BACKGROUND
Improving Maternity Care Through Better Access to Information
There is significant evidence that a lack of access to information about pregnancy history can lead to poor outcomes for mothers and babies. Staff can’t always see information relating to bookings, pregnancy conditions, outcomes, deliveries, discharges or safeguarding from one another’s systems. Patients are often frustrated when they have to repeat facts or issues about their pregnancy, and often key facts are lost.
Joining up maternity services has been a long standing ambition in both the West Yorkshire & Harrogate Health Care Partnership (WY&H HCP) and the Cambridgeshire and Peterborough Integrated Care System (C&P ICS). Independently, they have enlisted Synanetics as a leading integration specialist to achieve interoperability between maternity systems, wider information sharing and improved clinical processes.
HOW WE ARE INVOLVED
In both localities we began by analysing existing clinical processes, determining information needs and assessing integration options between different maternity systems with a view to increasing automation wherever possible.
We worked closely with the NHS staff to identify architectural options and recommendations to meet their data sharing requirements.
When designing solutions, our approach was to establish a way for data stored in various maternity systems including K2, Epic-Stork, TPP, Cerner, Badger-Net, and Silverlink to be exchanged so that it can be viewed in the system that the clinician normally uses. We looked to minimise the impact on the system vendors and still develop common shared ‘open’ central components that are compatible with ICS strategies.
Differences in local capabilities and technical foundations naturally led to different solutions.
In C&P, we designed an XDS architecture which includes the automated pushing of documents to Health Visitors and GP’s and simplify access to maternity documents and documents more generally via the Orion Share Care Record (ShCR) system.
In WY&H, we developed an embedded maternity portal and a common FHIR-based adapter which is now used by maternity system vendors to facilitate interoperability and connection to the Yorkshire and Humber Care Record (YHCR). Data from maternity systems is also accessible outside of the maternity pathway: any system connected to the YHCR can consume maternity data for the purpose of direct care.
>> STRATEGY
>> ARCHITECTURE
>> IMPLEMENTATION
>> SUPPORT
TECHNICAL SUCCESSES
- Developed common infrastructure which is used across systems in WY&H to facilitate interoperability
- Created ‘open’ architectures for interfacing with the ShCR’s with the minimal possible impact on system suppliers and their respective maternity system products
- Helped define the core dataset needed by midwives, obstetricians and health care workers to provide optimum care
- Incorporated an event-driven care automation design within a shared care record
- Provided a standards-based and future proofed (XDS/FHIR) generic capability for handling documents (beyond just maternity documents)
OUTCOMES
- Achieved sharing of maternity data relating to bookings, pregnancy conditions, outcomes, deliveries discharges or safeguarding within 12 months
- Facilitated the assembly of a full medical history for pregnant women wherever the data resides
- Delivered improved clinical processes and patient safety
- Reduced the administrative obligation on clinicians by having information readily available in local systems – reducing phone calls, emails etc
- Integrated with a ShCR architecture facilitating wider document sharing
- Reduced the replication of documents – leaving documents at source
