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Liverpool aims to be digital health and care leader

Liverpool Clinical Commissioning Group is working to join up apps, health records and clinical systems to make it easier for patients to interact with the NHS

Liverpool has an ambitious programme to make it easier for patients and clinicians to get the most out of digital technologies.

The city wants to be one of the top 10 digitally advanced health and care economies in Europe by 2020. It aims to empower patients by maximising the benefits of digital technology.  

Dave Horsfield, the programme manager for the More Independent programme at Liverpool Clinical Commissioning Group (CCG), spoke to Computer Weekly about the project.

He said that the main goal is to combine different technologies and put information in the hands of the public. This will be done in a way that lets patients be in control, he added.  

“We want people to start engaging better with their health,” he said. Part of this is to give people access to their electronic patient records.

However, if patients want to get access to their records now, they could go to their GP and ask for it.

“We’re able to get access to our records if we want to get them. But people haven’t been flocking to their GPs asking for records,” says Horsfield.

There’s an app for that

NHS England’s Patient Online programme has a goal of offering patients access to their full GP records by the end of March 2016 – and patients already have access to their summary care record online. However, uptake has been slow, with only 2% of the population interacting digitally with the NHS.

Liverpool CCG wants to give people a reason – or a purpose – to engage with their record. Whether it’s people with diabetes, mental health issues or someone who wants to quit smoking, there are a plethora of apps out there to help.

Horsfield said it’s critical to have good apps that sit behind it, because people won’t use it if there isn’t a good reason. This means engaging with the digital marketplace to ensure suppliers develop technology people want to use.

“We created a platform that’s capable of hosting applications through a set of APIs [application programming interfaces] and business rules that can access that information,” said Horsfield.

For example, if a patient is diabetic and uses a diabetes app to monitor blood sugar levels, mood, weight or eating habits, the platform lets the patient upload the information from the app into the patient record.

“It means you can share information with a clinical professional safely,” added Horsfield.

Read more about a digital NHS

He said the information won’t necessarily be in the clinical record, because it would cause “a real panic” in the clinical community if everyone could write anything in the record.

“You wouldn’t want patients going in and changing all the information in the clinical record. We’re envisioning a clinical element where you have to be a clinical professional, and a patient element where the patient can enter information,” he said.

To ensure the record is secure, the CCG is working with the Health and Social Care Information Centre (HSCIC), NHS England and the Government Digital Service (GDS) to develop an identity authentication scheme suitable for the NHS.

GDS has developed its Gov.uk Verify identity platform, but the CCG and the HSCIC feel that health needs an extra level of security. “People need to feel certain that the information is secure,” said Horsfield.

Mapping new tech

Becoming one of the leaders in digital health and care requires the CCG to keep track of the latest, innovative technologies.

“The NHS is a bit slow when it comes to technology. It often takes years with clinical technology to get it to a safe and appropriate level where it can be deployed in a clinical setting. Then we spend more years embedding it into the service,” he said. “That’s not viable if we want to be a leader.”

The CCG therefore has a map where it adds technology it expects to see develop over the next five to 10 years. It then has meetings with clinical teams to build services based on what the technology might look like.

“We are no longer buying systems off the shelf,” added Horsfield.

In its blueprint, the CCG has set out its goals for the next decade. In the next five to 10 years, the CCG aims to have a virtual hospital service across Liverpool, which provides access to specialist care across the secondary care infrastructure.

It’s also looking at a range of assistive technologies from standard telehealth services to advanced sensors and smart bandages. “We want an intelligence-led NHS. What if the bandage can send out an alert when it needs changing?” said Horsfield.

The CCG is also looking at predictive analysis to anticipate care trends and illnesses to help keep patients out of hospital.

Joining up health and social care

By 2020, the NHS needs to be fully integrated with social care due to a mandate set by government.

In Liverpool, the iLinks programme has been working for the past few years to make sure health and social care practitioners can view whatever information they need about the patient in their care.

The programme aims to have a shared digital care record across all health and care settings, which is accessible to the right person at the right time.

It also includes making sure there is no “wrong front door” to the NHS, meaning that it shouldn’t matter if you go on a hospital website, a CCG website or a GP website – you should be able to find what you need.

“We’re looking at this now, but it’s quite a new piece of work,” said Horsfield. “The idea is that if you go on a hospital website, but you need to make a GP appointment, you should be able to. The question is how we do that.”

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