Reflecting on 2021 and looking forward to 2022

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Reflecting on 2021 and looking forward to 2022

As 2021 and my first year as Managing Director comes to an end, this marks an important time for us to reflect on the progress made towards a fully interoperable and digitalised healthcare sector, and the significant changes we have seen within the healthcare technology landscape throughout the pandemic.

By looking back at everything we have learnt over the past year, Healthcare Gateway can remain adaptive to the next stages of the nation’s response to new COVID-19 variants. Looking forward to 2022, we can set goals which continue to put patient care at the heart of everything we do.

From the outset this has been another year of significant change as we have all become accustomed to the new normal. Healthcare Gateway has continued to follow government advice, whilst doing everything we can to look after our employees: we’ve continued home working alongside voluntary nominated days in the office, as well as the use of collaboration hubs and meeting facilities to bring teams together for in-person working and social events. Employee health and wellbeing remains paramount at Healthcare Gateway, and allows us to keep serving our customers through these challenging times.

We recognise that our NHS colleagues have also changed their ways of working, and we have worked hard to support this using remote meetings as a normal now that we have proven technology can, in most cases, provide the same level of interaction. In situations that have required onsite, in-person meetings, we have supported this whilst working hard to ensure everybody’s safety.

During the year, Healthcare Gateway has become independent as we separated a host of functions from parent companies, and we are now responsible for all back-office functions. This includes: HR, admin, contracts, finance, and internal IT infrastructure. This independence has led to the development of a new department within HGL, and a restructure which sees key individuals taking lead roles with Customer Experience and Product Development. I am confident that this restructure is best designed to aid us in improving healthcare for all and provide our customers with interoperability products and services that meet their needs today and in the future.

Between the transition away from our parent companies, our internal restructure, and the ongoing challenges of COVID-19, there has been a lot to do at Healthcare Gateway. This allowed us to review our corporate and social responsibility which has resulted in a host of positive changes. We encouraged home working, removed company cars, reduced travel, closed an office as our staff transitioned to home working, removed all printing facilities, plus recycled old equipment.

Throughout 2021, we collaborated closely with our 80+ partners to make even more vital patient data available to those that need it. Nurturing and developing relationships with our partners is crucial to our success in facilitating data sharing and supporting our mutual customers in their efforts to provide the best possible patient care. We’re incredibly proud of what we have achieved by working closely together and realising the benefits for patients. In 2022, we’re looking forward to dataset developments including the launch of Mayden Iaptus (IAPT) Dataset which will enrich Shared Care Record ambitions with even more patient information via the MIG. Moreover, we’re looking forward to the development of Personal Demographic Service (PDS) functionality which will provide the foundation for us to be able to progress the retrieval of GP Connect data.

Our overarching strategy is to continue to support the NHS in their response to COVID-19, and their aims to advance ICS-wide digital solutions. Healthcare Gateway is not just a technology provider; we offer an end-to-end managed service to support every step of an interoperability journey, regardless of digital maturity. Our focus will continue to provide ICS-wide digital solutions as well as expanding our Medical Interoperability Gateway (MIG) coverage to support NHS Health Boards across Scotland to provide solutions solving interoperability challenges, enabling clinicians access to vital real-time patient data.

News of plans for NHS Digital and NHSX to merge into NHS England and NHS Improvement, bringing all the National Healthcare System’s tech, digital and data expertise together under ‘one roof’, is a move that has been expected. In reality, the challenges in making digital transformations are not technical; they are clinical, human and cultural. Combining these entities and providing a collaborative approach with a shared agenda should accelerate digital transformation. We are excited to see what comes of the merged organisation.

Wishing all a Merry Christmas and Happy New Year from the team at Healthcare Gateway

Liam King, Managing Director, Healthcare Gateway

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Easing winter pressures in the NHS with interoperability

ambulance in the snow

Easing winter pressures in the NHS with interoperability

Winter is always a difficult time for the NHS, with some health conditions being worsened by cold weather, including asthma. This, along with other ‘seasonal illnesses’ such as flu, means the NHS is often overwhelmed during the winter months.

These pressures occur during winter every year, but with Covid-19 still a threat nearly two years on, this winter could create an even greater demand on the NHS services.

Preparing for winter 2021/22

The Academy of Medical Sciences have released a report titled Covid-19: Preparing for the future – Looking ahead to winter 2021/22 and beyond’ which outlines the challenges that the NHS will face this winter. These include:

  • A resurgence of respiratory infectious diseases – There is expected to be a surge of winter viruses and with some of these illnesses having similar symptoms to Covid-19, it will become harder to distinguish between them, increasing the spread of Covid-19 and adding further pressure across the NHS.
  • Wider health and wellbeing impacts of the pandemic – During the pandemic, there has been a rise in delayed diagnosis of illnesses and treatments, which has led to a poorer physical and mental health across the UK. This could mean that there will now be higher rates of conditions such as asthma, COPD and heart attacks this winter.
  • Continued disruption to health and social care delivery – Prior to the pandemic, winter bed occupancy in the NHS regularly exceeded 95%. This year, the NHS will be operating with a reduced number of beds in line with inflection control guidelines, which will be a huge challenge to overcome.

How can interoperability help to ease these winter pressures?

By definition, interoperability in healthcare is the ability of health information systems to work together within and across different organisations to advance the effective delivery of healthcare for individuals and communities. With the increasing pressures on the NHS this winter, here are the ways in which interoperability can help overcome these challenges.

More informed care

Having greater access to real-time patient data from health and social care settings, allows for more accurate diagnosis and treatments. A holistic view of a patient’s full medical history can aid in reducing errors or duplication of work, saving clinicians both time and resources. This saved time can be then spent treating patients, to speed up their recovery, increase beds available in hospital settings and work to reduce the backlog in care.

More efficient care

The pressures on the NHS system show the need for better connected systems across health and social care. Joined up systems means joined up patient care. Connecting health and social care systems reduces the duplication of effort between different settings. Saving time in this way allows for more time to be spent face to face with patients, reducing errors and improving quality of care. More efficient care may benefit the patient by reducing the length of stay in hospital, helping free up staff resources crucial during the winter months. Plus, saved time can be used to focus on the backlog of treatment caused by the pandemic.

Improved transfer of care

Sharing patient data between health and care organisations allows patients to be treated at the right place at the right time, whether that be at a GP practice, in the community or in a hospital. Coordinating care effectively in this way can help increase treatment outside of hospital settings and reduces hospital admissions, to ease the pressures within secondary care. For those who do require treatment in hospitals, there is a reduction in delays in transfer. With access to all necessary data, clinicians can make faster more informed decisions, which allows for rapid discharge and reduced readmissions.

Conclusion

In conclusion, the pressures upon the NHS will face this winter are ever increasing. By implementing interoperability solutions, day to day processes can be simplified and made more efficient which will help to relieve the challenges.

At Healthcare Gateway, we are interoperability specialists, and provide a managed service which helps organisations to achieve interoperability goals at scale and pace in order to improve the quality and efficiency of care in health and social care settings. Get in touch to find out more about how working with us can help ease winter challenges.

 

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Standards: the key to providing a show stopping interoperability service

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Standards: the key to providing a show stopping interoperability service

As the cold, dark nights draw in there is nothing I like more than settling onto the sofa on a Tuesday night and getting my weekly fix of the Great British Bake Off. The technical challenge is always an amusing section, watching the bakers try to interpret the minimum instructions and create a super-sized baklava that will meet Paul and Prue’s professional eye. How many different interpretations of Baklava can there be? 

Interoperability without standards is a bit like baking a cake without a recipe or ingredients, it’s complex, if nigh on impossible. For systems to communicate with each other, we need to know what resources should be included, what transportation method should be used, how we should transform it etc. This is where standards come in. They give us the full recipe and ingredients to enable us to make the right information available at the right time to the right person and remove that need for interpretation…we can all produce an identical show stopping cake that Paul and Prue would be proud of. 

Standards in Healthcare Gateway

Healthcare Gateway have been providing interoperability for over 10 years and our product strategy is to enable our customers to conform to nationally mandated standards, where applicable.

PRSB

With regards to standards, we were delighted this year to be provided with the opportunity to become a PRSB (Professional Records Standard Body) partner. This partnership has enabled us to attend events to hear about the standards that are in development and the impact that these standards have had on users and other system suppliers, and we hope to build some of these into our roadmap for next year.

FHIR

FAST Healthcare Interoperability Resources (FHIR) is essentially a standard for exchanging healthcare information – a specification on how one system asks another system for data and what it gets back in return. It covers both the technology and an agreement on what the data means. We are currently working with NHS Digital to gain accreditation for their Personal Demographic Search (PDS) FHIR API and have recently gone through conformance testing for this development. Gaining this accreditation will enable us to proceed further and become accredited to use GP Connect as a middleware supplier, allowing us to provide our customers with the ability to conform to national standards. PDS accreditation also enables us to integrate with a wider range of products produced by other providers, as well as to conform to best case information transfer schemas.

SNOMED

SNOMED (Systematized Nomenclature of Medicine) CT is a clinical coding language used in electronic record systems in health and care. It is an international standard language that is being adopted by the NHS in England for the use in all systems used for the direct management of care. It is seen as the most comprehensive and precise clinical health terminology product in the world. SNOMED covers a wide range of clinical specialities, disciplines and requirements. It is used in more than fifty countries and is mapped to other international standards. Applying SNOMED CT as a standard means clinical information is recorded in a consistent, common way through all clinical records and supports the sharing of information with all individuals involved in the care of a patient. Our content model and some of our specialist datasets are going through a transformation to conform to SNOMED CT. We are re-specifying our content model into SNOMED CT and working with PRIMIS to enhance our content model to include additional items such as, Accessible Information Standards, radiotherapy and chemotherapy procedures, cervical cytology, Rockwood scores, height, weight, BMI and many more. We are also going to apply the national exclusion list to the content model to ensure sharing exclusions conform to national standards. Whilst this transition is in flight, we are working with our GP system suppliers to ensure that any new SNOMED CT that do not have a backwards map are incorporated into our existing content model, such as COVID-19 codes and you will be notified of any updates through our newsletter.

REST

REST (Representational State Transfer) is the communication service used to allow services to connect to other servers/API and it uses a standard list of commands. REST is lighter weight and more efficient as it can use smaller message formats, and it also has the ability to handle multiple types of call and return different data formats. As part of their annual objective, our Development team have been working on creating a “RESTful MIG”. They are in the process of creating Extended Patient Trace, Patient Search and Detailed Care Record version 2 as a customer facing RESTful service. Creating these services in REST means we are future-proofing our services and provides us with more flexibility to enhance our services. It will also make it easier for new consumer systems to accredit to consume MIG data.

Looking forward to 2022

As 2022 approaches, we are excited to continue on our standards journey and receive that Star Baker apron. However, we’re always looking for ways to improve and innovate our services and help you conform to standards and would love to hear your views and ideas. If you would like to discuss your vision, ideas, gaps that need filling or hear more about what we have planned in the future, please contact the Product Management team.

Sarah Dunwell-01By Sarah Dunwell, Head of Projects and Product at Healthcare Gateway  

Sarah began her journey with Healthcare Gateway four years ago in the role of Product Manager, and since has built a wealth of expertise in product management. Sarah has recently been promoted to Head of Projects and Product where she will be bringing together different teams to efficiently manage and deliver the whole product life cycle.

 

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Transforming healthcare across Nottinghamshire

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Transforming healthcare across Nottinghamshire

Watch our latest video, to find out how the MIG and our managed service is supporting interoperability across Nottinghamshire.

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