Are we taking a rain check on health and social care integration?

Implementing systems to facilitate the integration of key data between health and social care has been attempted for many years, with mixed results. The obstacles usually centre on information governance issues, other pressing priorities and, occasionally, a lack of expertise. But this need not get in the way of integrating health and social care systems; approaching it in bite-sized pieces can be the key to success.

Overcoming the obstacles

Why forge a path when others have already done it for you? Tried and tested methods are an easy way forward in terms of getting projects in live use and eliminate the need for specifying interfaces, which can be complex. Good IT suppliers already have live examples that can be re-used.

One example of such a project is the Digital Discharge: Assessment, Discharge & Withdrawal notices (ADW) using Message Exchange for Social Care and Health (MESH). This is a proven interface between social care and hospital systems to aid discharge management.  

Councils including Wirral, Lancashire, Rotherham and Hertfordshire were successful in their bids as NHS Digital Demonstrators and all have used the funding to implement this interface and realise efficiencies through Digital Discharge by supporting real-time exchange of hospital admission and discharge notifications.

The interface uses NHS Digital’s Message Exchange for Social Care and Health (MESH), which utilises the new ‘Fast Healthcare Interoperability Resources’ (FHIR) message standards. This speeds the discharge process and ensures a clear audit trail.

Rebecca Doyle, integrated health & care project manager at Wirral Council, says: “Health and social care integration is a key priority for us at Wirral Council, so we embraced the opportunity to bid as one of the MESH Demonstrators with NHS Digital. Liquidlogic has understood our plans for implementation from the outset and dedicated resource to ensure that we went live on time.

“I am pleased to confirm that we are now able to securely exchange hospital admission and discharge notifications from local health partners into our Liquidlogic case management system, which will support our ambitions to reduce bed blocking and promote efficiencies between health and social care teams.”

Tony Pounder, director of adult services a Lancashire County Council, explains: “The ability for social workers to view hospital Assessment, Discharge and Withdrawal notices in our case management system aligns with our strategy to link social care with health and reduce delayed transfers of care from hospital into the community.

“Part of the success of the project has depended on the robust partnership arrangements involving a number of third-party suppliers of systems, not least Liquidlogic, to properly coordinate the ideas and actions of so many people.”

Shared care record exporters

Providing real-time access to a single, secure ‘shared care record’ is a reality and in operation at a number of councils including Bolton, Bracknell Forest and St Helens. This allows care professionals to communicate and collaborate safely and effectively across disciplines and organisations. Professionals working in hospital, community, primary and social care services can all have immediate access to the same up-to-date patient information.

Social workers can access a patient’s health and GP record, including medication (current, past and issues), risks and warnings, procedures, investigations, encounters, admissions, discharges and referrals alongside their social care data. Similarly, those in a healthcare setting are able to view social care information, such as allocated case worker, associated carer, disability and any risks, hazards/alerts, protection notices, care plans and services already in place.

Mike Roberts, St Helens Council’s central systems support team manager, comments on the council’s decision to implement a shared care record: “The CareCentric system from Graphnet has been in place for almost a year in both adults’ and children’s services and we can already see the benefits.

“Our social work professionals can make better decisions, because they are presented with the complete view of a person. There are also time saving efficiencies linked to a reduction in making and answering calls to gather information – instead the data is there in front of them. The information that social care now has access to is terrific. The information which health has access to is phenomenal.”

Liquidlogic links with a range of healthcare IT providers including Graphnet, Orion and Cerner to view shared care records in the Liquidlogic case management system. The record appears as an additional tab within the social care platform and is consistently updated to provide a live feed.

Medical Interoperability Gateway (MIG): Cumbria County Council

Social care staff at Cumbria County Council are viewing shared cared records via the MIG and can view GP records 24 hours a day. Cumbria also sends relevant social care data to GP systems.

Since implementing the MIG, calls to surgeries have reduced and the council has seen an improvement in streamlined communication between different organisations. Health and social care teams are working collectively, which has reduced admin and created more time for patient contact.

Speaking about use of the MIG, Shaun Smith, business systems & information manager at Cumbria County Council, says: “Health and social care teams are now able to share relevant information in real-time. This secure, bi-directional data sharing underpins Cumbria County Council’s vision to present social workers with relevant and current health information, as well as providing colleagues in a health setting with social care data which can often provide missing pieces to a jigsaw. This will help to ensure that the people in our care are given the very best treatment and support.”

Summary

These are two examples of interfaces to health systems that are live in multiple councils and are delivering benefits right now. The ‘shared care’ interface shares data, giving social and health care professionals an understanding of a person’s health and social care record; whereas the hospital discharge interface helps to manage and improve a process between organisations. These interfaces are a low risk and proven place for any authority to start in linking their social and health care systems together.

Liquidlogic works particularly closely with its parent company, System C and Graphnet, and also has interfaces with products from companies such as EMIS Health, Healthcare Gateway, Orion, Cerner and others.

For further details on how Liquidlogic can facilitate joined up working between health and social care, contact marketing@liquidlogic.co.uk.