Connecting Care

Connecting Care is a digital care record system for sharing information in Bristol, North Somerset, and South Gloucestershire. It allows instant, secure access to your health and social care records for the professionals involved in your care. Integrating care across health and social care settings has long been the primary focus of UK healthcare. But with local authorities, community care, mental health, GPs, and acute Trusts, all having widely differing methods of person identification, this has proved a gargantuan task – until now. The Bristol, North Somerset, and South Gloucestershire Connecting Care Partnership now integrates data across some 13 organisations to provide a single care record that can be used as the basis for care decisions across the geographic location.

This pioneering partnership emerged in 2011 and rapidly developed into a recognised Exemplar, winning the EHI Overall Winner and Integrated Care Awards in 2015. The EHI Awards are the UK’s only dedicated healthcare IT award scheme designed to recognise excellence in delivery.

As Andy Kinnear, Connecting Care Programme Director, states “We did not let challenges in identifying patients and connecting their activity across multiple health and social care organisations remain a barrier to integration.”

Selected as an IDCR Exemplar by NHS England in 2014, the programme currently has 2,000 users from clinicians, nurses, crisis teams, occupational therapists, GPs, pharmacists, social workers, care of the elderly, out of hours GPs to – pathologists, anaesthetists, ambulance, and A&E staff. The plan is to accommodate 10,000 users within 5 years. As well as introducing new users, the intention is to develop the richness of the record and support specific care pathways or clinical needs. One recent ‘Children’s Project’ allows the inclusion of child social care data to improve safeguarding across the community.

Connecting Care was faced with the challenge of consolidating a single medical record from 13 disparate systems across the health and social care setting from social workers, local government, and mental health, NHS Trusts, GPs, A&E, and GP Out of Hours. They needed to be able to accurately identify patients to compile a near real-time master record of historical care/medication upon which all future care decisions can be based. Connecting Care needed to eliminate duplicate and partrecords to ensure quality of care, efficiency, safety, joint working, and reduced spend.

Robust identity data management is the cornerstone to the success of Connecting Care. The Enterprise Master Patient Index (EMPI) combines records in a multitude of different formats from disparate systems across the region. The major challenge for the whole of the UK is the matching of health to social care records, especially as all social care systems do not yet use an up-to-date and verified NHS number. With Rhapsody, Connecting Care did not have to wait for the NHS number to become a universal identifier.

The EMPI matches records against a huge range of parameters including given name, family name, address, NHS number (where available), NHS status, sex, date of birth, post code and phone.

To date over 6.5 million partial or duplicated medical records have been consolidated into just over 3 million complete patient records, each of which have been given an Enterprise Unique Identifier (EUID). This EUID, together with its associated clinical data, forms the to the single-best record which clinicians across the region refer. Access to this invaluable data source is provided by Orion Health, a premier Rhapsody partner, via its highly successful Clinical Portal.

Benefits cover almost every operational aspect, including streamlined patient care and cost savings due to reducing duplicate tests, as information is now readily available because of the EMPI. Referral management has improved because they are able to better trace care and determine who to contact next. “Whilst initially we had a shared belief that information sharing would provide better, safer patient care, the evaluations throughout the life of the programme have continuously demonstrated significant frontline benefits and people now trust the Connecting Care data.” states Jocelyn Palmer, Connecting Care Programme Manager. Connecting Care has proven to be invaluable for clinicians and care practitioners alike. Pharmacists and anaesthetists can receive instant access to GP prescribing and patient allergies.

Because of the evident success, the project is now gathering momentum with more departments wanting to be involved. Incorporating the increasing range of disparate systems, or multiple applications within one organisation, presents an ongoing challenge. The sophisticated algorithms and high probability matching ensure that new data from the multiple silos, each with their own unique formatting and spurious data quality, can be assimilated into the central care repository – and interoperability can be ensured without having to modify the source systems. The Rhapsody EMPI is rated the No. 1 EMPI by KLAS Research and is the gold standard in patient data matching, designed specifically for healthcare’s unique data and workflow requirements.

“This rigorous process of identity matching ensures we stay on top of data quality as the new systems are integrated – our ultimate aim is to encompass all episodes of care,” adds Jocelyn Palmer. “Connecting Care is now seen as strategically important in the digital agenda and fulcrum to the transition plans for health and social care locally.” Andy Kinnear concurs “Integration is not a ‘nice to have’, it is essential for sustainability and survival of the NHS. A wider adoption of this non-invasive, cost-effect approach would have significant impact for clinicians, patients and care commissioners alike.”