The Painful Process
Within NHS Care providers, the use of the NHS number as the unique patient identifier helps ensure that a patient’s care and information about that care is better joined up and more efficiently and effectively coordinated.
University Hospital of North Staffordshire’s Patient Administration System (PAS) currently holds 1.3 million patient records. Simply tracing every patient attending on a daily basis was a huge task to undertake without the additional work then generated by the need to updating the records.
"The Data Quality Team ranged in size from one to two people and typically were able to update somewhere between 10 to 25 records per day."
University Hospital of North Staffordshire (UHNS) was the first NHS Trust to successfully implement an NHS Interoperability ToolKit (ITK) Spine Mini Service and did so using products and services provided by Quicksilva.
The solution uses Quicksilva’s orQestra® product and enables UHNS to directly trace and verify patient demographic information (including the NHS Number) held on the Personal Demographics Service (PDS) significantly faster and more accurately than was previously possible.
The project began in February 2011 and involved UHNS and Quicksilva completing the NHS Digital Common Assurance Process (CAP) with the First of Type implementation going live only 10 months later in November 2011. It also involved Quicksilva working closely with NHS Digital to develop the ITK Spine Mini Service concept. A key feature of this is that orQestra® need only be accredited once via CAP, further deployments are then covered under the auspices of the ITK Trust Operating Model which significantly reduces the deployment timescales for future customers. As a result 4 other orQestra® deployments have been rapidly undertaken with a typical deployment time of 4 months.
Now we have a fully integrated real-time solution within which NHS numbers can be verified and updated automatically on a daily basis. Because orQestra® electronically updates our records we’re able to focus on other data issues such as ensuring we have the correct GP recorded, safe in the knowledge that our PDS is consistent and accurate.
Rebecca Gallimore, UHNS NHS Foundation Trust
The Happy Outcome
orQestra® employs various algorithms to search for patients which have resulted in on average 99.6% of all patients who attend UHNS on any given day being traced on PDS. As a result UHNS is now automatically correcting approximately 360 NHS numbers on a daily basis whereas via the previous manual process only 4 NHS numbers per day were updated.
With a database the size of UHNS’s (1.3 million records) there was a 1.1% improvement in the number of records with a verified NHS number after the first month of usage.
> 99.6% of all patients verified
Data Quality Team Productivity Increased
In addition, orQestra® has also improved the productivity of UHNS’ Data Quality team by automatically identifying and reporting on differences between UHNS’s record and that held on PDS. Use of these reports as opposed to manual techniques has enabled UHNS to increase the volume of daily patient record updates being performed by a factor of five.
The average number of updates up from 10 to over 85 per day per team member, an increase in productivity of 850%.
Data Quality Increases
By improving the accuracy of its patient demographics UHNS also improves the accuracy of the monthly CDS submission that is communicated to the commissioning bodies ensuring UHNS are correctly paid for any services provided.
Identified differences such as these have been corrected in the local PAS improving data quality.
Record Updates Increased
The chance of a discharge summary being incorrectly sent to a patient’s GP has been reduced; likewise the chance of correspondence to a patient being incorrectly addressed has reduced.
Patient address updates increased from 5 to 38 per day and GP updates up from 8 to 48 per day.
Time to Implement Reduced
In addition to the benefits reaped by UHNS the project also demonstrated the benefit of the ITK Spine Mini Service approach and how use of the ITK Trust Operating Model can reduce implementation time without compromising the assurance process.
Every second counts in the immediate aftermath following an incident. Two pioneering ambulance Trusts had a vision to enable paramedics mobile access to real-time patient information, at the point of care.
This first-of-its-kind solution would enable paramedics using the service to deliver improved and safer care experiences for patients by reducing the risk of clinical errors and providing ambulance crews with key visibility of the patient’s pre-existing conditions and current medication.
Together, Quicksilva and Ortivus deliver a managed electronic care record service for up to 1,300 ambulances across the two Trusts’ service areas.
Swedish mobile solution supplier Ortivus were awarded a four year contract to deliver the solution with Quicksilva as their delivery partner.
Ortivus required a solution which would enable crew members to capture and search for information using innovative handheld devices and an operating system supplied by them.
Quicksilva’s orQestra® Spine Mini-Service offered a quick and simple way to securely access both the Personal Demographics Service and Summary Care Record services of the NHS Spine, 24 hours a day.
As orQestra® is an ITK-Compliant Mini-Service, Ortivus were able to avoid having to undertake NHS Digital Common Assurance Process compliance and were able to implement the solution within a matter of weeks.
Quicksilva were also able to offer a fully hosted solution with levels of Availability and 24x7 monitoring, enabling Ortivus to deliver its business-critical service with confidence.
5,000 Paramedics in 2 Trusts will access the orQestra® Spine Mini Service.
The Summary Care Record will be embedded into the application enabling crews to easily view the patient’s record once the patient has consented at the point of care. The devices that are being rolled out will in addition enable our staff to capture and exchange demographic and vital clinical information to improve patient safety and care.
Georgie Cole, Project Manager, South Central Ambulance Service NHS Foundation Trust
Patient Safety Improved
Access to the Summary Care Record at the point of care means crews are better informed in the critical decisions they make on the front line. Real-time access to existing medical conditions or ongoing treatments mean an improved and safer experience for patients.
Real-Time Data Verification
Benefits Keep on Coming
However, the benefits don’t stop there. Further benefits include a reduction in unnecessary ambulance journeys and potentially attendances at A&E, as ambulance crews will have better decision support when presented with a patient.
Patients can potentially be treated at, or closer to home, thus reducing unnecessary ambulance journeys and attendances at A&E. Access to additional information will also enable the paramedic crews to provide additional care and gain an increased decision support in the way they treat patients.
Carl Ekvall, CEO of Ortivus AB