The relevance of accessing up to date patient’s medical information is no longer a topic. Yet, there are still opportunities to improve the overall efficiency and experience of professional users with the existing systems in order to optimise the time needed to get the proper information.
The growing number of chronic conditions and mental health disorders followed by a multidisciplinary approach to disease management has increased the need for the information exchange between healthcare organisations and individuals. Not only it should involve the exchange of medical information between different healthcare information systems, but also a proper and easy-to-use representation of the data shared, that professionals can read and use at a glance. The treatment of the patients without proper medical background information is hazardous and should be avoided.
The challenge
Essex Partnership University NHS Foundation Trust (EPUT) is a UK organisation that provides community health, mental health and learning disability services for a population of approximately 1.3 million people throughout Bedfordshire, Essex, Suffolk and Luton and employs almost 6,000 members of staff across 200 sites.
Following EPUT’s incentives, namely:
- Short-term Incentives: replacing the existing professionals’ application in order to modernise and improve the overall user experience;
- Long-term Incentives: modernise and further develop a foundation for the future health service offering enhancements – such as enabling coordinated care closer to patients outside hospital walls by enabling access and exchange of relevant patient data between different levels of care;
the NHS organisation has contracted Parsek in order to improve the overall existing service accessibility and delivery.
The aim
To increase the competitive positioning, balancing expenses and introducing process improvements in mind, the following customer objectives are being considered:
- Improved and supported decision making as many patient consultations take place without access to Mental Health reports, or lacking information to help make informed decisions on patient care and pathways;
- Minimised efforts and costs of current information inquiry and information exchange and to better deal with these as the majority of the existing processes are optimized for paper-based communication and limited interoperability;
- Faster time to result as standard ways to obtain information take days to weeks;
- A solution that is easy to use in the contrast to the existing information systems and the ability to access data across organisations;
- Setup of a scalable framework that can expand to 360 degrees coordinated care for people with mental health diseases.
The solution
The majority of process improvements within the EPUT Professional portal is concentrating on reorganising the existing care and administration processes to enable:
a) Information sharing between NHS Secondary care & Social care:
- All-time secure and prompt access to Social care information (Approved Mental Health Professional (AMHP) reports) from Essex County Council (ECC) staff
- Access and visibility of live integrated patient notes & records held by EPUT NHS Trust from ECC sites and ECC remote workers
- Accurate information to improve patient outcomes due to informed decision-making
b) Sharing EPUT Patient Summary Report with GP Practices
- Access and visibility of live integrated patient notes & records held by EPUT NHS Trust from GP sites in a structured and accurate manner for greater efficiency when searching for key patient information.
How it works
Using the solution, the EPUT professionals are offered to:
- access the application effortlessly using the existing credentials (AD integration);
- easily search a patient by their NHS number, first & last name, date of birth… ;
- view patients’ details (patient demographics, Patient documents, Patient summary);
- access and view the documents from various repositories using a regional interoperable backbone.
Registration & login
The professional users must be registered in EPUT Active Directory (AD). An EPUT system administrator sets specific permission in Active Directory to allow access to the application.
At first login, a user account is created in Vitaly Identity Provider (IdP). The following user’s data are retrieved from the EPUT Active Directory: Unique ID, First Name, Last Name, Organisation.
To log into the application, the user must enter existing EPUT AD user credentials (user name and password). After successful log-in into the application, the user is redirected to the Search screen.
Patient Search
When the professional users are logged in, they can easily search for a patient by using the search field, advanced search option or can locate the patient from the Last viewed patients functionality.
Search can be done using Patient NHS number so that professionals can easily locate the patient they are searching for. Upon entry, search results are shown as a list in the Display area. The list consists of basic patient information relevant for the professionals, such as Patient’s full name, NHS number, date of birth, gender and address.
Figure 1: Patient search results list
Patient information view
Patient Summary
Professional users can easily access and view Patient Summary which contains a comprehensive overview of general patient information in a structured manner. In this way, the responsible professionals can quickly find and review the most relevant patient documentation and additional information that can support them in decision-making about patient’s further care.
Patient documents
Professional users can access and view patient documents (retrieved from the system). They can see the documents from two separate categories: Current and Historic, which allows them to see the patient’s most recent and historical medical background documentation. They can sort documents in each category by document name, type, date, author and format and can also preview and download the document directly from the application.
Figure 2: Patient‘s document listing
Professional users can narrow down the document list using Filter option, which enables them to effortlessly find the exact information they are looking for, by selecting document type, document author (specific author or all), document creation date (from-to).
Adopted standards and integrations
The solution is built on open standards and consists of following IHE profiles and integrations:
- Patient Demographics Query (PDQ)
- Patient Identifier Cross-Referencing (PIX)
- Cross-Enterprise Document Sharing (XDS)
- XDS Registry Integration
- XDS Repository implementation with the ability of 3rd party access (for integrating additional 3rd party systems
- Audit Record Repository integration with Vitaly being audit event source (ATNA)
- Integration with existing affinity domain (existing regional backbone).
Estimated benefits and impact
For professionals
- Improved support in decision-making processes due to comprehensive patient overview and essential patient information at a glance (e.g. diagnoses (clinical problems), past operations, appointments and other relevant background information);
- Greater productivity due to less paperwork and unnecessary administration;
- Decreasing professional workload powered by easy-to-use application and structured data for more efficient governance and cost optimisation.
For patients
- Better care options and quality of care due to comprehensive patient data overview with up-to-date medical information which enables professionals to accept better decisions about patient’s future care.