LPRES: Creating a single, integrated care record view accessible across all care settings (UK)

Challenge

In the UK the largest health organization NHS is fragmented for different regions, arisen historically therefore no standardized services overall the regions are provided. As modern healthcare moves away from the hospital to the community, especially for elder people who suffer chronic illnesses, it is widely acknowledged that a sustainable primary care is essential for a sustainable NHS. For example booking an appointment to a specialist the patient needs a referral from the General Practitioner (GP) while getting an appointment at GP has become increasingly difficult. At the same time with a growing and ageing population the GPs have to deal with more complex health problems – and as a result, their job is more challenging than ever before. So patients end-up going to hospitals which face problems as e.g hospital beds are over occupied, patients have extremly long waiting times for urgent situations. So supporting the communities and moving the care outside the hospitals is really needed as the NHS is still centred on the network of district general hospitals.

Remarkably, the administrative handling of total resources in the medical sector in contrast to other industrial branches is on incomparably lower level of informatization. In fact, the involved institutions are logistically poorly integrated and that’s why the overall administrative effort in manual handling is higher than the state of the art would require. Both of course results in higher costs and lower availability of the care services.

In the professional medical environment, we face estimated 60 million specialized jobs (doctors, medical specialists, nurses, laboratoy employees, pharmacists, medical administration, medical informatics, research, etc.), so we face one of the largest industries worldwide which has deprived the classic mechanisms of IT. In some cases this is desirable in other cases this is clearly directed against the interests of the patients (e.g. comparability of treatments, free and objective choice of the physician, patient rights, transparency of data use).

Aim

The aim is to provide a centralized technology platform to facilitate the exchange of information about 1.8 million citizens in Lancashire and South Cumbria region. The personal electronic healthcare record is going to be accessible from any internet browser (a smartphone, tablet or desktop computer). The citizen access will transform patient care by enabling new ways of working, e.g. less repetition of medical history each time treatment is accessed in different organizations as latest information will be available through interoperability – alongside the necessary data-sharing agreements once consent is given. This enormous advancement in IT and technological innovations in the health care sector support the NHS to bring it up to modern standards meeting the needs of the 21st century.

The potential benefits include:

• Faster real time clinical decisions based on comprehensive and more timely information;
• Improved continuity of care for patients across organisational boundaries;
• Reduction in prescribing errors;
• Reducing the number of diagnostic tests carried out;
• Reducing the length of stay due to accurate, up to date information to aid clinical decision-making;
• Improved patient outcomes due to improved self-management.

Many of the potential benefits from implementing interoperability are non-financial (qualitative) but are centred around putting the citizen at the heart of care provision, empowering care givers with real-time, accurate information and improving patient outcomes.

Solution

In collaboration with the NHS in the north-west region of the UK LPRES (Lancashire Person Record Exchange Service) as a centralised technology platform and programme delivers a joint approach to information sharing via the Health Information Exchange (HIE) supporting the mechanism of facilitating data exchange for citizens. Easy access to appropriate health information is provided by data sharing about patients and care givers across care boundaries. This enables the relevant data being availabble to the authorized members of the portal supporting timely patient care.

• The portal leaves the data secure with the information owner;
• The information owner has the control over his data and decides who can access and process with it;
• Extracted data sets can be used for research, benchmarking, improvment of treatments or effectivness of medication for civilazation dieseases like e.g. cancer or diabetes.