Mark Hindle, Vice President EMEA at Orion Health

Although part of the UK, the healthcare system in Wales has been designed to best serve its population of 3.4 million. Wales has successfully built a national approach to data sharing between organisations, developing the Welsh Clinical Portal (WCP) that brings together information from different healthcare settings. Live since 2011, this consolidates care documents, test results, GP information and more into a single view.

With the WCP in place, historically the region hasn’t faced the same challenges around data sharing between primary and secondary care settings as we’ve seen in England. The Portal, and all the great work Digital Health and Care Wales have done to enhance it over the past 12 years, provides a strong foundation to move to the next phase of data sharing capability, integrating community care information.

The potential for Wales  

Wales has been working on integrating health and social care services to ensure a more coordinated and seamless approach to health and care.

Currently, the WCP does not integrate information from mental health, social care and other community care services. Patients move between these settings, as well as between acute and primary care, all the time. The lack of a single, holistic view of patient information means that care teams often make decisions without a complete picture. In recognition of the fact that data must follow the patient to enable the best care at every touchpoint, Wales is planning to procure a wider-reaching shared care record (SCR) this year. This would be a national system, able to share data across its primary care, acute care, mental health, social care and broader community care system – enabling a joined-up approach.

With this holistic patient view in place, the benefits will be widespread. Social workers will have fewer wasted visits to patients who have already been admitted to hospital, the hospital discharge process can be sped up with better workflows between acute and community care and clinicians in emergency care can take into account medications prescribed by mental health services; the use cases for positive impact on care are almost endless.

Without this full picture, there is a risk that clinicians make suboptimal care decisions without access to all of the information they need, patients fall through the cracks between care settings, are kept in hospital longer than they need to be and become frustrated repeating their information to multiple providers involved in their care. The new shared care record can potentially make concerns like these a thing of the past.

One of the most advanced shared care records in the UK. 

We often look to our peers for inspiration, and for an example of a mature and successful shared care record, Wales could look to one of its neighbours just across the Severn Bridge. 

There are clear parallels that can be drawn between the digital maturity that Wales’ healthcare system has in place now and where the integrated care system for Bristol, North Somerset, and South Gloucestershire (BNSSG) was when it began its SCR Journey. 

Before the SCR was procured, the region was experiencing an above average growth in unplanned hospital admissions and a disconnect between its health and social care systems. But the introduction of The Connecting Care Programme means BNSSG now has in place one of the most advanced shared care records in the UK, encompassing community care settings including care homes, health visitors, school nurses, children’s and adults’ social care, mental health and more.

Since going live in 2013, a huge amount of innovation in information sharing has seen Connecting Care become a trailblazer in areas such as interoperability, partnership working and developing a rich source of citizen information, with over 20 IT systems now contributing data.

One such innovation was the formation of the Community Integrated Care Bureau (CICB) in 2018 by 10 stakeholder organisations. It consists of three community health and social care hubs that provide rehabilitation before a patient returns home from hospital. 

The CICB set an ambition to manage its patients through the Connecting Care shared care record. To achieve this goal, the CICB Tracking Form was developed, a digital tool that facilitates rapid, seamless and effective transition of care from an acute bed to the community. It supports the visibility between the referrer and onward care providers in terms of what has happened, what is happening currently and what still needs to happen for each patient to enable safe and efficient care management.

As a result, CICB, acute hospitals and other relevant care providers can monitor where a patient is at any point in the assessment, intervention, and discharge process from within their clinical workflow. The solution has allowed the CICB service to safely manage more referrals, remove care variation, provide visibility back to service providers and deliver a better patient experience.

Paving the way to innovation

Rich data is key to how healthcare systems operate going forwards, and a SCR is a data treasure trove. With this SCR implementation, Wales should keep in mind the need for a future-proof data strategy. Ensuring that the SCR can work with a health data platform that will enable data to be captured, standardised and analysed paves the way to make smarter use of this great strategic asset. 

Imagine what a difference it would make if it was possible to leverage AI to analyse the vast amounts of data within patient records, quickly and accurately, to provide snapshot summaries, identify patterns, help predict diseases and recommend interventions. Or if we could help reduce the administrative burden on hospitals by automating tasks that should be simple, like appointment scheduling or extracting national returns. 

Ultimately, the new shared care record for Wales signals a step change for patient care, both in the immediate implementation and in the future opportunities it opens up for smarter use of data. With improved patient care and clinician experience plus reduced system wastage and pressure on acute services, everybody wins. By embarking on a shared care record built on modern technology whilst considering a long-term data strategy, Wales just might leapfrog any other programme in the UK.