The Connecting Care Interoperability Programme has gone live with its first Care Connect FHIR API so staff working with homeless and vulnerable people can see if they have a prescription for Opioid Substitution Therapy (OST) drugs.
The Care Connect interface links Orion Health’s pioneering integrated digital care record and the Cyber Media drug and alcohol system, Theseus, which is used by Bristol City Council. It was developed to reduce the risk of duplicate prescriptions being issued for controlled drugs, which can lead to overdoses and other serious incidents. Dr Mike Taylor, lead GP at The Homeless Health Service in Bristol, said: “GPs working ‘in hours’ or ‘out of hours’ now have a reliable, quick, efficient way of knowing whether the patient in front of them is receiving opiate substitutes from drug workers outside practice-based care.
Clinicians in hospitals can also be aware of this source of prescription. This has real potential for saving lives and reducing drug-related deaths.”
The link is also significant because it makes NHS South Central and West Commissioning Support Unit (SCW), which supports Connecting Care, one of the first organisations nationally to use the Care Connect FHIR APIs championed by NHS Digital and INTEROPen.
NHS England commissioned the development of Care Connect APIs to make it easier for health and care services systems to share information, using HL7 FHIR, a new standard for exchanging healthcare information electronically.
Emlyn Jones, technical lead for the Connecting Care programme said: “Our long-term goal is to create a consolidated list of medications for each patient, and this is the first step in doing that. So, we were looking for an interface that we could re-use, and the FHIR profiles felt like a good fit.
We spend a lot of time in the tech community talking about FHIR, and this seemed like a good opportunity to try it. FHIR is polished by being used. By doing things, we get them right.”
To support timely availability of the OST medications, the Theseus system, presents Connecting Care with an API that the Orion Health Clinical Portal calls to find out if a listed patient has been prescribed controlled drugs.
Fran Draper, senior project manager and engagement lead, Connecting Care Programme said: “This was a very rapid project; from design to go-live took just seven weeks.
It was an exciting project to work on, but it was just dipping our toes in the water. We want to go further, and to use this work to get into the technology of the twenty-first century and beyond.”
The Care Connect FHIR API initiative was started in 2016 and is at the heart of INTEROPen’s vision to create nationally defined HL7 FHIR resources and interaction patterns, to simplify integration and interoperability within UK health and social care. NHS Digital are supporting INTEROPen to foster collaboration between industry, standards bodies, informaticians, terminologists and health and care providers to define FHIR resources tailored to the NHS which support interoperability between health and care systems.
Orion Health, which provides the technology that underpins Connecting Care, was one of the founder members of INTEROPen. The INTEROPen initiative can help support the vision of the secretary of state for health and care, Matt Hancock, by introducing the data interoperability standards he wants to make sure that the IT systems used by NHS staff can “talk to each other.”
The work in Bristol puts SCW and Orion Health in the vanguard of this national agenda. Dr Amir Mehrkar, GP and co-chair of INTEROPen, said: “Members of the INTEROPen collaboration have co-produced a set of national CareConnect FHIR profiles over the past year, so it is wonderful to see real implementation of these interoperability standards in the service.
“There is a lot more work to do but this is an important example of how sharing clinical information stands to make a real difference in patient safety.”
Connecting Care is one of the longest-running and most extensive integrated digital care records in the country, enabling secure, instant view only access to health and care records for around 6,000 professionals working in Bristol, North Somerset and South Gloucestershire.
Role-based access is built into the Orion Health technology that underpins the project, so professionals can only see the information they need to do their jobs. Citizens can opt-out at any time.
Every new interface added to Connecting Care goes through a rigorous information and clinical governance control process that can include discussion by the Connecting Care board.
The new FHIR supported interface is already live in Bristol, where it can be viewed by staff working in 27 organisations, including 85 GP practices, NHS hospitals, mental health and out of hours services, social services, paramedics, charities and hospices.
The next step will be to extend it to the other areas using Connecting Care. Gary Birks, general manager, UK and Ireland, Orion Health, said: “We are proud of our association with Connecting Care, which is undoubtedly one of the most-cutting edge integrated digital care records in the country.
Orion Health was a founding member of INTEROPen so we were particularly pleased that SCW decided to use a Care Connect FHIR API for this important project. We continue to work with SCW on developing leading edge interoperability and look forward to more successful delivery in the future.”
