Healthcare Interoperability Preview

Brian Derry, Connecting for Health’s Informatics Review programme director

Brian Derry, Connecting for Health’s Informatics Review programme director, one of the speakers at E-Health Insider’s 30 October Healthcare Interoperability conference and exhibition, tells EHI editor Jon Hoeksma why interoperability underpins the future digital NHS.

We live in a connected information age, of e-mail, mobile phones and the internet. In most spheres of our lives we take it for granted that using our phone we can call someone or if we send an e-mail it will reach the person we send it to. The underlying technology doesn’t matter to us, we just expect it to work reliably.

Healthcare, with its unique complexities, still has a long way to go before patient information is so easily and readily available at the point of care by clinicians. But achieving interoperability, and as a result achieving much more easily available data, is the underlying goal of all those working in healthcare IT.

This is not just a technological argument. Healthcare delivery in the NHS, and in many other countries, has long been hindered by patchy, disconnected data. Joining up different systems and islands of data directly translates into better patient care.

But now there is a new imperative: unless patient data follows the patient, the locally delivered health service of the future set out by health minister Lord Darzi in the Department of Health’s NHS Next Stage Review will not be possible. The future NHS requires that integration happen much more widely than just within the walls of individual organisations.

“Interoperability is a destination rather than a technology. It’s the means by which information is shared between those who need to have it,” says Brian Derry, Connecting for Health’s Informatics Review programme director.

He says that sometimes the technical underpinnings of interoperability – such as data and messaging standards – can actually be a distraction from the compelling message about what it enables. “Clinicians know they want all of the information they need to treat a treat patients.”

Derry says clinicians don’t need any convincing of the benefits of having all the data they need at the point of care to treat a patient. “Clinicians are personally accountable for their decisions and actions to an extent few other people are.”

But he adds the challenge is no longer to just deliver data to one clinician within one organisation. The move to locally delivered care delivered by multi-disciplinary teams means interoperability is no longer just important- its now essential: “Healthcare is now delivered by a range of organisations and professional teams, working from multiple locations. So information must be able to go with the patient. For me that is what interoperability is about.”

He argues that Lord Darzi’s Next Stage Review maps a future in which health communities will increasingly be defined by interoperability. “Health communities will be defined by interoperability, the extent to which they are able to work together and use common standards such as SNOMED CT.”

“We are defining health communities around patient pathways, rather than institution, organisation or groegraphy. That is the challenge,” says Derry. An individual clinician is likely to belong to more than one community, some of which will overlap.

Derry says that the development of such digital health communities will be gradual until the NHS moves away from today’s mixed economy of electronic and paper. “At the moment even digital GP practices get some discharge summaries and test results on paper that they still have to get onto their systems.”

While there is still much to do he says the balance is decisively shifting away from paper to interoperable electronic systems. “We are already seeing signs of this trend with the Summary Care Record, GP2GP record transfers and electronci prescribing. These are all important steps but there is still a lot of integration to be done.”

He says that the implementation of integrated Picture Archiving and Communications Systems (PACS) across England is a great example of the benefits of interoperability in action.

Derry adds that while developments like PACS rightly grab attention the systems that enable the health service to run are just as important. “People need to understand that service administration is absolutely central to good patient care. The patient administration functions must be integrated into patient care. We need seamless systems.”

He said that the whole point of CfH is to support patient care, with achieving interoperability being one of the guiding principles. But to achieve this the agency, NHS customers and suppliers have first had to put a lot of effort into building the key technical infrastructure needed, like the NHS Spine, and N3 network. “We now have that vital infrastructure in place.”

Brian Derry will be one of the speakers at E-Health Insider’s 30 October Healthcare Interoperability conference and exhibition, Birmingham, England. For full details and to book to attend visit www.healthinteroperability.com