NHS Dumfries and Galloway first in Scotland to roll out the Medical Interoperability Gateway (MIG)

NHS D&G

NHS Dumfries and Galloway first in Scotland to roll out the Medical Interoperability Gateway (MIG)

NHS Dumfries and Galloway become the first in Scotland to roll out the Medical Interoperability Gateway (MIG).

The Health Board have completed a pilot project with Healthcare Gateway connecting 31 GP practices across the region providing clinicians with real-time access to patient data, supporting faster and safer care. Serving a rural population with NHS Dumfries and Galloway’s ambition is to digitise health and care, driving forward with electronic records to diminish paper records.

Benefits of accessing the primary care data has been invaluable for clinicians and usage statistics have recorded over 40,000 transactions since go live. It means clinicians now have access to rich patient information at the point of care where previously, they would spend time on the phone or emailing GP surgeries, which often led to delays in care.

"We knew what concept needed to be applied to help us achieve our digital transformation goals and Healthcare Gateway turned our concept into a reality. The team owned the delivery and moved it forward by liaising with third parties directly, providing a seamless pilot project experience."

Clinicians across all the secondary care settings can now access the MIG’s Detailed Care Record (DCR) which presents ten tabs of information from the GP record including a patient summary and demographics, problems, diagnoses, medication, risk and warnings, procedures and investigations, encounters, admissions, and referrals, direct into their patient portal hosted by Orion Health.  Sharing data via the MIG is boosting efficiency and making vital real-time information available to a wide range of NHS end users to provide integrated care for patients with benefits realised:

“The patients often find it difficult to remember this information. I would. Previously we had to phone the GP surgery and the receptionists were extremely helpful, but it was time consuming for them and us. Having access to this information is vital when we are thinking about escalating treatment. This has really helped us to deliver more patient centred and safe care.”

“I am using the GP info for almost all of my patients. It is invaluable for checking current medications and when seeing patients who are not reliable historians or have trouble remembering what medicines they take.”

“We’re delighted we can now offer our MIG Managed Service to identify, integrate and support data sharing solutions to all the Health Boards across Scotland providing the population with safer, more informed care.

This project with NHS Dumfries and Galloway has highlighted many quantifiable benefits in timesaving, efficiencies and providing a more positive experience for patients and healthcare professionals. We stand by our mission and are committed to improving health and care in Scotland, enhancing the full patient journey by working with our trusted partners to mobilise more data regardless of setting or system.”

“In the UK, Orion Health and Healthcare Gateway have a long standing and successful relationship supporting the sharing of a patient’s GP data digitally within the Orion Health Clinical Portal. Being able to share patient GP data in the Orion Health Clinical Portal such as diagnoses, allergies and medications can deliver big benefits to healthcare economies, health and care teams and their patients. Health and care professionals are better able to use this information to make informed treatment decisions faster and provide the most appropriate care leading to better outcomes.

There is a great deal of interest in Scotland in this innovative solution to support care and an improved user experience and we look forward to working with Healthcare Gateway in the future on similar projects across Scotland."

NHS Dumfries and Galloway’s next step on their journey to digitisation is to expand MIG connectivity, providing remote teams including district nurses and community mental health access to patient information, at the point of care.

IKR

It will take a village to improve the backlog

Photo of a doctor seeing to a patient

It will take a village to improve the backlog

When I came to work at Healthcare Gateway my experience of  interoperability was only from the patient’s perspective. I didn’t know the complexities of healthcare systems, but I did know that repeating stories at every appointment slowed down my care. I was also pretty sure daily inefficiencies mounted up to significant time lost for those providing care, who were already under huge time pressure to cope with their workload.

Now two years into my role as Product Manager, I’m delighted to be working on products that confront the issues I felt as a patient and I want to ensure our product roadmap continues to tackle the biggest problems felt in the sector. One of the dominating stories I have recently been looking at is how to deal with the huge backlog of patients waiting for elective care*. A Guardian report I recently read highlighted that a tenth of England’s population is already on the elective care waiting list and worst-case predictions are that this will rise to one sixth by 2024. The statistics are extremely worrying, moreover the personal stories of worsening health conditions causing despair and anguish for patients in the long wait for surgery are heart-breaking. Stories like that of Sybil Williams, 86, a retired nurse and amputee who waited 17 months for a hip replacement and developed debilitating shoulder pain after prolonged use of mobility aids. Sybil lost her independence and described feeling suicidal during the agonising wait.

This topic of concern across health and social care has been recognised as a challenge and earlier this month NHS published the Recovery Plan for Elective Care. The plan details the targets every area needs to make, including:

  • improvements on long waits
  • reducing diagnostic waiting times
  • delivering faster cancer diagnosis
  • improving patient experience.

Areas of collective focus in the proposal are:

  • increasing capacity
  • splitting out elective and urgent care
  • prioritising diagnosis
  • offering alternative locations to patients with long waiting times
  • ensuring patients are better informed and supported whilst they wait.

Amanda Prichard acknowledged that ‘this won’t happen overnight’ and that we needed to apply ‘the same determination and ‘can do’ spirit we have displayed throughout the pandemic making the best possible use of the investment to accelerate progress’ . Amanda talked about flexible working between teams and smarter use of digital care being at the forefront of this approach and I wanted to highlight how Healthcare Gateway’s current products and services can support this.

We can increase capacity

The plan commits to give clinicians more time to care and one way it aims to do this is to reduce the administrative burden on staff. The Medical Interoperability Gateway (MIG) does just this; it allows clinicians and healthcare professionals to view real-time patient data provided by other services and settings involved in a patient’s care. Thanks to MIG technology, this data is seamlessly integrated within existing patient record systems, enabling single-sign on, with no need to navigate new systems.

On average it takes as little as 1.3 seconds to return and present patient data, which is faster than making phone calls to all services involved in a patient’s care. A unique feature of the MIG is the Service Discovery Locator which uses an intelligent look up functionality to identify all patient records available via the MIG meaning clinical staff are presented with all available data feeds at the point of care.  One recent case study highlighting the solutions we provide across Nottinghamshire estimated that the MIG was saving two minutes per consultation and 30 minutes a day for each clinician working at the trust, furthermore these time saving benefits were reflected at the GP surgeries who would previously have handled these enquiries over the phone. Another case study featuring Connecting Care Bristol, North Somerset and South Gloucestershire told us how pre-operative assessments used to take around 2.5 hours per person and now take under a minute because real-time details pulled through the MIG are being used to support this process.

Infographics showing the benefits of the MIG

We can support new pathways and networks for elective care

The Recovery Plan aims to set up a network of surgical hubs and diagnostic centres covering the entire country. Other measures include more people being offered treatment at alternative locations, including the independent sector, where waiting times may be lower. Additionally, more patients will be cared for at home via virtual wards and community services, building on the benefits these options offered in the pandemic. These pathways will create efficiency but will require robust interoperability solutions to be fully effective and ensure that a patient’s data doesn’t lag behind them.

The MIG is already used in more than 5200 healthcare settings and we have over 80 partner systems accredited to the MIG, so we have a multitude of connections in place that can support new pathways and alternative treatment locations. Our technology supports cross border and wider regional sharing programmes such as OneLondon which help when patients are treated out of area. Additionally, our Shared Record Viewer (SRV) provides a mobile compatible “front end” viewer for MIG data. This can be rapidly deployed and provides a short-, medium- or long-term solution to view MIG data – for example if partner integration with the MIG is not immediately possible or a wider sharing programme of work is underway.

Infographics showing the benefits of the MIG

We can improve the patient experience

We understand that waiting for elective care plays a heavy toll on a patient’s physical and mental health, so naturally we want to do everything we can to make sure that a long-awaited appointment goes as smoothly as possible. We know that giving clinicians access to GP and specialist data feeds, such as our long-term condition care plans, removes pressure on patients to remember the details and avoids further admin related delays. One patient representative recently described the MIG as a ‘goldmine of information’ that ‘helps ease the load’ and that’s great to hear.

Patients in the recovery stages of elective care also benefit from MIG technology joining up services like community health teams and physiotherapists with patient data. Additionally, our document services allow the GP, to receive letters and documents, such as discharge summaries, back into the GP record in real-time. Document Services means that the patient is not relying on a paper trail to catch them up as they return to primary care and reassures them that their GP is acting with up-to-date details from any recent treatment in other settings.

We want to expand our support

There is no doubt that tackling the backlog of elective care is going to be one of the biggest challenges facing an already stretched and exhausted sector, and it is very clear that the additional funding is not enough to solve this problem alone. Our products already provide the tools for smarter, collaborative working and can be swiftly deployed but we’d like to offer even more support to the village of organisations working on this problem. We’d like to extend and enhance our reach of current products so that even more patients benefit from MIG technology, and we’d like to build new solutions that address even more of the problems related to elective care. As a product team we would welcome conversations with clinical staff, digital leads, programme managers and partner systems to provide real-world insights on problems you’d like us to solve or discuss collaborative opportunities for innovation, please get in touch at here.

* (a broad range of non-urgent services, usually delivered in a hospital setting, from diagnostic tests and scans, to outpatient care, surgery and cancer treatment)

  By Su Jones, Product Manager at Healthcare Gateway  

IKR