First child health events workshop

The PRSB is working with health, education and social care organisations as well as families and parents to create a single online picture of a child’s health and care history.

The aim is to replace the current mix of paper and electronic records held in different places with a single digital record. This will contain standardised information that is available at the point of care, so that people experience services that are more joined-up, safer, better quality and more timely.

Almost 70 professionals, parents and IT system suppliers attended the first child health events workshop, which took place last week (5 April) at the Royal College of Physicians in London.

Bringing a range of professional expertise and personal experience to the table, the group discussed the headings and content for the digital child health strategy information standard.

The PRSB has been working in partnership with NHS Digital’s child health programme to help implement NHS England’s digital child health strategy, and recognises the need for a multi-disciplinary approach.

From community care like midwifery and health visiting, to hospital admissions and GP visits, children see a wide range of health professionals, all of whom will be responsible for recording information about their health. This becomes even more complex for children with extra needs, who may also be seen by social care professionals, therapists, secondary care and family nurse partnerships. By liaising with both parents and professionals, we can get a clearer idea of what information needs to be recorded for each sector in order to ensure a joined-up approach to healthcare and records.

Kicking off the discussion, Dr Andy Spencer, chair of the information for quality committee, Royal College of Paediatrics and Child Health, said the project aimed to ‘get information right’ to provide better care and reduce variability in outcomes.

He went on to outline the project objective: to develop a set of requirements for community child health records which can support the healthy child programme, an early intervention initiative by government to prevent medical problems and issues before they happen.

Other speakers included Dr David Elliman, community paediatrician at Whittington Health, Professor Helen Bedford, professor of children’s health at University College London and Great Ormond Street Institute of Child Health, Martin Orton, director of delivery & development at the PRSB, and Alison Golightly, maternity & child health information consultant at NHS Digital, who is responsible for creating the digital child health strategy.

Speaking at the event, Alison said that knowing where every child is and how healthy they are is integral to the digital child health strategy. However, it will require collaboration between different groups and needs to be taken one step at a time. The child health events workshops are the first step in determining standards for the information that needs to be shared between professionals and parents. During the workshop, the group discussed the information surrounding child health events that needed to be recorded, and the best ways this could be done.

Covering topics such as feeding, birth weight and factors that could affect a child’s health during pregnancy, the group discussed appropriate headings, as well as the quality and type of information that needed to be recorded for the different people involved in a child’s care.

The group established that language is really important for defining headings, to avoid confusion or misrepresentations. Parents in the group also pointed out that terminology needed to be appropriate for both clinicians and parents, so that shared records were clear to everyone who was involved in a child’s care.

All attendants agreed that clear records were essential to their work, and could benefit all aspects of the health and social care system.

The views expressed by participants in the workshop will inform the development of standards for recording a child’s birth and early development history. The first of three online survey consultations will go live in May 2017, with the second and third workshops for Child Health Events taking place in June and July respectively. The final report should be delivered in September before it goes out for endorsement, and is likely to be published in late 2017/early 2018.

Read about the digital child health information standard or contact info@theprsb.org or read NHS England’s strategy, Transforming child health information.

The PRSB at e-health week

The PRSB exhibited at the UK e-health week event at Olympia earlier this month, to promote the development and integration of standards for better care.

Education on standards

During a session on clinical leadership for digital health and care, chair of the PRSB, Iain Carpenter, described how standards for care record sharing using digital technology can transform the quality, safety and efficiency of care. He added that achieving the benefits will require clinical vision and leadership. The PRSB will represent the ‘clinical and patient’ voice, to ensure that the information shared through digital records is relevant to the patient and will enhance their care.

During the session (hosted by the British Computing Society), senior lecturer in clinical data science and honorary consultant in cardiology at the Farr Institute of Health Informatics, Dr Ami Banerjee, said that education around information sharing needed to improve if we are to see the benefits of implementation. He pointed out that informatics teaching is highly variable between medical schools, something which needs to change. Banerjee also spoke about the NHS Digital Academy, a virtual organisation that will provide training and development opportunities for chief clinical Information officers (CCIOs), chief information officers (CIOs) and other leaders across the country.

Meanwhile, professor of health services research at Swansea University Medical School, John Williams, spoke about the development of the Faculty of Clinical Informatics, which is being established as the professional membership body for all clinical informaticians across the UK.

Interoperability

In addition to educating people on the importance of standards and ensuring the content is fit for purpose, the PRSB is working with other organisations to ensure interoperability between IT systems, so they can share information easily.

During a session run by techUK and INTEROpen, co-founder of INTEROpen Dr Dr Amir Mehrkar, urged collaboration between clinicians, health and care workers, standards organisations and IT system suppliers. He said that INTEROPen will act as an umbrella group, made up of key interoperability networks, all of whom will collaborate on the design and application of technical interoperability standards. Others under the umbrella include NHS England, NHS Digital, CCIO Network, TechUK and OpenEHR. Working in partnership with these organisations, the PRSB will represent the wider clinical, professional and patient view to support the development of interoperability standards. This will ensure information sharing in the health and social care sector is safe and effective, and that we will help sustainability and transformation programmes to provide better care within local communities.

Sharing health and care records with care homes

PRSB is supporting NHS Digital’s Social Care Programme (SCP) which aims to simplify and standardise the information that flows to care homes from other providers of health and care when patients are discharged from hospital.

Working with care home professionals to identify priorities

We are conducting a series of interviews and surveys with care home professionals to identify priorities for what information should flow from hospitals to care homes and provide assurance that the intelligence gained by the SCP is representative of the care home sector.

The research completed so far indicates that care homes are particularly concerned about the lack of information they receive when a resident is discharged from hospital back into their care. The survey seeks to explore this in more detail as well as understand and appreciate communications with other health and social care services in general.

This is a great opportunity for care homes to provide their views on what would help improve communications between care homes and other health and social care organisations in England.

 

Understanding patient data campaign launched

More than two thirds of the population feel they don’t understand how data is used by the NHS, according to research conducted by Wellcome Trust.

The project will support discussions with the public, patients and health and care professionals to help them understand how data can be used, the risks and benefits of its use and how it can be safeguarded. Wellcome aims to help people make informed decisions about how their data is used, examine the issues that emerge from the use of data-driven technologies and help to inform NHS England, the Department of Health and NHS Digital policy and communications.

Putting our standards into practice

While standards are essential to the facilitation of good care, they must be adopted by clinicians and professionals to improve the quality, safety and efficiency of care.

The PRSB is currently working to define the support we can provide to facilitate implementation, working in partnership with our member organisations, local health and care providers, vendors and professionals.

In addition to specific communications and engagement regarding the e-discharge standard, we’ll be exploring how we can offer practical tools, support and guidance, as well as education and training. The PRSB will be working with local organisations to understand the level of adoption of standards and to find out more about the lessons, challenges and benefits. This research is being undertaken with a view to sharing the lessons learned with professionals seeking to adopt the e-discharge summary and other PRSB standards.

This new phase follows on from last year’s pilot project, when the PRSB was commissioned by NHS Digital to test the proposed approach to supporting implementation. The project ran for five months and focused on implementation of the e-discharge standard, working primarily with Royal College of Nursing, Royal College of Physicians (London) and Royal College of GPs. The overall aim of the project is to create a cultural shift in health and social care to accept standards as the norm.

Got to our putting standards into practice project page for more information on this project and to access toolkits.

 

The PRSB welcomes INTEROPen

The PRSB has welcomed INTEROPen’s role in promoting interoperability as part of the digital transformation of health and care.

INTEROPen is a collaboration of individuals, industries, standards organisations and health and care providers, who have agreed to work together to accelerate the development of open standards for interoperability in the health and social care sector. INTEROPen will act as an umbrella group, made up of key interoperability networks, all of whom will collaborate on the design and application of technical interoperability standards. Other networks under the umbrella include NHS England, NHS Digital, CCIO Network, TechUK and OpenEHR, amongst others. Every member has a different area of expertise and all will contribute to the overall goal of ensuring interoperability across all systems in health and social care.

PRSB seeks social care involvement

Information sharing with social care is integral to the facilitation of good care.

Following a meeting with the UK’s chief social worker for adults, Lyn Romeo, the PRSB has been working to boost awareness of the importance of record standards within the social care sector. We are actively seeking involvement from social care representatives, to find out more about the information they need from healthcare professionals to provide better care for service users.

Meanwhile, we have also undertaken a project on care homes, which analyses information flows in and out of care homes, to determine where improvements need to be made. This report will be available on our website next month.

At the end of this week the PRSB will be attending a social care strategy meeting, to further discuss the ways in which we can work with professionals on the development of upcoming standards.

For further information, please contact info@theprsb.org.

PRSB working with care home professionals

The PRSB is currently working with care home professionals to better understand what information they need to improve the quality of care for residents.

The care homes project, which was supported by the Royal College of Physicians (RCP) Health Informatics Unit (HIU), evaluates how flows of information in and out of care homes can impact the work of care staff following hospital discharge.

The project

In order to form a representative view of the sector, we ran a series of interviews with care home managers about information flows, including those with GPs, social workers and hospital admissions and discharges. The interviews found that while care homes are increasingly using technology and have developed digital processes internally for managing care, these are not connected to the wider health and social care system. The interviews informed the design of the wider online survey with care homes, which received over 230 responses.

Survey respondents felt the main problems they face when a resident is discharged from hospital related to poor communication, lack of information and the discharge process. Potential solutions offered via the survey included: improving understanding of care homes, better planning of discharge and checking by the hospital that things were in place, improved handover to the care home, higher quality discharge summary information and discharging patients at appropriate times.

While some care homes said they regularly receive discharge summaries for service users, others said the available information was ‘variable’ with summaries being issued only half of the time. Of the care homes receiving discharge summaries, nine in 10 still get paper records, though two-thirds of those interviewed said they had their own digital processes in place. In the survey, care homes also identified the discharge information that was crucial to facilitating continued care, which includes medication, mobility issues, diagnoses, treatments and long-term care plans.

Findings from the survey and the interviews were combined in a report and will be analysed alongside data from NHS Digital’s social care programme, to start informing potential solutions to improve these information flows. In the coming months, the NHS Digital social care programme will be running a series of workshops to co-design solutions and test these with care homes.