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Informatics powering value

Gary McAllister, Chief Technology Officer for Our Healthier South East London and Guy’s and St Thomas’ NHS Foundation Trust, blogs about the value of using informatics to improve patient outcomes, the third blog in our Value Based Healthcare series. 

Gary McAllisterDigital is everywhere and is integral to how we carry out our day-to-day activities. We have adopted the use of information platforms for our shopping, banking, and travel. Online information systems are also used when we renew our passports and submit our tax returns. This is some of the most sensitive data any system can hold on an individual.

It is therefore disappointing that healthcare is so far behind the times in the use and provision of digital services. Across King’s Health Partners and the broader Sustainability and Transformation Partnership (STP) we are working hard to improve the digitalisation of healthcare. It is our ambition to create a single repository of information for our patients to support improved outcomes, enable research, and allow our patients to contribute towards and manage their own care.

As voiced by Professor John Moxham, ‘a value driven NHS can only be achieved through the sharing and use of high quality data in an open and transparent way’.

Watch Professor Moxham's short video on informatics, part two of our Value Based Healthcare miniseries: 

We believe that information is vital to improved outcomes as without information we are unable to measure our treatments effectively. Information is also needed to allow us to measure the broader outcomes of our services on the local population. Without the use of good information and analytical services our approach to healthcare is likely to remain out of date and unsustainable.

It is equally important that we allow our patients to contribute to their record and provide us with continued feedback on their care. It is our longer term vision, aligned to the personalised health and care 2020 strategy, to provide a series of scalable digital services that allow our patients access to their information from the technology that is most accessible to their needs. In the interim we will continue to see discrete patient accessible solutions until the ultimate aim of a single consolidated and interoperable record for the patient is achieved.

This is not an easy problem to solve as we continue to respect the information governance needs of the health service. Information governance is a really important part of the jigsaw to allow safe access to information and must be correct before we progress at scale.  Our information governance forum is working to ensure our digital strategy for King’s Health Partners is scalable and safe as we move forward.

LCR total cumulative viewsWe have had huge success across our partnership with the development of the Local Care Record, a portal that joins information between GP’s, hospitals, community and mental health providers. This platform is now accessible to all care providers across Southwark, Lambeth and Bromley supporting the direct care of our patients.  Our plan will see this service integrated with social care in 2018. On 5 March 2018 we switched on access to our partners in Lewisham, Greenwich and Bexley, creating a Virtual Care Record for the south east of London, supporting our STP ambitions, connecting 1.7m patient records at the point of care.

[The graph shows that a total of 1,870,869 patient records have been viewed through the Local Care Record as of February 2018]

This transformation will improve outcomes and value for our patients as information can flow across borders which were previously closed. Users of the Local Care Record have reported reduced duplication and improved quality, efficiency, and safety of care we provide across our region.

LCR unique viewsAs well as the Local Care Record our research platforms across King’s Health Partners are exemplary, the Digital Diabetes programme is bringing together diabetes information across our network, CogStack is providing a Google-type capability for our patient records, and the use of the Clinical Record Interactive Search (CRIS) platform at South London and Maudsley NHS Foundation Trust leads the way in mental health research. Our research data continues to contribute towards personalised care with our contribution towards the national 100,000 Genomes Project. Personalised care will deliver greatly enhanced outcomes for our patients.

[The graph shows that 443,638 patients had their records viewed through the Local Care Record as of February 2018]

Although we have made significant steps forwards we still need to focus on the basics.  The way we capture information at the point of care needs to be standardised to support system wide measurement.  Our focus on the ‘Vital 5’ of blood pressure, obesity, the mental health score, alcohol intake and smoking habits can only be measured with the standardisation of data capture across the sector.  We will need to start with small steps here, broadening the standardisation of data capture as we progress our informatics strategy.

It is important that we do not stop here, we must continue to develop digital services across our partnership and beyond, focusing relentlessly on improving outcomes for patients. The next step is the creation of a system wide interoperable data platform, putting our data into a single place so that we can analyse and provide access to the information easily. This approach will allow our patients, researchers and operational staff a complete view of the healthcare system, enhancing the end to end pathway experience so that every interaction with our services is one that increases value.

Read previous blogs from our Value Based Healthcare series:

Better outcomes drive better value – Professor John Moxham
Improving Value at King’s Health Partners – Professor John Moxham

Read more about Value Based Healthcare at King's Health Partners.