We are two\nyears into the local health and care record exemplar programme, which started\nin 2018, when NHS England announced the first wave of five LHCREs. A further\nthree followed in 2019.<\/p>\n\n\n\n
Since then, all\neight projects – Greater Manchester, One London, Wessex, Yorkshire and the\nHumber, Thames Valley, the Great North Care Record, Healthier\nLancashire and South Cumbria (which also includes Cheshire and Merseyside) and\nOne South West \u2013 have been on an interesting and varying journey; a\njourney which Orion Health has joined them on. <\/p>\n\n\n\n
When it\nannounced the LHCRE programme, the commissioning board said the aim was to move\naway from having \u201crecords distributed across various services\u201d and to \u201ccreate\nan information sharing environment.\u201d <\/p>\n\n\n\n
It argued that\nthis would help to integrate services, \u201csupport other functions, such as\npopulation health management and research\u201d and \u201cempower people to\u2026 make\ninformed choices about their own health and care.\u201d <\/p>\n\n\n\n
Each of the LHCREs\nhas taken different approaches to achieving this. For some, such as Yorkshire\nand Humber, they are taking a design and develop approach with software being\ndeveloped from scratch, based on the local technology landscape. For others,\nsuch as Greater Manchester where Orion Health has supported the supply of the\nRhapsody Integration Engine, there has been a \u2018best of breed\u2019 approach taking\nindividual components to develop an integrated care record platform. <\/p>\n\n\n\n
Others again, such\nas Thames Valley and the Great North Care Record, are working to develop their\nintegrated records through a single platform solution from individual suppliers\nto which other systems and integrated care records will contribute. <\/p>\n\n\n\n
In Wessex, there\nare already mature, local integrated digital care records in the developing\nDorset Care Record and the Care and Health Information Exchange (CHIE), which\ncovers Hampshire and the Isle of Wight. Since winning the contract to replace\nCHIE, Orion Health is working to further develop both care records and also to build\nout the Wessex Care Record as part of that journey. This will be achieved\nthrough information sharing from each of the care records at a local level and will\nsupport national record sharing too. <\/p>\n\n\n\n
It is essential\nthat technology-based change programmes in the health sector consider the full\nbenefits case, as they often tend to focus too much on the technology alone. This\nis a challenge shared with LHCRE development given the technology products and\nstandards involved.<\/p>\n\n\n\n
It is important\nthat we do not simply focus on technology for technology\u2019s sake and that each\nproposed development has a clear and developed benefits case. This should be aligned\nto the realisation of benefits for health services, for those that help deliver\nthem, the clinicians, and most importantly those that use the services – the\npatients. Orion Health is passionate about the development of technology, but\nequally so about the development of robust use cases. The evidence is clear, without\na benefits case defined prior to and during programme delivery, technology based\nprogrammes fail to deliver.<\/p>\n\n\n\n
Clinical leadership and patient engagement are of the utmost importance here. Notably, in our work in supporting the development of the Northern Ireland Electronic Care Record, we have seen the incredible impact of strong clinical leadership, both in developing the programme vision but also in the ongoing delivery of the programme. This in no small way contributed to the resounding success of their national Diabetes Care Pathway, which has a consultant endocrinologist at the helm. More recently we have seen the benefit of patient engagement in the Pathfinder Progamme for Dementia where service users have helped develop the patient portal used as a foundation of the programme, So, when we have been working with our LHCRE customers, we have said: we understand the financial case that you have to make, and we can help with that; and we understand the standards and technology that you need to use, and we can support that; but the thing that will make a difference is the development of a robust benefits case that will deliver for clinicians and patients. <\/p>\n\n\n\n
Developing\nlarge scale integrated digital care records is complex and challenging. LHCREs\nneed to consider the use cases not just at the top LHCRE-wide level, but also at\nthe next level down. Any successes within and across the individual organisations\nthat make up their footprints should be considered successes and be celebrated.\nAdditionally, these localised successes should be considered to be fully or\npart-replicated in other areas where possible. <\/p>\n\n\n\n
Using these use\ncases and technology cases already in place, tested and fully developed, can\nform the basis for success at a local service level and also at a regional\nlevel. As an example, Orion Health worked with Connecting Care in Bristol to\nuse national standards to deliver a FHIR Care Connect profile to share GP\nmedication data with organisations that work with homeless people. This reduced\nthe risk of the danger of duplicate prescriptions being issued for controlled\ndrugs, which can lead to overdoses and other serious adverse effects. <\/p>\n\n\n\n
Orion Health\nhas always been committed to the development of open data sharing technology\nstandards and is both a founder member and ongoing supporter of INTEROPen, the\nconsortium set up to accelerate their development and adoption in the health\nservice. INTEROPen was a key player in the development of the FHIR Care Connect\nprofiles.<\/p>\n\n\n\n
Joint working\nand the sharing of ideas across the health service also promotes the\ndevelopment of each care record. The development of the comprehensive Diabetes\nCare Pathway in Northern Ireland has led to the assessment of that technology\nfor the Dorset Care Record, who have in turn developed a Dorset-wide maternity\npathway. <\/p>\n\n\n\n
The full\nambition of the LHCREs could not be realised in two years, but the foundations\nto population health management are being progressed in each case. At Orion Health we support our customers\nthrough that journey with our interoperability and data maturity model. The\nmodel progresses through steps from the acquisition and aggregation of data,\nthrough accessing and acting on data, to the levels of population health\nmanagement and patient workflow management. These foundational steps can be\nbuilt on with machine learning and artificial intelligence which depend on a\nwealth of data to learn and refine functionality for a fully intelligent\nplatform. <\/p>\n\n\n\n
What this\nreally demonstrates is that the LHCREs are large complex programmes of change, and\nthat they take time. They require more than two years to be developed. Two\nyears feels like time enough only to start the development, rather than a\ntimescale for anything beyond that.<\/p>\n\n\n\n
The real impact\nof the programme has been to normalise the idea of interoperability, and to\ndevelop some useful, national standards for doing it. It has started to create\nthe foundations for data, so we can start to think more about what population\nhealth management means and about the role of advanced data techniques in machine\nlearning and AI. <\/p>","protected":false},"excerpt":{"rendered":"
We are two years into the local health and care record exemplar programme, which started in 2018, when NHS England announced the first wave of five LHCREs. A further three followed in 2019. Since then, all eight projects – Greater Manchester, One London, Wessex, Yorkshire and the Humber, Thames Valley, the Great North Care Record, […]<\/p>\n","protected":false},"author":6,"featured_media":15533,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[1],"tags":[44],"region":[27],"class_list":["post-2944","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","tag-population-health-management","region-uk"],"yoast_head":"\n