Tags: NHS

SynApps In The News

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In this key public sector publication, Head of the Healthcare Practice at SynApps Gary Britnell discusses the interoperability challenge the NHS faces as it tries to become fully digital.

According to US digital health guru Robert Wachter, brought in by the Department of Health to advise the government on how to transition to a digital health service, “If I had any one piece of advice for the NHS around going digital, it’s to get interoperability right from the start. We have hospitals in the US that have great computers, but where 95% of the systems can’t talk to each other.”

He’s right: hospitals want to share patient data internally, as the paper chase chokes productivity, as our everyday experience with our NHS Trust customers shows. They also know that they’ll want to share that data with other providers as we move to break down the barriers between health and social care.

Many practitioners believe the best way of doing that is the Integrated Digital Care Record, the IDCR. The challenge: there’s no central, top-down route to get an IDCR; Trusts are going to have to build their own.

Getting to the digital NHS we need is not going to be easy. The good news is that once we have this in place, we will be able to do great things in the NHS, such as route information without any need for re-keying or asking the patient the same questions, allow collation of data for better analysis of the bigger trends, programmatic search, and so on. SynApps is actively engaged on building just such a practical way of doing so.

Read the article for yourself here

2017: A Year The SynApps IDCR Moves From Blueprint To Proof Of Concept

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SynApps Solutions’s Joint CEO and Sales & Marketing Director Mark Winstone shares his thoughts about what he thinks 2017 will bring

For SynApps, 2016 has been very much about the NHS. But that doesn’t mean other markets haven’t been of huge interest to us. Our work in the Police market actually shares many of the same urgent business drivers as the health one, so there’s some useful commonality there.

However, the drive to interoperability in the NHS has dominated our work this year, as we’ve talked about [see here and here]. That’s to say that we very much agree and support the call from the very top of NHS England and NHS Digital, for a better way to use NHS IT to share information better.

That sharing has to be internally and externally, of course – which is why the CCGs, who are delivering not just a more interoperable NHS but also a more integrated and unified NHS and health and social care system, have been looking for ways to work toward the Integrated Digital Care Record, the IDCR, fast emerging as the most solid foundation for the next-generation NHS.

Think of it this way: you’re a CCG running a big city that’s got a chunk of countryside latched on. You could be talking about eight or nine Acute Trusts, maybe 80 or 85 GP surgeries. Throw in a couple of ambulance trusts, some mental health entities and local Social Services. It’s a complex network of people who want to partner better but don’t know how, and an awful lot of patients (many very vulnerable) who need to be looked after.

You will need technology to knit all this together, and patient information is the main ‘unit of currency’ that will make it work. This is so important and critical a problem for the NHS that we have spent the majority of 2016, led by my colleague Jason Scholes and his healthcare team, working on a framework for delivering the IDCR in a practicable way.

We know from all our experience with VNAs and data formats in hospitals that there are incredible disparities of technical knowledge and resource across the NHS. NHS England has been finding this out in its groundbreaking Digital Maturity Assessment work this year. We know there are different EPRs and different PACS systems and different IT systems in the NHS – even in the same hospital. So an IDCR is incredibly important, but also hard to deliver from scratch – which is what we have been putting our engineering and design resource into, in a bid to help the CCGs do this (our proposed IDCR blueprint work is here).

In 2017, this work will take a big step forward. Rest assured real proof of concept IDCR work is going on already at NHS customers, convinced by our vision and capability around clinical content and its safe management. IDCR will take a long time, but we will get there, and standards – always something we have lived or died by at SynApps – will be a key enabler, such as CDA, MESH and XDS.

We’re ready to make 2017 a really successful year!

Not all NHS organisations will get to any kind of IDCR finish line, of course. We anticipate that many won’t, and will want to instead benefit from the success of others, who may lease out IDCR capability through partners like us as cloud-delivered services.

This is something we see in our other big public sector ICT market, criminal justice. Individual Police Forces, the CPS and other stakeholders are also wondering if there might not be a more efficient, seamless way of sharing suspect information. Again, standards are being pushed and probed to see if they can help, and we are also working on demonstrators and PoCs to show what can be done.

The takeaway from all this is, I hope, clear: SynApps is working with its public sector and technology partners, doing important and interesting work – and 2017 looks set to be the year that these seeds bear fruit.

2016 – and 2017 and beyond – are about consolidating and building on the strong foundations that we think previous architectural work we did has laid down.

Can I now wish you all a great Christmas, hope you have a wonderful break, and see you in 2017 – when I hope you’ll join us and our partners and NHS IT customers in building more IDCR frameworks that will help patients, budget holders and the country as a whole.

Mark is SynApps Solutions joint Chief Executive Officer, as well as its Sales & Marketing Director

Coded And Non-Coded: Why It Matters

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October 21st, 2016 – In a recent blog article, SynApps has given more details on how to get to the the Integrated Digital Care Record (ICDR) via not just CDA and MESH but other ‘pieces of the jigsaw puzzle’. That’s because while we now have a format for producing some documents and a great way to send them, there is information that is falling between the gaps. Hospitals can generate a PDF for a discharge note, but then end up printing it off and posting it to the GP, which is not really the mission.

The heart of the matter is that not enough NHS stakeholders have understood the difference between coded and non-coded documents. Non-coded documents are less useful than coded, though a lot more useful than just paper, says the article. With coded documents, you can add in more information that health systems at the other end can pick up automatically.

Ideally all data formats (and there are lots) should be coded. In the meantime, your ICDR needs to work with the non-coded ones, as well as the coded ones, so that information is not falling in the gaps (think those posted discharge notes).

To read the full article, go here

NHS Interoperability Is The Main Reason We Need IDCR


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“If I had any one piece of advice for the NHS around going digital, it’s to get interoperability right from the start… we have hospitals in the US that have great computers but where 95% of the systems can’t talk to any other system.”

For me, if there’s any one sentence that sums up why we’re working so hard at SynApps Solutions around interoperability at the NHS, that’s probably it.

And it’s from an absolutely impeccable source, someone who really knows what he’s talking about – Dr Bob Wachter, the US digital health guru the government brought in to advise the UK on how to better utilise digital technologies.

Wachter told the delegates at HETT recently that of his three main messages to the Department of Health, interoperability built on a solid foundation of standards was just as important as his other two.

The warning is incredibly timely for NHS leaders. That’s because we have designed a standards based architecture here at SynApps Solutions helping build a practical solution to help NHS leaders avoid that fatal lack of interoperability (1).

Let’s remind ourselves what the agenda is here. Hospitals want to share patient data internally, as the paper chase is killing off productivity and is increasingly recognised as archaic by smartphone-savvy users. They also know that soon, they’ll want to share that data with other providers in a more integrated health and social care chain.

A new way to exchange health information and data

To that end, NHS England and NHS Digital are promoting the IDCR as the ideal way to achieve that. The challenge: unlike in the days of NPfIT, there’s no central, top-down procurement process to get an IDCR. You’re going to need to build one.

The good news is that SynApps and our partners can help. But it’s still a significant undertaking. There are two big parts of the puzzle emerging – CDA and MESH. CDA is an HL7-controlled standard for working with Clinical Document Architecture (think things like discharge summaries and progress notes), so is a great way to put your output into a useful XML-based format, while MESH (message exchange service for health),which is replacing the older NHS DTS standard, is a new way to exchange health information and data (2).

So now there is a format for producing at least some documents and a great way to send them. However, there is also information that is falling between the gaps. Hospitals can generate a PDF for a discharge note, for example, but then end up printing it off and posting it to your GP. That’s not really the mission here, clearly.

The heart of the matter here is that not enough NHS stakeholders have got their heads around the difference between coded and non-coded documents. Put simply, non-coded documents are less useful than coded, though a lot more useful than paper. With coded documents, you can add in information that health systems at the other end can pick up automatically, which gives the recipient a lot more context and useful information about the patient and the case.

So what we want to do is to provide a way for NHS practitioners to a) more easily start using coded electronic documents that best exploit the power of the CDA standard and b) allow them to start using the power of MESH to safely route and share such digital assets. The key to this is realising that hospitals have lots of different types of documents and data, e.g. DICOM and non-DICOM. We have to work with all these data formats to get to the kind of interoperable future Dr Bob, Jeremy Hunt and NHS Digital wants us to be moving to.

A fantastic opportunity

What we want to offer is a way to check in all those different sorts of documents and formats into a safe place that means they can get routed out again in packages that conform to the CDA and MESH protocols. It will be able to work with coded documents – and we think non-coded is the stepping stone we have to work with to get there.

Once we have this basis in place, just think of the things smart documents could do in the NHS – route information without any need for re-keying or asking the patient the same questions 20 times, allow collation of data for better analysis of the bigger trends at the local, regional and national level, programmatic search, and so on.

We are convinced IDCR is a content problem. Our distinctive contribution to all this is content. We are a content management company; to us, CDA and coded documents are just more content forms to store, manipulate, access and share. We are also very experienced in hosting, and IDCR is a prime candidate for being delivered via a web-based solution to promote intra-stakeholder collaboration and partnership.

We can deliver on the Watcher Review’s aims and get interoperability bedded down as soon as possible here, as well as make IDCR a really fantastic way to share data tomorrow.

If that sounds like work that will help your organisation, then get in touch to discuss how to build the best IDCR to meet your team needs. Drop me an email today.

Gary Britnell

SynApps Solutions Healthcare Business

  1. We’ve also discussed this fascinating work here and you can check out the details of Wachter and his team’s recommendations in the full report, Making IT work: harnessing the power of health information technology to improve care in England, here
  2. see this NHS England guidance for more on that transition

A Huge Digital NHS Push

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medic-563425_1920October 17th, 2016 – Gary Britnell, who leads the work in the NHS for SynApps, has published an article that puts the recent announcements by the Secretary of State for Health at the Health and Social Care Innovation Expo in Manchester in context.

Britnell explains how the speech is our clearest indication yet of what the NHS will look like as the extra £4.2bn the government has allocated to new IT comes on-stream.

These include the 12 first Exemplars, the opening up of official NHS apps, and a major refresh of the main NHS website – but for Trusts, especially any looking to build IDCRs (Integrated Digital Care Records), more pressing might be the demand for, “Instant access to personal health records online” and, “More interactive, local information about the performance of health services [so] patients can see how the performance of their local services has changed over time.”

According to Gary, the message for the NHS IT leader from Manchester is coming through loud and clear: data, and that it’s useless unless it is made interoperable and securely shareable, which is where SynApps’s work on IDCR is going to help, he argues.

To read Gary’s helpful overview go here

Manchester Was The Countdown To A Huge Digital NHS Push – Are You Ready?

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medic-563425_1920Anyone who is part of the UK health IT community gets used to big statements regularly being made about the digitisation of the NHS.

Last month, the Secretary of State for Health Jeremy Hunt spoke at the Health and Social Care Innovation Expo in Manchester, and finally set the seal on what the government expects the NHS to do next.

I probably don’t have to tell you about the context; the 2020 paperless NHS target, the NHS’s Five Year Forward View to ‘harness the information revolution,’ and the findings of the Wachter Review into what needs to be done (see here).

What matters now is what the Secretary specifically announced. (This is the main DoH press release)

The new website will also enable patients to download their personal health records to their phone securely

Hunt confirmed there are three broad themes in the current NHS IT plan, which are a renewed focus on interoperable electronic health records, a call for more use of patient-focused digital technology, and another go at care.data – data harvesting and exploitation of NHS information through secondary use of data, transparency and consent.

These themes matter, as they a) gave specifics on what the government expects the NHS to do with IT reform and b) reset some deadlines, most especially the 2020 paperless target, which has been pushed out to 2023 due to Wachter’s intervention.

Most germane for CCIOs is what NHS England, and more crucially NHS Digital (the old HSCIC), sees as its role in the post-Wachter regime. NHS England lists the following as the most important outcomes of Hunt’s September speech as the Exemplars, the opening up of official NHS apps and a major refresh of the main NHS website: “NHS Choices website will be relaunched as NHS.UK with a wider range of online patient services, including the ability to register with a GP, book appointments, and order and track prescriptions all in one place. The new website will also enable patients to download their personal health records to their phone securely, giving them instant access to important healthcare information, such as prescriptions and test results” (see here).

Now, a lot of this is outside what most Trusts will have to immediately worry about. But there were absolutely some things that will concern them. Consider this:

“Instant access to personal health records online – inspired by the ‘blue button’ app in the US, the new NHS.UK site will also enable patients to securely download their personal health records, giving them instant access to important healthcare information, such as prescriptions and test results.”

and this:

“More interactive, local information about the performance of health services – from today, the MyNHS website will give better data on how NHS services are performing across dementia, diabetes and learning disability services. Maternity, cancer and mental health data will follow later this year. In future, the revamped site will also include maps, graphs and tools so that patients can see how the performance of their local services has changed over time.”

The central role at local level of the IDCR to make this data-driven NHS work

The keyword for the NHS IT leader of today is data.

The Secretary says there is £4bn available now to digitize the NHS along these lines.

That data, however, is useless unless it is made interoperable and securely shareable.

Which is where our attention has been focused, with our work on helping draw up realistic roadmaps for helping health and social care organisations deploy Integrated Digital Care Records (see here).

So to sum up, this is the SynApps view:

Manchester was where the blue touch paper was lit for the next phase of IT innovation in the NHS.

Data is central.

And the IDCR is going to be a key way to deliver against all of this.

I encourage any NHS IT team to get in touch – and let’s see how we can help you make all of this a reality at your local and regional level.

Gary Britnell

SynApps Solutions Healthcare Business

SynApps Collaborates with Alfresco and Enovation to Produce Blueprint for Integrated Digital Care Record

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September 6th, 2016 – SynApps is working with NHS Trusts to open up a practical pathway for health and social care stakeholders to share information – the IDCR (Integrated Digital Care Record).

Working with teams at Alfresco and Enovation, SynApps has developed a blueprint that offers a way for many different data owners to securely and efficiently share data, checking it in and out of a rich central repository.

Find out more about SynApps’ IDCR solutions.