Tony Backhouse, head of SynApps Solutions’ Health Practice, believes standards for document sharing will be a huge help for an NHS trying to beat its dependence on paper.
A key goal of the NHS: be digital – ‘paperless’ – by 2018. That much is certain. However, what is often not appreciated is how far we are from achieving it – as the NHS is still very reliant paper.
As it stands, even in 2015, paper-based medical records still have travel between hospital departments, following the patient. It’s an expensive and cumbersome way to manage this information, even if it’s the approach we’ve always used. In order to meet the challenge, hospitals are implementing electronic document management or records management systems in order to manage their information digitally, and make it available for both the clinician and the patient at the point of care.
The challenge is formidable – in particular, providing access to this electronic content beyond the Trust, which is the next step hospitals are going to have to take if they are serious about moving to integrate health and social care at anything more than a trivial level.
That’s to say, policy-makers increasingly want to share information – not just between hospital departments but across organisations, regionally and beyond, driven by a move by government to integrate health and social care better, and at a local level by devolution of power (consider ‘Devo Manc’ and ‘Devo Devon’).
To make the integration challenge a lot easier, however, there is a standard that many organisations are finding useful. It’s XDS, for Cross-Enterprise Document Sharing, which turns out to be ideally suited to help Trusts start sharing innovation, as well as information in a secure controlled manner and in such a way that suits their individual needs.
In effect, XDS offers Trusts a way to build a repository where they can store documents, profile and mark them in an internationally agreed industry-standard, open manner. It also comes with an access registry, a mechanism that highlights what patient documents and images from Radiology, for instance, are available and for sharing. That could be internally, across departments, but also across other Trusts – within a region or even nationally, as it’s all done over a secure Web-based mechanism.
The standard also allows organisations to set up a federated structure, with different repositories linked together. That means each hospital can have its own (safe) repository but still be able to see the information in other hospitals easily, thanks to all the underlying standardisation. Plus, with XDS you can connect VNAs, or Vendor Neutral Archives, imaging databases that also can also hold unstructured content, Electronic Patient Records, laboratory systems, dermatology systems, case notes, and more. That’s because XDS is a data umbrella, enabling organisations to easily retrieve information from many different types of systems. In practical terms, say one Trust has an XDS registry and one of its patients is in another Trust; with XDS, you can request that patient’s information and get it shared securely and quickly.
As a result there are no more USBs to carry around and lose, no more logging into different systems, but just simple, secure and open access to information to help treat paitents better.
Our European partner, J4Care, has considerable experience helping healthcare organisations in sharing information not just between departments, but increasingly, across organisations, at all sorts of levels. It’s already done that in Finland, Holland and other countries, and for its Global Marketing and Sales Director, Marcel Swennenhuis, “As XDS is a universal standard defined globally by a worldwide standards body, the IHE, Integrating the Healthcare Enterprise, vendors can build XDS and deliver software on a truly international scale.”
Swennenhuis believes that IHE standards will also be used in a pan-European way. “At present, if a Dutch national visits a pharmacist while holidaying in Spain to get medication but the pharmacist has no clue about what they are already using, that pharmacist will simply refuse to issue anything. But with something like IHE-standards like XDS, problems like that immediately go away,” he says.
“XDS is the right technology to allow you to do that, as we are starting to witness in Finland, Holland and England, but also other countries around the globe,” he adds. We agree, and in the end we’ll see that at not just the Trust, but soon local, region and eventually country, even pan-European, levels.
Many hospitals will also use it internally, since by forcing suppliers to support the standard, they can generate one ‘view of the truth’ internally without having to move to one system. In any case, any NHS Chief Clinical Information Officer looking at ways of getting to that all-important paperless goal should think about adding XDS into the mix.
The author is Head of the new Healthcare Practice at SynApps Solutions (http://www.synapps-solutions.com/), a pioneer in the delivery of advanced vendor-neutral archive based solutions to the NHS. SynApps’ Clinical Content Store is a powerful data repository for all clinical and patient data, both structured or unstructured.