Developing Shared Care Records – Surely Data First?


Developing shared care records is one of the greatest digital transformation challenges facing the public sector today, but really it is a data challenge. Therefore, success will be largely dependent on a change of mindset; from project management to data enabled journey, from milestones to scalability, from tool implementation to insight and from focus on inputs and outputs to evolving user benefits and outcomes.

The high-level benefits of effective Shared Health and Care Records to patients, nurses, doctors, support workers, clinical and care service managers and commissioners have been clearly defined and as such investment has followed and the ICT solutions market is now offering a range of tools and platforms to ‘enable’ this ambition. The NHS is clear that the approach to developing this capability should be determined locally with the key stakeholders in Health and Social Care collaborating to agree the right solution in the delivery of the ambition. Collaboration has been supported through investment in the Better Care Fund and technology and digital care funds, however, approaches to collaboration seem to regularly hit difficulty at ‘solution selection’.

Local solution selection is still dominated by vendor beauty parades where local Health and Care leaders have been left to determine the vapour-ware from the tangible solutions, the right platforms for today against the platforms right for tomorrow as well as a range of other intensively resource burning considerations. So far the results are mixed, but it is fair to say the ambition is far from embedded in any locality let alone nationally. Part of the issue appears to be the capability to really collaborate around data rather than platforms. The lack of a top down national platform should be an opportunity to think differently and think locally and that should start with thinking about data.

First, there is a lot of it, but it’s not all ‘Big Data’ instead it’s highly varied, high volume data sets held by Acute Hospitals, GP Practices, Community and Mental Health Teams and Social Care. Developing shared records that can enable more effective, efficient and seamless health and care pathways within this legacy data environment is never going to be an out of the box implementation. It must be an iterative journey but, how do you iterate without data to identify priorities and then show the impact of each iteration?

Second, are we clear on what data the Stakeholders currently have and what they really need? This goes beyond data they can access but to data they value i.e. data they can draw insight from and act appropriately, make the right decision in the right timeframe. Very few practitioners or commissioners will benefit from reams of confusing tables!

Third, prioritisation must go beyond need, to proximity of opportunity, data is essential in determining this. Where are there significant data quality issues, what are the regulatory compliance issues, what is our shared data management capability, what data is duplicated or difficult to match? As ever the greatest need can be far from the closest opportunity when the detailed state of play becomes clear.

There is a compelling case for developing in-depth data knowledge before any solution is considered. Of course, selecting the right digital tool/s is then essential, any platform must enable operational and strategic collaboration on common cases and data sets, master data management, workflow as well as advanced analytics. However, each of these capabilities has a myriad of options and a significant road map of development within the shared care record. The process of developing ongoing platform capability would be more likely to yield positive results if informed by data based evidence. Finally, the process is more likely to be efficiently developed in a truly scalable public cloud environment but the lack of development on such technology highlights a more traditional ‘application’ mindset is still prevalent.