Lessons learned from the Welsh Clinical Portal

Digital Health and Care Wales (DHCW) – previously the NHS Wales Informatics Service – is at the centre of NHS Wales’ digital transformation, collating healthcare data to develop new programmes and interfaces, improving outcomes for staff and patients. One of these programmes is the Welsh Clinical Portal (WCP), and product manager, Griff Williams, considers the role that this technology has played throughout Covid-19 pandemic, including the successes, lessons learned and the next steps for digital healthcare in the future.

The first iteration of the Welsh Clinical portal (WCP) was created in 2011 with a vision of bringing together patient health care information into one common user interface. By 2016, the ministerial objective of ‘Once for Wales’ was realised through WCP users in all of Wales’ seven health boards. Currently over 29,000 healthcare professionals across Wales use the platform, with a repository of more than 36 million care documents, over 2001 million tests results and access to 3.1 million GP summary care records. The platform enables information sharing across care organisational boundaries, with 1 in 10 results being viewed from a different health board to that in which the test was performed.

Delivered benefits include visibility of all radiology imaging, reducing repetition of test, reducing medicines reconciliation times, improving safety and speed of services and releasing more time to health care professionals to care. The service has evolved with an award winning mobile app version improving accessibility on the move. The DHCW team are delivering e-learning programmes to upskill clinicians to use the system effectively and WCP is used by hospital staff, GP practices, pharmacies, emergency services and even in the helicopters of the Welsh Air Ambulance.

Successes, developments and expansions

The Single Record team, who are responsible for the continued development of the WCP, rapidly worked to expand and implement digital infrastructure needed to keep NHS Wales afloat amid the pandemic. This included supporting the coronavirus testing effort. The team created and implemented Electronic Test Requesting software used in test centres to improve turnaround times and laboratory efficiencies in processing swab samples safely.

The Single Record team accelerated the read and write capabilities within the digital record facilitating remote working clinics as clinicians often worked from home. Accelerating the use of a digital ‘discharge advice letter’ for inpatients improved care transfer, and linking with community pharmacy medicines review reduced inpatient stays.

Reflections on progress

The Single Patient Record, via the Welsh Clinical Portal, has grown exponentially since 2012, continuing to evolve how it supports the wider NHS. Now we can reflect on the challenges and lessons learned from the establishment of the Welsh Clinical Portal and wider Single Record services.

We began with the ambition ‘collect and share’ the patients’ health record along their care journey, aiming to provide a content rich digital record to professionals to facilitate the delivery of safe, prudent care. We collaborated with the end users, gathered user requirements and looked to prioritise the user’s needs. Engagement and collective buy in is not always straightforward and parts of the journey have been challenging and this is why it takes time. But by working with clinical and informatics networks across Wales, with a patient centric objective, many of the expected benefits have been delivered. The pandemic has made us re-focus on these objectives and realise that this is the best approach, as access to patient information for care is undoubtedly the most important part of what we deliver.

Looking to the future

The key priority for DHCW is expanding the digital record content. In 2021 we will bring in cancer centre records supporting oncology services, palliative care records and support screening and digital services for public and patients. These programmes are planned to deliver the ambitions set out in Welsh Government ‘A Healthier Wales’.  We have made a great deal of progress in the last decade and as we drive forward the digital transformation of health and care in Wales it is crucial that we continue to collaborate with our users and maintain a patient centric view to help improve health care outcomes across our nation.