If you were to type ‘delivering data at the point of need’ into any popular search engine, your return would be pages and pages of results relating to a multitude of industries, technologies and countries.
In my opinion, it is an often over-used phrase; with many IT vendors and end-user organisations claiming to have achieved that ultimate nirvana. In practice, being able to access data wherever it resides is one of the largest obstacles many organisations will face when trying to deliver data at the point of need.
At The London Clinic, we want all patient data in a single location; not just clinical but also administrative data. If we cannot get everything into a single place, we cannot efficiently interrogate that data and deliver it back to where clinicians need it.
One of the primary rationales for doing this is to manage stress. It’s easy to underestimate how much stress is caused by trying to locate data from disparate sources. Or how much stress is imposed on patients when consultants try and find information and explain problems to them at the bedside or in the consulting room. The data is eminently out there; it is sitting in other ‘siloed’ systems.
Poor data standards
Bringing all the data into a single place and then being able push it out to where it is needed is easy to say, but achieving it is time consuming and difficult.
Recently, health providers have been hearing a lot from technology vendors about data standards. But, in reality, most standards are poorly implemented by suppliers; and you soon discover there is a distinct lack of vendor neutrality that complicates data management processes.
Some organisations will try and drive you to their almost proprietary data storage – picture archiving and communications solutions are an obvious example, but they are not alone. A lot of hospital information systems try and ‘drag’ IT teams in a direction that is detrimental to maintaining neutrality of their data.
There are countless numbers of applications across a hospital that produce similar types of data – DICOM data, image data, email data, and so forth. All of these different environments have a common problem and that is, they are using different systems and storing data in different ways.
Another major challenge is developing a way of accessing data and pulling it into a central location in an efficient way. People will talk about archiving, data recovery and data marts, which are all positive things.
However, I prefer to talk about a ‘membrane’; a vehicle by which you can extract data from a source environment and place it somewhere where it is going to be available in the event of a problem; for instance in the case of a complete disaster, loss of system or service. It’s also going to be available for you to mine so that you can do useful things with it.
At The London Clinic we have taken great strides in being able to deliver data at the point of need. The key to this has been identifying a vendor scenario that could be leveraged across all of our other applications and hospital systems.
By using BridgeHead’s healthcare data management solution, which features, among other things, a vendor neutral archive, we have been able to leverage it across multiple environments – endoscopy, ophthalmology, cardiology, HIS, PACS and Microsoft Exchange – to name but a few.
We have been able to build out more and more access points into our data mart enabling us to freely dip back in and get the data out.
Having a vendor neutral environment gives you a very good chance of enabling clinicians to access any patient data that they need to deliver better and more efficient patient care. Many of our clinicians have their own practices, too, so they like the idea of being able to work them ‘on the run’, or from other locations.
Additionally, having all your data in a single place makes managing it much easier, and gives you a better understanding of what data you have – including what information is actually redundant.
This data transparency can have a significant impact on reducing your storage costs. It is about providing the ‘availability spectrum’. People talk about disaster recovery, information lifecycle management, and high availability and back up. I think they are all part of the same thing – it is about being able to get that spectrum to work right for the user.
The London Clinic operates predominantly in the private healthcare market, but there are many synergies in terms of what we have done and the challenges that the NHS faces today, particular as the National Programme for IT in the NHS’ contracts come to an end.
If our experiences have taught us anything - which they have – it is that the first thing to think about is data access. How do you manage vast quantities of data and how do you get access to that data without spending significant amounts of money with providers on proprietary solutions?
The London Clinic has worked with a lot of vendors that also work in the NHS and we often find that there is a tremendous drag back to the vendor in terms of managing data.
Eventually, your data gets pulled in all sorts of different directions. In some instances, the drag back to vendors in terms of managing data is inevitable, but by adopting the ‘membrane approach’, departments can go to a more industry standard view of data.
If hospitals take this approach, their IT departments will get flexibility, both in terms of managing that data and in terms of wanting to make any changes to proprietary hospital systems – another unexpected nirvana when taking this approach to delivering data at the point of need.
About the author: Mike Roberts has been the London Clinic's director of IT for more than five years. He is responsible for all aspects of technology across the hospital including GPs, consultants, the business and diagnostic services. In addition, he provides relevant 'business consulting' to the rest of the organisation. The London Clinic is working to transform its IT services so they support decision-making by giving consultants and GPs a complete view of the patient record in a single view. This is being constructed from both internal and external data sources and includes access to all pertinent images.
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