Sharing data across systems brings many benefits
What is systems interoperability?
Healthcare services gather a vast amount of information about patients. Traditionally this has been collected on paper and stored at the point of collection. But organising, storing and sharing data this way has always posed challenges.
Over the past 20 years, the benefits of moving from paper to digital have been widely recognised. In the move towards digital healthcare, services set about developing systems to meet their needs, but little thought was given to how these systems would communicate. What emerged were lots of systems all collecting data that could not be shared. Therefore, many of the benefits of digital healthcare could not be exploited.
Interoperability is the ability of systems within healthcare organisations to exchange and integrate data. This should allow the sharing of data from one department to the next or one organisation to another, breaking down traditional regional and national barriers.
Why is systems interoperability important?
It is believed that interoperability will improve patient experience and safety, and increase productivity while reducing costs. It will also support collection of health data for strategic planning and research.
Interoperability allows all of a patient’s health information to follow them no matter where they access care. This has the potential to improve the care experience for patients as they do not have to recount their medical history to numerous professionals. It could also be more efficient for clinicians because it is estimated that 25 per cent of their time is spent taking medical histories.
Interoperability can support patient access to healthcare by allowing them to see their records, communicate with healthcare professionals, book appointments and order repeat prescriptions on their home devices.
It allows systems to be combined. Simple barcode technology can link patients directly to their records and allow providers to know who the patient has seen, the procedures they have undergone and any medications, devices or prosthetics used.
Recording information like this directly to the patient record can provide a real-time audit trail and reduce the margin for error.
Decision-support tools are also being developed more widely where systems support clinical decision-making with the aim of reducing clinical errors and patient harm. For these systems to work efficiently, they must access health information from multiple sources.
In the UK, an estimated 237 million medication errors occur each year. Many of these relate to transition from one service to another, and to dispensing, administration and monitoring of medications. With an electronic system, alerts can be created for those with sensitivities, allergies and contraindications, increasing service safety.
The data captured within interoperable healthcare systems also supports audit and research, which is key to improving services and strategic planning. Patient information in paper format or held in systems that are not interoperable are notoriously difficult to extract data from.
Interoperability means data from hundreds of thousands of people can be collected and analysed easily and cheaply. It also provides the opportunity to use data for activities not directly linked to patient care such as:
Predicting health events, including epidemics.
Guiding workforce planning and policy development.
Transition to fully interoperable healthcare is not easy and is in its infancy. There are inconsistencies, with some healthcare trusts leading the way and others left behind. Many have outdated IT systems but upgrading them will be complex, costly and time-consuming.
As well as these practical difficulties, there are many issues around privacy, safety and the security of patient information. These can affect the sharing of data.
Examples of systems interoperability
The benefits of an electronic health record (EHR) have long been acknowledged. But the process of developing one is long, complex and fraught with difficulties, and interoperability is a major issue.
A fully functioning EHR should collate healthcare information from multiple providers and clinicians, allowing an individual’s record to be accessible wherever the patient is over a lifetime.
Leeds Teaching Hospitals NHS Trust has been leading the way, starting a project to develop an EHR back in 2003. Since then, it has been built upon and now shares data between 35 different systems across health and social care. The system has developed over time and now provides a comprehensive EHR. It includes:
Basic patient demographic data.
Allergies.
Care plans.
Consultation summary.
Problems and diagnosis list.
Medications.
Referrals, clinic letters and discharge information.
Test results.
The system provides an integrated care record for 2.8 million people, is accessed every 3.8 seconds and delivers 50 million pieces of information every month.
The Northern Ireland Electronic Care Record (NIECR) is a computer system that health and social care staff can use to retrieve a patient’s medical history to make sure the best care is offered.
The NIECR contains information from existing electronic record systems from hospitals and clinics, as well as data recorded directly in the system, where this is helpful to a patient’s care.
What should I do next?
Browse the following resources:
NHS England: Interoperability.
Leeds City Council and NHS: Leeds – Local Digital Roadmap.
NHS Long Term Plan (pp25-28, plus pp91-99).
Further information
King’s Fund: Interoperability and the NHS: Are They Compatible?
NHS Digital: Interoperability Toolkit.
YouTube: What is Interoperability?
Authors:
Christy Holland
Peter Cumpstone
Tommi Capstick
Edited by Daniel Allen