Lincolnshire NHS, The King’s Fund, Oxford University Hospitals and NHS Digital.

The report explored the challenge of achieving interoperability and analysed accomplishments to date through a series of case studies. One of its aims was to define and summarise the next set of interoperability challenges that need to be overcome and the steps that should be taken to get there.

The report gives five key recommendations for a new, national initiative. They include:

  • Introduce legislation to underwrite agreed national data standards and mandate NHS organisations and social care bodies to use them for patient records
  • Extend the 2024 deadline for NHS trusts to achieve a “core level of digitisation” to take account of the impact of COVID-19
  • Publish a technology implementation plan for health and care that sets a budget with clear milestones and measurable actions for achieving full interoperability
  • Provide seed funding for accelerated trials of the Trusted Research Environment model to address questions such as how to accredit participating researchers
  • Commission a data security team to help NHS trusts meet the Cyber Essentials Plus standard introduced after the 2017 WannaCry ransomware attack.

One of the case studies presented in the paper, included a focus on interoperability in Estonia, ‘one of the most advanced e-health systems in the world’, the paper suggests.

The case study notes that the Estonian National Health Information System (ENHIS) holds more than 40 million health documents and is used by 99 per cent of all patients. It also includes ‘an e-Health Record accessed through a Patient Portal’, ‘an e-Prescription system linked to every pharmacy and hospital in the country’, and an ‘e-Ambulance service that can locate phone requests for an ambulance within 30 seconds’.

The country highlights the benefits of its blockchain technology, ‘Keyless Signature Infrastructure (KSI)’, for the security of patient data and cyber security.

Professor Peter Bannister Executive Chair, IET Healthcare Sector and Vice President Life Sciences, Ada Health said: “Until recently, healthcare interoperability has been regarded as a goal in and of itself but as this report highlights, it is more correctly viewed as a methodology which can be delivered through a framework of governance, standards, skills and best practice to enable integrated, patient-centric care while also allowing for rapid adaptation in a truly agile manner to respond to global pandemics.

“Interoperability goes beyond healthcare systems being able to share information: it necessitates a robust, trustworthy approach to patient data handling and its implementation needs to be considered in the context of equitable health and care provision to prevent situations where large disparities can quickly arise between siloed systems and their respective patient populations.”

Dr Lisa Cameron, MP and Chair of the All Party Parliamentary Group (APPG) on health, added: “The interoperability of medical records in the NHS is a very daunting task. Obstacles arise including the sharing of highly sensitive personal health information. Shared health record systems have to conform to the UK’s strong legal protections for patient confidentiality and link up technologies developed within a complex network of organisational silos.

“I would like to sincerely thank the IET and all contributors for constructing this report. It highlights key elements of a framework for interoperability.

“There must be robust protections for patient confidentiality; national data and content standards; localised delivery of integrated patient records; and development of the health informatics profession and I support the IET’s work in this area.”