Sean Riddell explains why sharing patient information is vital in the new NHS and how clinical commissioning groups can make it happen on the ground.
Sharing patient information across the wider healthcare team is not only desirable, it is a must if clinical commissioning groups are to deliver more efficient care outside institutional settings to an increasingly elderly population with multiple health needs.
It is always worth reminding ourselves of the tangible benefits of mobilising patient data; evidence shows it delivers efficiencies and higher-quality patient care.
For example, in Cumbria, access to patients’ GP medical records has freed up 15 to 20 per cent of clinical time for community healthcare teams. Community services no longer go chasing GP records any more – and the GPs know what is going on in the rest of primary care.
In Liverpool, record sharing has enabled a community-based anti-coagulation service to deliver 13,831 local consultations that would normally have been done at a higher cost in hospital. Consultations were also delivered closer to people’s homes; 1,002 patients were treated with 15 minutes of their home.
In Cheshire, a record-sharing project is giving around 4,000 healthcare professionals – including GPs, district nurses and physiotherapists – access to patients’ records to provide the type of integrated care that CCGs are looking to commission.
Record sharing on a large scale is not easy to achieve. In my view, there are two main hurdles. First, people. You can’t open up access to patients’ records without getting clinicians – particularly GPs, who hold the richest patient data – on side.
Quite rightly, their principal concern is patient confidentiality and they need cast-iron assurances that this will not be compromised.
Cheshire is a good example of how to achieve this. When seeking to implement an ambitious record-sharing project across eight organisations in central, eastern and western Cheshire health communities, the local ICT project team tackled GPs’ concerns head on.
They knew they would have many questions and so made time to meet with them face to face to explain the benefits of the project and the security aspects.
It was agreed that all access would be recorded in the audit trails of the viewing and sharing clinicians. The resulting system prompts clinicians to request the patient’s consent each time the record is accessed, and then makes a record of that consent, before allowing any shared data to be viewed.
The second hurdle to sharing patient data is of course the technology. I am increasingly seeing demand from CCGs for truly integrated healthcare systems. These enable clinicians in the same locality working across services to use a common system that shares the patient record but is tailored to their own specialty.
Patients benefit from truly integrated care – with pathways seamlessly plotted across different healthcare teams and supported by a common approach to referral management. Cross-organisational appointment-booking can be delivered – reducing paperwork and administration for the CCG as well as saving time and hassle for patients.
Clinical safety can be improved through a standard formulary, protocols and embedded decision support.
Ultimately it is for individual CCGs to decide the best way to achieve a shared patient record, in line with local needs.
Here are some important points to consider when making your decision:
- What you want to achieve through data sharing. Consider whether it is simply to give clinicians/ managers access to raw patient data using interoperability, or to go one step further and create your own integrated care “ecosystem”. This can enable clinical efficiencies through more co-ordinated working practices.
- The information needs of the care pathways and standards you want to introduce. Common formularies, templates, protocols and workflows will create greater synergy between different teams.
- What your users want. Consider the systems staff are used to and their vision for how technology can help them deliver better patient care.
- What your patients want. Patients usually welcome shared record access as it delivers better informed care. But you may also be able to use technology to make their lives easier and involve them more actively in their own care – for example, by introducing a common patient transactional portal across your health community.
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