London shares urgent care plans

Thousands of urgent care plans for the chronically ill and dying will be shared between health and social care providers across London using InterSystems’ HealthShare.

Coordinate my Care provides opt-in urgent care plans for more than 20,000 patients in London and Surrey Downs, including information on the patient’s preferred place to die and do-not-resuscitate orders.

Rolling out from September, the programme will use HealthShare to electronically share these plans with staff in urgent care settings, including ambulance, NHS 111 and A&E staff.

Patients will also be able to access and read their care plans on the new system via an app being launched next March.

Dr Julia Riley, clinical lead at Coordinate my Care, said the programme currently uses a web-based platform that providers must log into to create an urgent care plan in conjunction with patients.

More than 8,000 clinicians across the city have been trained and given a password to access the information.

However, she said the web platform needs upgrading. While flags in the multiple clinical systems are used to show staff that a CMC plan exists for a patient, they have to log into a different system in order to view it.

"Clinicians love the principle and idea and with HealthShare we plan to make it a very seamless and easy to use care plan that’s interoperable,” she explained.

CMC general manager Kate Mansell said the interoperability of HealthShare is key as it will allow people to access and update the care plans within their own clinical systems.

This functionality is due to go-live for GPs using Emis in December, followed by TPP’s SystmOne and Vision. Next the team will work on embedding CMC plans in A&E systems. They are already available within out-of-hours services using Adastra and to NHS 111 staff.

“In the first instance it will be through buttons and seamlessly going to other systems; in the future we will move to a more seamless two-way exchange of information so we don’t have to move between systems,” said Mansell.

“We think with HealthShare we will see a large increase in the number of care plans being created as the system becomes easier to use and interoperability will help.”

The InterSystems platform will also allow people to use mobile devices to view care plans.

All patients with plans have given consent for them to be shared with any legitimate health or social care provider and for their anonymous data to be used for audit and research purposes.

Riley said the plans are created mainly by district nurses, GPs, hospice and hospital staff who know a patient well. They give direction for out-of-hours staff to handle the patient, helping to avoid unnecessary hospital visits and hospital deaths.

Coordinate My Care is also working with InterSystems to build an ‘integrated care exchange’, which will be developed using open standards and available to all NHS trusts to use to share information.

Mansell said: “this goes beyond urgent care plans. It might be that people want to create another data set for another care plan and use our platform to exchange that information.”

Steve Garrington, InterSystems’ vice president international, said: “coordinating care across London's large and complex healthcare community is a significant challenge.

“HealthShare, with innovative shared care plan technology, will enable joined-up healthcare by enabling care professionals to understand and respect the patient’s urgent care choices.”

CMC is commissioned by London's 32 clinical commissioning groups and is hosted by The Royal Marsden NHS Foundation Trust.