VNA

Making your Local Health and Care Record initiatives Real in 2019

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2019 is going to be a very important year for the NHS, and I wanted to resume our ongoing conversation here with a timely reminder to all NHS leaders that the clock really us ticking on a very crucial piece of work – what you need around your STP work.

As I won’t need to remind you, STPs – Sustainability and Transformation Partnerships – were set up by NHS England back in 2016, split into organisations covering every part of the country.

The idea is to find new local and integrated ways to improve health and care, with NHS organisations and local councils in England being asked to join forces to co-ordinate services around the whole needs of each person.

STPs are very much part of the idea of delivering against some of the key goals of Simon Stevens’ Five Year Forward View vision of a much more sustainable and digital NHS. But they are also very, very local – the stated aim is come up with plans to plans drawn up in your area that will set out practical ways to improve NHS services and population health where you live.

STPs then in turn have led to another great programme, Local and Health Care Records – an attempt to enable the safe and secure sharing of an individual’s health and care information as they move between different parts of the NHS and social care. To make that idea a reality, a number of a number of so-called Local Health and Care Record Exemplars have been set up that have been given special finding partnerships of up to £7.5 million over two years to put in place an electronic shared local health and care record that makes the relevant information about people instantly available to everyone involved in their care and support.

Exemplars were supposed to be 2018 spend drawing up requirements for what a ‘local health and care record’ is supposed to look like. They were meant to be building a Proof of Concept (PoC) against that definition that can then be proven and tested, leading to building of a full solution by the end of the 2019, and rolling out to all members of their STP during the 2020 Financial Year.

But here’s the problem: A lot of organisations really trying to do the right thing here are a bit stuck, as there are no clearly defined requirements

A ready-to-use Local Health and Care Record Demonstrator

We’ve talked to lots of organisations on the ground on both the NHS and the local council side of this who are struggling to find a suitable technology to use to build their PoCs.

This really does prove how far we are from the days of NPfIT, when the plan was that a central system should have been provided to work with. Now, the onus is on the local teams to find their own best fit for this work – and it’s not easy. A big issue seems to be scale… a lot of the systems people have been testing out seem very precarious at connecting multiple back-end systems together in the secure way that NHS England will want.

So we have addressed this head on.  Working with a number of frontline NHS organisations, we at SynApps have built a Local Health and Care Record proof of concept (POC) to demonstrate how this works.

What that means in practical terms is that we have a testbed ready based off our NHS Integrated Digital Care Record system.  It is proven technology and utilises all of the power of our Vendor Neutral Archive (VNA) and Enterprise Document Sharing (XDS) solution and which you can literally plug in to you and your partners’ systems tomorrow to help you build a convincing PoC.

That also means you will have a system which can support every sort of content a Local Health and Care Record will need – from path lab results to X-ray imagery, NHS Records to GP notes and even your social care records.

So if you are starting 2019 concerned about what you can do to capitalise on the opportunity the Local Health and Care Record programme represents for your area, fear not – we can likely help you.

Get in touch to see what we can do to help you move your Local Health and Care Record ideas off the PPT and into real instantiation in working software.

Chris is Director of all SynApps Solutions’ Sales & Marketing activities

Tackling the referred pain of digital patient referrals

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As NHS England mandates that faxed referrals are phased out, and trusts look to alleviate the grind of manually re-entering details between different IT systems, SynApps Solutions’ Chris Brice charts a practical, pain-free way to exploit NHS Digital’s e-RS referrals service more fully – which delivers for patients, trusts and NHS budgets

On the face of it, NHS trusts are already making progress with electronic patient referrals. Steadily, GPs and patients are defaulting to the NHS Digital’s e-Referrals portal which will soon be mandatory for primary care referrals, to guarantee payment for services. Yet, although this is widely understood – and despite an appreciation that referrals by fax, email or other manual means are not efficient or easy to trace – a large majority of patient referrals are still being handled using complex, time-consuming workarounds. Even where requests are channelled via the NHS e-Referral Service (e-RS).

This undermines the purpose of the NHS e-RS, which is designed not only to provide a single central digital platform for capturing and coordinating patient referrals, but also to streamline associated processes, speed up treatment, and provide reliable traceability of a patient’s progress and status.

So what is preventing total take-up of the broader digital experience – where referrals pass quickly to the right person, and targets of faster patient diagnoses and treatment are met?

The issue is two-fold.

First, NHS Digital hasn’t yet developed its own workflow-driven applications to make it easy to pass referrals through the system automatically and track and report on progress.

Second, the diversity of IT systems used by GPs and hospitals has proved a barrier to integration. As a result, primary care providers have resorted to faxing and emailing referrals. For their part, hospitals have printed and scanned those requests, manually re-entering and tallying these with patient records held elsewhere on their systems. Rather than accelerating case flow-through or alleviating administrative workloads, this has often created more work and delay. It is not unusual for a trust to be manually re-entering details of 15,000 referrals per month. Some major trusts accept up to 50,000 patient referrals daily.

Joining the dots

For the NHS e-Referrals programme to have its intended impact, digital processes need to be joined up end to end. Then they can start to exploit intelligent automated workflow. That includes prompt diversions of cases to more appropriate specialists or services (inside or beyond the immediate hospital); and complete traceability and reporting – with rules-driven alerts, to ensure that no case enters an administrative cul-de-sac or slips through the cracks, and that critical performance targets are not missed.

All Acute trusts are aware that the current piecemeal situation cannot continue. As of 2020, faxed referrals will no longer be accepted, and NHS services already face the prospect that they will not be paid for referrals accepted through any channel besides the e-RS portal. So trusts and their primary care practitioners might as well ensure that the e-RS leads to perceptible benefits for staff and patients.

Fortunately, approved NHS Digital development partners SynApps Solutions and Alfresco have already put in the groundwork to deliver end-to-end electronic referrals solutions. These offer trusts all of the integration; rules-based workflow; process automation; monitoring, prompting and reporting required to fully harness the benefits of digitising patient referrals.

From electronically capturing patient requirements and connecting these to patient records; to accelerating the triage process and clinicians’ acceptance/refusal/redirection of referrals; to vigilantly monitoring, prompting and reporting on referral-to-treatment progress, our combined, modular solutions are designed to extract maximum early benefits from NHS Digital’s e-Referrals initiative for everyone concerned.

The expected benefits are substantial – including efficiency gains of 60-70 per cent compared with manually processing, checking and following up on referrals and progress to treatment.

And that’s aside from the benefits to patient safety, as cases are proactively tracked and escalated thanks to automated rules in the system. Robust compliance and performance measures, meanwhile, will help ensure that trusts are paid in full and within acceptable timeframes for the cases they have accepted.

None of this needs to be an upheaval or costly exercise for trusts, either. Our solutions can be run in the cloud as well as on premise, and there are significant grants available for trusts ready to make the full transition now. Funding is applicable especially where organisations come together on joint projects, in line with NHS England’s Sustainability and Transformation Plan. Each trust can go at its own pace too, or prioritise how it tackles its respective migration to a fully digital referrals scenario. That’s because the SynApps Solutions/Alfresco solution suite is modular, offering trusts the flexibility to concentrate on just the capabilities they seek right now.

How the market finally caught up with the Vendor Neutral Archive (VNA) promise

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I hope you spotted the great news that came in at the end of last month that the most trusted name in the IT commentary world, Gartner, rated us extremely highly in that part of the market known as the VNA.

VNA is not the sexiest term for a technology ever, I’ll grant you – but actually, it’s a really important tool and one that could really help a lot of people.

That’s because the name – it stands for ‘Vendor-Neutral Archive’ – doesn’t really convey what its power or potential actually is. We know – we’ve been marketing some excellent VNA solutions, especially for the NHS market, for a number of years now, and the vagueness of that name has perhaps not been to its help.

Why? Because NHS buyers see the VNA as in, essence, a medical device… it’s a bit of software that is good for storing my medical imaging data, specifically all the PACS and DICOM data that I needed to find a safe and secure home for when the old off-site PACS storage NPfIT contracts came to an end in 2015.

Which it is – a VNA is a fantastic way to store very large data files and access them really easily. But that was never what a VNA was only supposed to do. That’s because, out of the gate, you had this really cool XDS tech built into it – XDS standing for ‘Cross Enterprise Document Sharing’.

Why XDS is so useful is that it is a standards-based way to work with multiple forms of content, of all different types. That means that a VNA isn’t actually just a place to stick big X-ray image files, though please carry on doing so… it’s actually an Enterprise or Document Management System.

Why should I care, I hear you thinking? Well, a VNA might not be a whole lot of use to a manufacturer, a retailer or a financial services CIO.

But if you are

  • an NHS CCIO or CIO trying to help colleagues in different departments
  • and/or an NHS CCIO or CIO tasked with helping connect records with other stakeholders
  • a local authority social care team looking to join up information on vulnerable or elderly patients to help address their complex, cross-team needs
  • a GP surgery looking for better ways to document the patient journey
  • a CCG committed to more paperless ways of working with patient data
  • a policymaker in an NHS England STP (Sustainability and Transformation Project) interested in the power of digital to revolutionise patient care

Well, then – yes – what a VNA can do suddenly becomes absolutely central. How: because it’s the proven, available and tested way to keep all patient data – from notes to prescription charges to medical imagery to social care interactions – in one place.

And from cradle to archiving – across multiple stakeholders.

In that Gartner report, that route of travel has been clearly signaled. The good news is that here at SynApps Solutions, we spotted the potential for this years back, and have accumulated relevant expertise and intelligence on doing just this kind of Super-VNA work (and have some significant trails underway to make a VNA-based Shared Care Record a reality – an in months, not years).

It’s brilliant to see that Gartner has caught up with us – but we’re not boasting, we’re just saying that we are ready whenever you are.

Let’s work together to make VNA do what you and your patients and service users really need it to.

Chris Brice is SynApps Solutions’ Director of Sales and Marketing

SynApps Cited as Key Player in Gartner’s Market Guide for Vendor Neutral Archives (VNAs)

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November 26th, 2018 – SynApps Solutions today announced that it has been included in Gartner’s Market Guide for Vendor Neutral Archives (VNAs), November 2018.  Citing a dozen or so key suppliers, the new guide targets healthcare CIOs looking to understand the VNA proposition, market direction and notable vendors.

Gartner defines the vendor-neutral archive as a standards-based, interoperable, patient-centric medical image management platform.

Citing customers including Royal Liverpool and Broadgreen University Hospital, Croydon University Hospital, Kingston Hospital and Northampton General Hospital, the report describes SynApps’ VNA as a flexible platform supporting a broad base of content types extending to both DICOM and non-DICOM, so clinicians can access all related content.

The SynApps VNA offers increased flexibility because it’s been built on an open, standards-based enterprise content management platform (ECM), so it can be used to securely store and organise all kinds of content – not just medical images.  This same flexibility extends to its use as a community engagement platform for a shared care record, opening up access to GPs, CCGs and Local Government.

Speaking of the company’s inclusion in the report, SynApps Solutions’ director of sales and marketing, Chris Brice said, “We are delighted to be recognised alongside major market vendors as a key player in the VNA market. The SynApps VNA has been built on an open, standards-based enterprise content management platform, so it can be used to securely store and organise all kinds of content – not just medical images. It can be integrated with any number of different applications and data sources too, including electronic patient records.  This flexibility and openness has served us well and considered a key benefit by our clients.”

Find out more about the SynApps VNA here

Is Vendor Neutral Archiving the best building block for a digital patient record?

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With the National Programme for IT fading into the rear-view mirror, new storage contracts for many NHS Trusts need to be sourced. The good news is that this doesnt have to be a problem – and indeed, could be a real opportunity to find new ways of working with patient data of all sorts, thinks Mark Winstone of SynApps Solutions. Read more from IDMi magazine here – IDMi_Nov15

SynApps coverage in Bdaily: The DNA of VNA

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October 30, 2015 – Tony Backhouse, the Head of the Health Practice at SynApps Solutions, has got some great attention in an important online business publication, Bdaily.

The publication had asked him for his views on how the shake-up of England’s medical imaging market could open the door to achieving a true EPR.

Tony was happy to guide readers on how VNA is a standards-based way of extending PACS (Picture Archiving and Communications System) services to incorporate DICOM and other format content.

That, he advised, is going to be key to making the sharing of medical data easier for clinicians, as well as making patient records available across any combination of service providers.

“All a VNA is really doing is to extend your proven, workhorse PACS systems by adding a new dimension to the medical images you already need to capture and share,” Tony says.

“By applying a content management approach to your VNA-based medical records, you can make sharing medical data easier and more practical – as well as incorporating lifecycle management and retention policies to support information governance requirements using standard interfaces, which is what the Department of Health wants everyone in UK health informatics to be doing.

“It’s also sensible to use technology we know works in one part of the NHS and extend it to help in other areas, avoiding many of the mistakes we made in the Programme, and also opening up NHS information ‘silos.’”

He concludes:

“Put all this together, and you can see why VNA is swiftly becoming a promising new option for an NHS-wide approach to electronic medical records.”

Tony was also able to get a great shout-out in for our growing roster of successful NHS Trusts working with SynApps to do just what he explains in his article:

“And for a growing band of major [NHS customers], our Vendor Neutral Archive platform is doing just that – extending a central PACS repository to become a key component of a new generation of virtual EPRs.”

Check it out for yourself here