Preparations are well under way for nearly half a million patients in Wiltshire to come on board our electronic Shared Plans (esP) this summer.
The platform gives clinicians an interactive view of patients’ medical records tailored to their specific needs on the computer, tablet or phone. This has endless uses but will serve as Wiltshire’s Electronic Palliative Care Coordination system (EPaCCs) for end of life care plans, making this most difficult time that bit easier for their 470,000 patients.
People with 12 months left to live are put onto an end of life care plan to ensure they live as well as they can and die with dignity. It is supposed to do this by providing clinicians with the patient’s up to date preferences in both their care and their death. But often the healthcare professional with them at the critical time does not know or have access to these wishes in an authoritative single shared care record.
If this information is stored digitally, it tends to currently be both created and held separately across isolated systems. Where there is a single shared care record it only contains certain elements rather than a full care plan with all the necessary information. Both of these shortfalls mean too often the healthcare professional dealing with a “crisis” situation does not have the right information at the right time to make an informed decision. This is exacerbated as those on the plan are in far more crisis situations than any other patient.
It means doctors are forced to make agonising “if in doubt” decisions; around half of patients die where they do not wish to, while many who are resuscitated did not want to be. As well as the pain to families, this ties up resources from others who desperately need it.
We designed our EPaCCs with NHS staff to ensure clinicians always knows the patient’s latest wishes so they are respected no matter where or when that critical time is. Our eSP enables healthcare professionals to create and maintain a single “truth” – an up to date record of their wishes and appropriate medical information live from the patient’s GP record. This is shared live across all NHS services which can contribute in real time throughout the patient’s journey, with the plan automatically updating healthcare professionals accordingly.
Wiltshire coming on board is also a special moment for the team as they are part of the same sustainability and transformation partnership (STP) as Swindon – our longest serving customer. We developed our first platform, electronic Referrals and Appointments (eRA), with Swindon in 2013 for GP extended hours and access. It was the first live use of HL7 FHIR in the world, a system for exchanging health data in a common language that is now the NHS standard. This is transforming the ability to safely exchange health and care data across systems opening up huge potential for the future of our health service.
Swindon will also be joining Wiltshire on eSP and both will be live by mid-summer. Their GP surgeries and associated organisations are among 900 joining us on the platform this year, on top of the 600 already with us.