FHIR spreads to Bristol as Connecting Care embraces open standard

Bristol’s shared record programme has gone live with an interoperable FHIR data standard for a project aimed at cutting drug abuse-related deaths.

Bristol City Council is using a Care Connect FHIR application programming interface (API) developed by INTEROPen and NHS Digital to link its Theseus substance abuse management system with the Connecting Care shared record programme.

The programme is underpinned by technology from Orion Health. The supplier said the go-live was one of the first examples of the the Care Connect FHIR APIs being used within a shared care record initiative.

Theseus is being used by the council to reduce the risk of substance abuse by homeless and vulnerable people using prescription drugs, namely by helping eliminate duplicate prescriptions.

The Care Connect FHIR API allows the system to interface with the Orion Health Clinical Portal to find out if a listed patient has been prescribed controlled drugs.

Mike Taylor, lead GP at the Homeless Health Service in Bristol, said: “GPs working ‘in hours’ or ‘out of hours’ now have a reliable, quick, efficient way of knowing whether the patient in front of them is receiving opiate substitutes from drug workers outside practice-based care.

“Clinicians in hospitals can also be aware of this source of prescription. This has real potential for saving lives and reducing drug-related deaths.”

NHS England commissioned the development of the Care Connect APIs to make it easier for health and care services systems to share healthcare data using the HL7 FHIR standard.

The Care Connect FHIR initiative began in 2016 under attempts to simplify integration and interoperability within UK health and social care.

The new interface is now live in Bristol across 27 organisations, including 85 GP practices, NHS hospitals, mental health and out of hours services, social services, paramedics, charities and hospices.

Emlyn Jones, technical lead for the Connecting Care programme, said: “Our long-term goal is to create a consolidated list of medications for each patient, and this is the first step in doing that. So, we were looking for an interface that we could re-use, and the FHIR profiles felt like a good fit.

“We spend a lot of time in the tech community talking about FHIR, and this seemed like a good opportunity to try it. FHIR is polished by being used. By doing things, we get them right.”

The use of interoperability standards like FHIR have been championed by health secretary Matt Hancock, who has gone so far as to suggest that clinical vendors risk losing business with the NHS if they don’t embrace data sharing.

In a therefore timely move, System C & Graphnet Care Alliance last week pledged commitment to ‘full FHIR support’ for all its shared records, EPR, child health and social care systems.

The go-live in Bristol makes South Central and West Commissioning Support Unit (SCW) one of the first health organisations to use the open standard.

Amir Mehrkar, GP and co-chair of INTEROPen, said: “Members of the INTEROPen collaboration have co-produced a set of national Care Connect FHIR profiles over the past year, so it is wonderful to see real implementation of these interoperability standards in the service.

“There is a lot more work to do but this is an important example of how sharing clinical information stands to make a real difference in patient safety.”