Delivering new models of care: Why we need a new digital paradigm

Having been a cornerstone of modern healthcare organizations, traditional electronic health records (EHRs) can become monoliths that are resistant to change. Implementing new models of care requires a more flexible digital platform that ends vendor lock-in and separates data from applications.

In the UK, plans are well underway to establish 42 regional integrated care systems (ICSs) across England and Wales to better meet changing and growing patient demand.

ICSs are new partnerships between multiple health and care organizations to coordinate and plan services in a way that improves population health and reduces inequalities between different groups across a given region.

Siloes and barriers

This ambition requires a vast number of separate providers – acute, community, voluntary and mental health services – to be able to aggregate and share data. Yet, the way electronic health record (EHR) systems are currently set up makes this a difficult task.

Once the cornerstone of modern healthcare organizations, organic digitalization has turned many EHRs into monoliths that are resistant to change.

Implementing new care models requires a flexible digital platform that separates data from applications.

The causes, for the most part, lie in progressive and organic digitalization. When healthcare organizations look to resolve an issue, they procure or develop their own system or application. As a result, healthcare data has traditionally been non-standardized and stored within incompatible computer systems. Moreover, the vendors of these systems typically prohibit (or charge for) access to stored data, which is a barrier to the research and innovations that are so crucial to the discovery of new treatments.

Vendor-neutral data core

One solution could be to develop ways of integrating all the different systems. The problem with this approach is that it’s costly, time-consuming, and risks data loss. As well as being impractical, it also offers no guarantee of forward compatibility as new applications are developed in the future.

A better way forward is for organizations in the health and social care ecosystem to move away from app-driven to data-driven systems by adopting a shared digital health platform. Such a platform is based on open standards, vendor-neutral, and designed to secure and separate data from applications. This means that healthcare organizations can buy or create applications, all drawing on the same data core.

Flexibility and future-proofing

This paradigm brings many different benefits for healthcare providers and the populations they serve. It simplifies the approach to digitalizing and connecting all components of care pathways. Healthcare providers have more control of data and how they want to use it; and they have the freedom to work with any vendor to better help patients and clinicians. They can pick and choose what they need, while also developing digital solutions themselves — from simple forms to complex applications.

Importantly, the platform positions clinical and digital leaders more robustly for the future. There is a persistent data repository which remains for the lifetime of patients, and no data is lost between the development of different applications. In addition, vendors have the freedom to collaborate and innovate — to support remote connected care, for example.

Better data, better care

At Better, we’ve been talking about and advancing this for a while. Our next-generation openEHR platform is a standards based digital health record solution. This approach is already working in several European countries and we think it’s key for the new ICSs – eight of which are already using Better’s digital health platform. Crucially, migrating to a regional digital platform doesn’t mean that organizations must get rid of the systems they already use; they can co-exist with the new systems deployed via the platform. As each organization adds new applications, they can work with the same data used by other organizations and their existing systems.

Ultimately, better data equals better care. With such intense pressure on the healthcare system, this is an approach that can help clinicians and the digital specialists who support them. Done right, digitalization should free up clinicians’ time, not demand more of it. CTOs, CIOs and CDOs must have the freedom and flexibility to harness data and work with any partner to help digitally transform health and social care.

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About Jack Williams
Sales and Client Account Director UK&I at Better
Jack’s primary focus is to support Better’s partners at an Integrated Care System level across primary, secondary and community care settings. He helps develop an understanding of their unique requirements and supports digital development priorities which provide an opportunity to enable rapid digital transformation. This is enabled via Better’s open data digital health platform, designed to store, manage, query, retrieve and exchange structured electronic health records.

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