Managing interoperability within the NHS 

We are led to believe that our systems within the NHS talk to each other and are doing so to alleviate the need to check in multiple places for patient information, so that we have an informed approach when assessing our patients.

I am using first hand personal experiences to try to make sense of how this actually works when trying to put into place a package of care with basic needs for a member of my family.

Interoperability is ‘the ability of computer systems or software to exchange and make use of information’.

Therefore, if a district nurse comes to your home to assess a member of your family and states “everything is done on computer now so we don’t need to write notes and it talks to the other systems so everyone knows what’s happening”, you would feel as though there is a cohesive mechanism for delivery of care.

But when you have to call the district nurse on several occasions to come and see a family member as nobody has communicated to them since their first visit, this does not instil confidence in the service that is supposed to be looking after you and making sure that this is done safely and efficiently.

If we are going to use digital health to support services in the NHS – and also ensure the people that use it – firstly we must know how to use the application and what its purpose is for, and secondly we must know how to use the system to then pick up future visits/tasks that need to be actioned.

A member of the community liaison team visited to complete a home assessment and identified a number of services/equipment that would be required for my family member to be cared for at home. When she left again she said, “I have put this into the system so it will be all sorted!”.
My question is “when and by who?” as we didn’t get anyone to come and see my relative or any of the promised equipment over the next four weeks.

How do we tackle this problem?

If digital health providers are developing their systems and promoting interoperability and its importance in delivering safe and efficient care to our population, then surely something is going wrong with the way this is being introduced or deployed. I urge the ICSs to take a look at how care is delivered in the community and the areas where they can make improvements.

It is all well and good having a state-of-the-art system that supports your working practice, but if it is not fit for purpose or users are not trained effectively in how to use it, then it becomes an unsafe tool that can delay treatment and care causing both physical and psychological harm to our population.

So, review your operating procedures in line with the changes that are being made. Have local champions who can assist colleagues in teaching and awareness and make sure your workforce is fully prepared for what is coming before it is already in place. Always ask yourself what is this going to achieve, over what timescales and for what benefits?

Unless it is a positive experience that helps improve services, then you have to ask yourself – why is it being done and at what cost?

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