Comment: Healthcare data - data silos in NHS a risk to patient care?

Dr Saif Abed, chief medical officer at BridgeHead Software, discusses the essential role of data in delivering patient care in the NHS

In this article, Dr Saif Abed, chief medical officer (EMEA) at BridgeHead Software, discusses the essential role of data in delivering patient care in the NHS, arguing that the move to digital has just shifted paper online and that multiple data silos still exist, impacting on health providersí ability to provide care across organisations

Dr Saif Abed

When it comes to delivering excellent healthcare, all clinicians rely on one critical resource - data.

Not just any data mind you. It has to be from a credible source such as the patient, a relative, another healthcare professional, or a responsible agency.

Once again, having a single repository that takes ownership of the data should be a far-more-effective way of providing access to clinical information, especially as it would not be affected by the application ecosystem around it changing over time

Medical devices only communicate point-of-care data, such as heart rate, ECG trace, and blood pressure, rather than the rich qualitative data of a patient history.

One of the challenges for clinicians in years gone by was that it would often be difficult to access paper records purely because of the physical barrier of the records being in a different location.

Yes, paper records could be scanned, faxed or sent, but most clinicians would simply repeat taking a patient history rather than wait.

So, what would someone like me have to do when seeing a new patient?

Iíd have to take a complete patient history from scratch based on only the information that was handed over by another clinician or perhaps a referral letter.

In a world where patient care was becoming more demanding against a backdrop of less time, this clearly was not going to be a sustainable way of doing things.

The future was clearly digital and slowly the NHS started to adopt IT systems as a part of a journey to being paperless. However, this created its own digital version of the paper record problem I described before.

Essentially, if a patient needed to visit multiple healthcare organisations in their region, multiple data silos now existed, linked to applications in each of those places.

However, none of these systems had a means of being linked together to share or access data.

Clinical effectiveness is increasingly measured by the ability of healthcare organisations to provide high-quality care in a timely fashion

Clinicians, to this day, have to see and create management plans often with incomplete information because of barriers to access.

This is a pressing problem as the patient population is becoming increasingly complex as they have multiple conditions at any given time requiring multiple treatments and interventions.

This all begs the question then of how can we make it easier for different healthcare organisations to still use the applications that they prefer without hampering care co-ordination?

One way to consider doing this is having a central hub of data that is primed to be able to access and share data without being restricted by application specific proprietary tags.

Having an Independent Clinical Archive (ICA) like this would form a type of health information exchange that supports clinicians within an organisation to have a single source of truth, while allowing clinicians in other organisations to access specific data they need in a way which is compatible with their applications and viewers.

Achieving this type of outcome is great not just from the perspective of the clinical user experience, but at a strategic level too.

One of the common themes evolving in Sustainability and Transformation Plans (STPs) and their associated Local Digital Roadmaps (LDRs) is a focus on integrated care. A lack of application interoperability is clearly going to hamper achieving this goal. Yet, trying to connect all these disparate applications together with one another would be tremendously time consuming and expensive.

It makes sense to manage clinical data in a way that opens it up to sharing and access across regions rather than being trapped in application silos

Once again, having a single repository that takes ownership of the data should be a far-more-effective way of providing access to clinical information, especially as it would not be affected by the application ecosystem around it changing over time. You are effectively futureproofing a core part of an LDR.

Clinical effectiveness is increasingly measured by the ability of healthcare organisations to provide high-quality care in a timely fashion. Indeed, there are growing calls to even change the way hospitals are reimbursed to emphasise outcomes rather than activities.

Given this is an inevitable direction, it makes sense to manage clinical data in a way that opens it up to sharing and access across regions rather than being trapped in application silos.

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