Smart foundations for Integrated Care Systems

With population health management and joined up-care on their to-do lists, good technology systems in place will be vital for many Integrated Care Systems (ICSs) to have good technology in place. Bruce Horne, product specialist at Orion Health UK and Ireland, explores why smart foundations are essential. 

There is a lot of interest in the imminent arrival of integrated care systems in England. If the necessary legislation is passed, these new organisations will start work on a statutory basis in the new target month of July.

ICSs will have three big tasks: to join-up health and care services; to shift the focus of commissioning from contracting to population health management; and to create digitally enabled care pathways that engage patients as ‘close to home’ as possible.

To succeed, ICSs are going to need good IT systems to share information, collect and analyse data, and reach out to their populations. Technology companies understand this and are approaching ICSs with a confusing array of approaches and products.

Established electronic patient record suppliers are telling ICSs that they can address their information sharing challenges by extending their acute systems into the community, or by adding a health information exchange.

While new entrants are advising ICSs to start from scratch with an orchestration layer or data platform that will integrate information from different systems and run it into analysis products and digital patient apps.

Business information companies and analytics start-ups are coming forward with analysis offers. And there are dozens of innovators moving into remote monitoring, digital triage, and wellness apps. How are ICSs and their digital leaders supposed to make sense of all this?

Shared care records are a great investment   

If you are one of those digital leaders, a good first step would be to take a deep breath. Take stock of what you have already, and then think about how you can build on those investments; or where you might want to swap out some elements for systems that will better serve your strategic needs.

After all, ICSs may be new, but the idea of joined-up care and technology to support it isn’t. The UK has been developing information sharing platforms and shared care records for two decades, with programmes like Connecting Care in Bristol showing the way.

The value of shared care records was recognised by the former chief executive of NHS England, Sir Simon (now Lord) Stevens in 2020, when he set a target for all areas of England to get a ‘basic’ record in place by September 2021.

Orion Health developed an ‘out of the box’ shared care record for ICSs looking to meet the target and is pleased to be working with three new areas, including Derbyshire and Cambridgeshire and Peterborough, as a result. However, a shared care record is only the start.

If you are a digital leader, you’ll want to make sure that your platform comes with an interoperability model that will take you from ‘viewing’ data to ‘doing’ analysis and co-ordinating care along digitally enabled pathways.

Follow ‘What Good Looks Like’ and build strong foundations  

NHSX (now retired) recently published two documents to help ICSs work through the mass of technology decisions that they are faced with: ‘What Good Looks Like’ and ‘Who Pays for What’.

Both stress the importance of ‘smart foundations’, and the deployment of an industry standard shared care record puts those in place. A ‘basic’ record will deliver benefits, because it will enable healthcare professionals in different care settings and using different care systems to access information at the point of care.

That will give teams a more holistic view of a patient’s condition and treatment and supports effective intervention. However, additional benefits will come with digital maturity, so it’s important to pick an approach that persists data for those more advanced analytics and care co-ordination approaches.

Ideally, that platform will not only store data, but come with tools to manage, administer and deploy algorithms to provide predictive insights, because anticipatory care is already here. During Covid, we saw a ‘risk of mortality’ score deployed within a shared care record to guide treatment decisions for patients.

Finally, an ICS is likely to need to work with many technology partners as it matures; and that will be easier if your core supplier is committed to open standards for recording and transferring data.

Pick an approach with a maturity model built in

ICSs will need to set a strategy that enables them to create a data platform, shared care record, population health management analytics, and new, proactive tools to enable professionals and patients to collaborate on care ‘closer to home’.

Digital leaders will need to cut through the noise created by having so many suppliers with so many approaches and products lobbying for their attention. If you’re one of those leaders, you’ll need to focus on an approach that strikes the right balance between the type and number of suppliers that you need to move forward.

In doing so, you need to consider how you can make the most of your existing investment in a shared care record or find a new partner to build out the analytics, care coordination tools, and integration with additional innovations that you need.