Tags: NHS

SynApps Coverage In Document Manager

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In key industry publication DM Magazine, an article has been published by our head of Healthcare Practice Gary Britnell on the best response by the UK health IT community to Secretary of Health Jeremy Hunt’s recent apparent dismissal of the importance of NHS paperless targets.

For Gary, NHS IT leaders should instead look at the great progress to paperless made so far. He discusses how getting to a paperless NHS is not going to be easy, but practical techniques like the integrated digital care record (IDCR) are emerging as a great way to get there.

Read the article in full here

SynApps Seen As The Foundation Of Key Digital Exemplar EPR Project

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In widely-followed sector publication Digital Health, SynApps Solutions project at the Royal Liverpool and Broadgreen University Hospitals NHS Trust has received some positive coverage.

A project is underway there to deliver a new Electronic Patient Record strategy based on an open standards-based vendor-neutral archive. The article discusses how Royal Liverpool is one of NHS England’s 16 global digital exemplar sites, which are being centrally funded to provide digital transformation best practice for other trusts to follow. IT systems used by the exemplars are likely to be adopted widely by other trusts, observers expect, for example.

Digital Health highlights SynApps role in preparing for the EPR in 2013, when we helped Royal Liverpool migrate nearly 90 million images to the SynApps vendor neutral archive (VNA).

Find out more about the project in more detail here

Jeremy Hunt’s Dismissal Of A Paperless NHS Target Shouldn’t Detract Us From The Goal

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“I am quite relieved that most people seem to have forgotten that I made that promise.”

A lot of us working in NHS IT were quite surprised to hear that claim from the Health Secretary.

The promise Jeremy Hunt was referring to was nothing less than the directive from the Department of Health for us all to work to in order to become fully paperless by 2018.

To quote respected public sector ICT site diginomica’s write up of the Secretary’s appearance before the NHS Sustainability Committee, ‘The paperless NHS by 2018 challenge was announced by the Health Secretary back in 2013. Somewhere along the line this got pushed back to paperless by 2020. However, following a review by Professor Bob Wachter of the University of California, which stated that the 2020 target was also “likely to fail”, it is now thought we are looking at at least 2023 before the ambition is realised’.

Hunt told MPs that he “made big, bold statements about” going paperless, admitting he’d perhaps “rather bravely said I wanted the NHS to be paperless by 2018 in my first few months as Health Secretary”. (Hunt made the admission to the Committee in a closed December meet – the remarks were only made public last week.)

2018 might well be a realistic target for some ambitious Trusts

The problem for some us is that the sector took the plan to become fully digital very seriously.

After all a paper-free NHS was a route of travel that at one time featured its own special section on the DoH website, was regularly discussed by Jeremy Hunt and senior stakeholders in NHS England – and Trust IT managers had to find ways to deliver against it [https://www.gov.uk/government/news/jeremy-hunt-challenges-nhs-to-go-paperless-by-2018—2]. Only last year, Hunt announced that he had received an extra £4bn to help Trusts get there.

The good news is that the promise of going digital hasn’t being forgotten by Hunt or NHS England – it’s just been pushed out further, as we try and action some of the Digital Exemplar and other items that came out of last September’s Wachter Review.

Hunt did confirm all this in his Committee appearance and there’s lots of great progress being made. After all, it would be a false economy to scrap the target if it’s anything to do with saving money on IT as paper is far more expensive in the long term.

We know. We are seeing it every day with our NHS clients, who are achieving great things with content management in cutting down the paper chain and achieving the kind of benefits that the 2013 set of objectives called for.

That doesn’t mean there still isn’t work to do in terms of getting to paperless. Although a lot of digital format medical and patient data is starting to circulate between some parts of the local health system, even some of it as far as A&E, it’s not yet flowing as well as it could be inside the Trust as a whole.

We’re a bit disappointed with the Health Secretary for being a bit flippant about something we take very seriously.

But that hasn’t lessened the commitment we have as an NHS IT supplier to the goal of a digital, joined up NHS.

And some of us will get there in 2018.

Now that’s the kind of big, bold statement I like.

Gary Britnell
Head of the Healthcare Practice
SynApps Solutions UK

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