Taking care of the patient data journey: success for Oxford Health NHS Foundation Trust in first step towards regional-wide interoperability.

In this case study, discover how Oxford Health NHS foundation Trust, a forward-thinking Global Digital Exemplar, embarked on a high-impact interoperability roadmap with international integration provider Enovacom that empowers NHS staff to create in-house interfaces with potential to deliver significant benefits across the health service.

Project scope

Oxford Health NHS Foundation Trust is a digitally advanced mental health, community and learning disability trust. It is a mental health Global Digital Exemplar (GDE). It provides physical, mental health and social care for people of all ages across Oxfordshire, Buckinghamshire, Swindon, Wiltshire, Bath and North East Somerset.

Services are delivered at multiple locations including community bases, hospitals, clinics and people’s homes. Interoperability - the ability to share and use information seamlessly across a patient journey - is vital in supporting the trust’s aim of delivering care as close to home as possible.

The interoperability challenge

Historically, interoperability has been an expensive and complicated challenge for the NHS to solve. The Five Year Forward View and its subsequent digital strategy, Personalised Health and Care 2020 set the vision for fully interoperable patient records, but Health Secretary Matt Hancock’s Tech Vision and the NHS Long Term Plan has propelled interoperability up the healthcare agenda.

The bigger picture for interoperability goes beyond integrating hospital-wide systems into developing regional shared care records through Local Health and Care Regional Exemplar (LHCRE) programmes for improving and coordinating individual care.

Oxford Health NHS Foundation Trust, facing these common integration challenges, embarked on a strategy to implement Enovacom’s user-friendly and scalable technology that will release immediate patient safety and efficiency benefits, but importantly lay the foundations for regional-wide interoperability.

The two organisations have ambitious plans to help transform healthcare on a global scale. As a Global Digital Exemplar the trust appointed Enovacom as its international partner supporting healthcare organisations across the world with learnings and best practice from their interoperability successes.

Tackling the initial challenges around interoperability

Scoping the project

Oxford Health NHS Foundation Trust prioritised three key areas for an initial proof-of-concept using the Enovacom Integration Engine.

1/ Sharing of clinical information from CareNotes electronic patient record (EPR) with external NHS organisations

Clinicians will save up to four clicks per patient case when transferring validated clinical documents and discharge summaries to GPs.

2/ Clinical information exchange from the trust’s EPR to external Child Health Information Services (CHIS)

The Enovacom Integration Engine automatically sends clinical information such as New Birth Notifications to the local CHIS removing the need for manual creations, consolidation and uploads of CVS files, saving staff time.

3/ Transferring data between CareNotes EPR and Ascribe pharmacy stock and dispensing system

The Enovacom Integration Engine will use HL7 messages to transfer data between two disparate systems: the EPR and pharmacy dispensing, and stock control system. It is arguably the biggest opportunity for immediate realisation of benefits, which are:

• Eliminating duplication of data entry - covering patient ward transfers, change in consultant or hospital discharges - on both systems
• Improving discharge process with efficient medicines management (which will follow the initial proof of concept stage)
• Patient safety, care quality and outcomes enhancements
• Reducing human error of incorrect data entry.

Delivering benefits

Early benefits around pharmacy integration

Research into potential efficiency savings from the CareNotes and Ascribe system integration through the Enovacom Integration Engine highlights positive results. The table below shows that a total of 34 hours was spent by trust staff replicating data from CareNotes to Ascribe over one calendar month. This equates to 408 staff hours and just over £9,000 in salaries annually.

Research conducted in November 2018 has been shared courtesy of Rachel Hanks of Oxford Health NHS FT.

Data sharing for blood tests efficiency

“We discovered that we could potentially improve patient outcomes and deliver efficiencies between organisations. For example, one area we will be exploring is that if a patient is being treated by one of our clinicians here and had a blood test with another NHS organisation, we would not need to request another blood test when the result is safe enough to use. So we would save precious NHS time, effort and money from ordering an unnecessary blood test, plus the clinician has all information in front of them to make a quick analysis and outcome.” Dr Fathi Saad, EHR Systems Integration Manager, at Oxford Health NHS Foundation Trust

How will interoperability affect Oxford’s patients?

Rachel Hanks, EHR Technical Project Manager, at Oxford Health NHS Foundation Trust on delayed discharges: "Patients could get their medications quicker because staff do not have to spend their time entering information onto the pharmacy system. The faster automated data transfer reduces the likelihood of delayed discharges because medications are not being dispensed on time."

On better outcomes:

“There will be more opportunities to improve diagnosis and treatment because the information that clinicians need to make informed decisions will be available rather than having to call up other organisations to find out about a patient’s care."

Going further by partnering with Enovacom

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