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Opening up Digital Health Rewired

Editor’s Note: ‘Open’ was the theme that ran through the first Digital Health Rewired conference at Olympia London. Richard Strong, vice president and managing director, EMEA, reflects on how Allscripts and its Global Digital Exemplar (GDE) partner, Salford Royal NHS Foundation Trust, were delivering messages that resonated across the event.

Open was the theme that connected so many sessions at Digital Health Rewired. Bad Science author Dr Ben Goldacre made a passionate case for open data and the open analysis of NHS initiatives. Political advisor Hadley Beeman made a similarly committed case for the creation of NHSX.

“This new unit, which will pull together the policy, strategy, and innovation work that is split across the Department of Health and Social Care and NHS England, will focus on creating national standards for interoperability, and then leave trusts to buy any system that meets them” Beeman said.

Exciting possibilities

Allscripts supports the open theme – in fact it’s embedded in our company’s vision statement of making open, connected communities possible. Our electronic patient record system, Allscripts Sunrise™, is the most open EPR available in market.

We also have a track record in the UK of helping trusts to build a national-level ecosystem that can achieve their digital ambitions. It enables trusts to retain their patient administration systems and wrap our clinicals around them.

Achieving high marks

At the same time, we are able to assure trusts that our approach will get them to HIMSS Level 6 or 7 if they choose to. That is the ambition of our partner, Salford Royal NHS Foundation Trust, which is part of the global digital exemplar programme. Salford was very visible at Rewired, where Strategic Digital Advisor Rachel Dunscombe led two sessions.

Trailblazing a new approach

Dunscombe described how it had worked with KLAS Research’s Arch Collaborative to learn what clinicians thought of the Sunrise EPR that forms the core of the trust’s IT set-up. The trust was the first in the UK to use this approach, and it discovered that 94% of its clinicians are satisfied with the system, and 96% have trust in the IT team.

Back to the open theme, Dunscombe spoke about some work that it has been doing with Allscripts support to create an openEHR platform for innovation. Interoperability standards like HL7 FHIR are used to transfer information from one system to another, when those systems “won’t otherwise talk to each other,” as Matt Hancock often states it.

OpenEHR takes a different approach, by laying out a framework for constructing information models that mean, in effect, those systems speak the same language from the outset.

Will we no longer need HL7 FHIR?

Even if every health and care system could be rebuilt around information models created on openEHR schemas, there would be issues to iron out between them. So, really “they are trying to solve different problems” – and that means they are useful for different things.

FHIR is still good for transferring information between organisations, but openEHR is appropriate for trusts like Salford that want to innovate, because it enables information to be transferred between apps and devices whose information models can be controlled from the outset.

Crucial secret weapons

Back in her session, Dunscombe said Salford now has a ‘core’ EPR with an openEHR platform on top. Sunrise is the trust’s Samurai: it is always available and tightly controlled. The openEHR platform is its Ninja: it is set up to run 12-week project cycles that can test ideas and stop or iterate them safely.

“Allscripts are with us on this journey,” Dunscombe said. “It has worked with us, so we can do our core business and build innovation on top of it.”

That’s great to hear, particularly at a conference like Rewired, where ‘open’ was very much on the agenda – and in a way that shows it is the direction of travel for NHS policy makers and IT directors alike.

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