Digital Health Interoperability in the UK
As the world grows increasingly digital, the distance that divides us shrinks. Few industries showcase this shift more dramatically than healthcare. I say this coming from the United States, where an expensive healthcare model that falls somewhere between “flawed” and “absolutely horrific” (depending on how you vote), forces our public debate to look at other nations.
This dilemma is one factor driving my enthusiasm for the research KLAS has conducted recently in the UK. We’ve just spent the last year scoping, gathering, and delivering research on the state of interoperability within the NHS.
As KLAS is a research organisation based in Orem, Utah, USA (don’t worry, I’ll give you a second to google the place), it took quite a bit of elbow grease to put our traditionally North American–focused research arm to work across the Atlantic. But thanks to amazing, dedicated healthcare professionals in the NHS, we uncovered some deep insights on the state of NHS interoperability.
How Is Data Being Exchanged?
From interviews with 141 individuals at 124 different organisations across England, KLAS found that substantial data exchange is happening within the NHS, mostly through 61 local shared records across the country.
In large part, respondents told us that orders/results, hospital data/discharge summaries, and GP records are the most exchanged types of data. However, a full 42% of those we spoke with indicated that exchanged data impacts care “sometimes”, “rarely”, or “never.” This doesn’t seem too different from interoperability in the USA, where—when asked about the shortcomings of exchanged data—62% of respondents say their biggest problem is unwieldly or excessive amounts of data.
For many organisations in the UK, the inefficient data exchange they have today is better than nothing, as one head of IT at an STP explained:
“Any information sharing is better than no information sharing. We did a project a few years ago around serious mistakes, [like] where people had died. . . . In every instance, lack of information sharing was a contributing factor. We surprisingly get a lot of value from the HIE. In our outpatient clinics, they do digital dictation, and that information is immediately uploaded into the GP record. We have had patients who were diagnosed with cancer in the morning, and then they went to see their GP in the afternoon, and the GP was able to give the right kind of advice because the GP had the information from that morning. There are numerous stories like that.”
Others—like Rachel Dunscombe (CIO at Salford Royal NHS Foundation Trust)—argue that this view is a touch shortsighted: “While people may be happy with the[ir] solutions [for interoperability] today, consulting the solution road map will allow them to see whether their suppliers are moving towards the interoperability standards needed to support future requirements.”
While we can celebrate the successes that have been achieved thus far, I agree with Rachel—going forward, a strategic vision of data exchange will prove invaluable to provider organisations as they work with suppliers on future upgrades and implementations.
Are Suppliers Meeting Organisations’ Needs?
In addition to gathering general data surrounding interoperability exchange, KLAS asked study participants to rate the key suppliers with whom they have worked (or attempted to work) in pursuit of their interoperability goals. The average NHS customer rating for this metric is 5.5 (out of 9.0). To put that into context, the average KLAS score across all market segments and questions is 7.0. Andy Kinnear of NHS South, Central and West CSU explained, “In England we have created the framework of principles, behaviours, and commitments necessary to create a truly interoperable digital health and care system. The Newcastle declaration, the TechUK Charter, and the INTEROpen movement are all established and have ‘right’ on their side. What we need now is for the suppliers to adapt their approach and recognise the new future we are all heading towards. Collectively, we could create something truly special and will never have a better chance than this to do it.”
Ultimately, with this research and our future efforts to measure digital care in the UK, KLAS hopes to provide healthcare providers with the knowledge and data they need to drive an informed digital health vision across the NHS. As W. Edwards Deming said, “Without data, you’re just another person with an opinion.”