Dr Afzal Chaudhry, consultant nephrologist and CCIO at Cambridge University Hospitals, details the trust's journey to moving away from paper-based processes.

Opinion: Delivering a UK interoperability breakthrough

By Afzal Chaudhry
08:49 AM

Credit: Cambridge University Hospitals

At Cambridge University Hospitals, a HIMSS EMRAM Stage 6 UK trust, we recognise the importance of accurate and timely access to information – for patients themselves, for our hospital clinicians and clinical teams, for a patient’s primary care providers and for other hospitals involved in a patient’s care. By working closely with our staff, patients and healthcare partners, and developing and utilising the extensive capabilities of our electronic patient record (EPR) system, we are able to innovatively share electronic patient records and data to enable joined-up healthcare to benefit our patients, both nationally and internationally.

FULLY INTEGRATED ELECTRONIC PATIENT RECORD

Configured in-house by our eHospital digital division comprising of clinical, administrative, operational, analytical and technical expertise, our EPR allows clinical teams to see a single unified view of a patient’s health record in its entirely. Implemented Trust-wide (Addenbrooke’s and The Rosie hospitals) in October 2014, it has enabled us to transform clinical processes from paper-based to fully digital ways of recording care and accessing information; supported by medical device integration in 40 theatres and 148 critical care beds, handheld and mobile device integration to enable care to be recorded in real-time at the bedside, and a connection with national systems including the NHS Spine (national personal demographics service) and e-Referral Service (electronic referral service by primary care to secondary care). It has become an essential tool in supporting staff with the provision of high quality patient care. With 95 per cent of requested changes to our EPR made by our eHospital division, we have been able to continuously develop our system and use in-house expertise to extend its interoperability capabilities to further benefit patients and clinical teams.

INTEGRATED PATIENT PORTAL

We have over 6,000 patients using our patient portal, which is populated automatically with information from their record within our EPR; including appointment details and clinical correspondence, vital signs and the automatic release of test results. Patients can access there information anytime, anywhere, using a computer, laptop, Apple/Android Smartphone or tablet device. We are looking to extend our portal’s capabilities to allow Bluetooth-enabled devices to be connected from either a wearable or home device via Apple’s HealthKit on iPhones, or via Google Fit on Android phones. Data from these devices can then flow straight into the patient’s record in our EPR; enabling remote review by clinical teams, or providing data in advance of a forthcoming clinic appointment. This data can be graphed, tracked over time, and can drive clinical decision support processes – so in addition to engaging patients with their care, it will enable more timely review and interventions leading to better quality care.

REAL-TIME DIGITAL RECORD AND DATA SHARING WITH OTHER HOSPITALS

In April 2018 we delivered a UK interoperability breakthrough by linking our EPR with a neighbouring hospital’s EPR – two different software suppliers (Epic and Cerner) - to enable real-time digital record sharing to advance patient care. We now share approximately 400 patient records a month with West Suffolk Hospital, enabling clinicians from both trusts to securely access the clinical information they need about our shared patients. This link also connects Cambridge University Hospitals globally with other hospitals that use an Epic EPR to advance the care of our internationally shared patients. In addition, we have integrated our Epic EPR to Royal Papworth Hospital’s Lorenzo system to enable the real-time sharing of test results as soon as they have been verified in our laboratories.

DIGITAL CONNECTION WITH PRIMARY CARE

In May 2018, we enabled General Practitioners (GPs) and community nurses of Cambridgeshire’s largest primary care service to securely access the hospital records of their patients through a digital portal. At the touch of a button they can securely view information in their patient’s hospital record to advance shared patient care in a more timely and effective way. They are able to view the latest information about their patients – from conditions, tests and procedures to results, treatments, clinical letters and recommended follow-up care.

With all of these combined initiatives, each of which we have tailored to suit our hospital/clinical needs as well as those of our patients and healthcare partners, this now means that our patients, their clinical teams and their GPs all have a more comprehensive view of their health and care status, so enabling more informed decision-making and involving patients more in their care.

We are excited about exploring the possibilities of advancing technology further to connect with other healthcare organisations, both nationally and internationally, that are embracing EPRs to digitally transform healthcare for the benefit of patients and their carers.

Dr Afzal Chaudhry, consultant nephrologist and chief clinical information officer at Cambridge University Hospitals NHS Foundation Trust, will be speaking at the HIMSS Health 2.0 European conference taking place in Helsinki this June. Healthcare IT News is a HIMSS Media publication.