Oli Hudson, of Wilmington Healthcare, explores the implications of a new deal to create the country’s largest regional patient record.
Introduction
The NHS’s bid to create new regional patient records, combining GP, hospital, and other health and social care information, took a major step forward recently when a group of providers signed a groundbreaking deal.
Five Integrated Care Systems (ICSs) have agreed to contribute to what will become the biggest electronic regional record in the country so far, covering 3.8 million people.
Known as the Thames Valley and Surrey record, it is one of five Local Health and Care Record Exemplars (LHCRE) that were announced by NHS England last year and will also receive some central government funding.
LHCREs currently cover five sites and 40% of the country, with full coverage expected by 2024. They have significant implications for the medtech Industry since they will integrate information provided by devices and equipment, ranging from ultrasound scanners to pacemakers, with a patient’s full health and social care history.
Thames Valley and Surrey record
The ICSs involved in the Thames Valley and Surrey record are Frimley Health NHS Foundation Trust, Surrey Heartlands Health and Care Partnership, West Berkshire, and Buckinghamshire. The Milton Keynes area of Bedfordshire, Luton and Milton Keynes ICS will also be covered, alongside healthcare organisations in Oxfordshire and East Surrey.
The ICSs have committed to a £12 million, seven-year deal with IT supplier System C and Graphnet Alliance to build the regional record. The ICSs will contribute funding to the project until 2026, alongside £7.5 million in central funding in the first two years.
The LHCRE will draw on information from three smaller regional records that already exist as well as directly from some NHS providers. Dozens of NHS and social organisations will be involved in feeding patient information into the record, either directly or indirectly, across three separate Sustainability and Transformation Partnerships (STPs).
Benefits of LHCREs
LHCREs will enable medical history and ongoing care records to be shared by health and care staff. They will help to build population health capacity by providing detail on patient journeys and this will help the NHS allocate resources more effectively.
By providing a full history of how a patient has been treated in community care and social care as well as by GPs and specialists, single patient records will support point of care clinical decision-making. They will also reduce the risk of errors posed by the current system whereby three or four sets of paper patient notes are held in different sites.
Data that will be joined up into single patient records will range from vital signs taken by nurses on wards to clinical notes and appointments. It will also include specialist data – such as information taken from cardiac machines, ultrasound scans and endoscopies. This will help to realise efficiencies through wider system decision-making from the length of hospital stay required for procedures to how clinics are used.
Impact on medtech
LHCREs are in their infancy, hence there are lots of questions about how they will be regulated, accessed and anonymised. However, ultimately, improved data sharing and analytics will change the way the NHS works and how it measures success.
For example, joined up data will highlight anomalies in patient care and outcomes, and their financial impact. This will lead to a greater focus on delivering optimal patient journeys – like those already defined by NHS RightCare for various conditions. It will, therefore, be essential for medtech companies to understand what these pathways look like and how their products fit in.
Joined up data will also help the NHS to be more proactive about keeping healthy people well, nipping illnesses in the bud and improving the management of existing conditions. For example, the NHS will be able to risk stratify patients and deliver more proactive and preventative interventions. In line with this, we may see increased demand for technology that can help patients to better manage their health, such as activity monitors and blood glucose monitors.
NHSX, the new joint organisation for digital, data and technology, has indicated that it will be identifying standards to which technology used by the NHS must conform. So, if you have a medtech device that provides big data, such as glucose monitoring equipment, working with NHSX to conform to these data standards will be essential for NHS procurement and adoption. Patient facing apps that may eventually sit on the NHS app will also need to be evaluated to be included in the library.
Measuring success
Data sharing will make it easier for the NHS to measure value for money from medtech devices. For example, it will be able to see how many interventions or revisions were required after an operation to fit a pacemaker. It will also be able to gather a lot more detail on the patient’s experience and their ability to resume a normal life.
This level of data will enable medtech companies to prove how well their technology has performed over time and to cost up typical pathways in target localities to show how a particular device could improve pathways through modelling and scenario planning.
Conclusion
Data sharing is key to improving patient care and outcomes, and the bid to create the country’s largest electronic regional patient record is a major milestone in making this happen. LHCREs will bring huge changes to the medtech sales environment; hence it will be vital for industry to follow their progress over the next few years as their role becomes more clearly defined and understood.
For information on what the NHS Long Term Plan says about data and other issues affecting the medtech industry, download our free report Looking ahead 2019, here.
