In the ever-evolving landscape of healthcare, the integration of disparate systems remains a significant challenge. Recently, I came across an insightful article by a US clinical colleague that delved into the clinical and financial effects of operating within a fragmented healthcare ecosystem. This piece resonated deeply with my own experiences and prompted me to reflect on the potential solutions to this pervasive issue as seen from an NHS perspective.

The reality of disparate systems

Throughout my career, I have navigated various disparate systems, each designed to address specific needs within the healthcare environment. The idea of converging these systems into a single, unified platform often comes up in discussions. However, this notion, while appealing, is not always practical. The time, effort and initial costs required to replace existing systems with a new, unified solution can be prohibitive. Despite these challenges, the benefits of operating on a single platform are undeniable. It promises streamlined workflows, reduced redundancies and, ultimately, better patient care.

A better approach: Convergence without replacement

Instead of a complete overhaul, we should consider an approach that enables convergence without wholescale replacement. This strategy focuses on merging data from various systems to facilitate better, faster and safer clinical decisions. The key here is not merely about the solutions themselves but about how data is integrated and shared across platforms. Ignoring the needs of both clinical and non-clinical users can lead to significant pushbacks, as users are often attached to their bespoke solutions. Therefore, the goal to be considered is the effective sharing of data available through a consistent and familiar single point of access.

Instead of a complete overhaul, we should consider an approach that enables convergence without wholescale replacement. This strategy focuses on merging data from various systems to facilitate better, faster and safer clinical decisions.

The problems of fragmented information

The lack of integrated information creates several problems:

• Delayed decision-making: Clinicians often face delays in accessing multiple systems, which prolong decision-making processes.
• Information overload: Once accessed, clinicians must sift through information, much of which may be redundant or irrelevant. This is particularly evident in shared care records currently used in the UK.
• Inefficiencies in high-pressure environments: In high-pressure environments like ED and acute medicine or surgery, access to key information is critical in providing timely and safe care.
• Patient experience: Patients often must repeat the same information multiple times to different clinicians, which can be frustrating.
• Patient flow impact: Delayed decisions affect patient flow, not just in the ED but across wards, leading to longer pre-ward rounds and post-ward round tasks.

Documentation challenges

Another critical aspect is the documentation of decisions. Clinical staff must document their decisions to mitigate their risk, but accessing and consolidating information from multiple systems is time-consuming. This often leads to incomplete documentation, which is a significant risk, both to themselves and the care of the patient. There must be a better way to streamline this process, ensuring comprehensive and timely documentation.

A unique approach to converging systems

Enter Altera’s dbMotion UK Connect solution. While I acknowledge my affiliation with Altera as the International CCIO, dbMotion Connect, a part of the CareInMotion business unit, offers a unique and effective approach to the challenges mentioned above. This solution sits on top of existing EPRs or other clinical systems, meaning it does not require the replacement of current applications. Instead, it complements them by proactively notifying users where “new” information relating to a patient is available.

This notification is made available through the Agent Hub, a floating widget that integrates with the organisation’s systems. This removes the need for clinical staff to spend valuable time searching for information they might already know or might not be there. dbMotion also provides a function called Elastic Search, which enables clinical staff to search all the data held for a given patient, including the contents of documents, for specific information. Again, saving time and reducing frustration. The information in dbMotion is pulled from multiple systems, both from within a single organisation, as well as from external sources, for example, across all solutions in the ICB, enabling convergence.

Another key feature of dbMotion enables users to pull information into their own solution from the central repository dbMotion provides. This approach is far more powerful than traditional single-source solutions, as it connects clinicians to all the data they need without the burden of navigating multiple systems and drives convergence of clinical services without the need to replace systems or retrain staff.

Looking forward

The integration of disparate systems in healthcare remains a complex challenge. However, solutions like dbMotion offer a positive way forward. By merging data and providing seamless access through existing platforms, we can enhance clinical decision-making, improve patient care and streamline workflows. It’s time to embrace innovative solutions that address the realities of our healthcare ecosystem, ensuring better outcomes for both clinicians and patients. These solutions put organizations in a good spot to continue the journey upward to better care delivery.

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