Making patient data from different IT systems accessible in one place remains one of the key challenges in healthcare. An Israeli company, backed by one of the leading healthcare providers in the US, believes the answer lies beyond portals.
From Israel to England
DbMotion was founded six and a half years ago, out of a project to connect together patient data from different hospital systems in Israel. In its home country, it now integrates 20 hospitals and 1,500 clinics and manages 6m electronic patient records.
The company’s main technology is an eponymous integration platform that enables healthcare providers to get the most out of their existing clinical systems by connecting them together. This forms the basis for a shared electronic record, with analytics then offered on top.
Yuval Ofek, chief executive of dbMotion, is keen to stress that he the company is not just offering a portal. He argues that while portals have some benefits – such as providing one point of access to multiple systems – “they don’t get you too far.”
Although many NHS trusts seem to be looking to portals now the National Programme for IT in the NHS is winding down, he points out that in the US portal approaches have been around for a long time; but that in many cases they have disappointed.
Instead, he believes the NHS can benefit from a new approach to integration. “Our whole approach is about connecting the healthcare system. You’ve got a lot of investment out there already. The challenge is to get maximum value from it.”
DbMotion’s integration platform, he contends, contains portal features; but offers deeper integration, common patient records and data analytic capabilities. He also says this allows providers to gradually connect what they have, working at a pace and to a budget of their choosing, without disrupting or replacing current systems.
Invisible to the user
As Ofek explains it, the challenge the platform has been designed to meet is to provide data in a “semantically meaningful way; in other words, in which it retains its original context and meaning.
The aim is to build a single patient record that enables joined-up patient care by multiple health professionals working in different locations and which also can be accessed by patients themselves, paving the way for “engaged patient care”.
From a clinician’s perspective, the platform means they can use their normal patient record system, but by clicking a dbMotion button gain access to a patient’s other relevant records and test results. “From the user perspective there is no dbMotion - it fades into the background.”
Other features include the option of an enterprise master patient index, to ensure the accurate identification of all patients and their records, thanks to a partnership with Initiate, now part IBM, flexibility and speed.
Ofek says that for a customer who knows what they want to achieve and who is well prepared, a dbMotion implementation can take just six months.
Sizing up the NHS opportunity
Over the past three years, dbMotion has been working with University of Pittsburgh Medical Centre (UPMC), connecting multiple systems across its hospitals into a data repository. The deal included UPMC investing an unspecified sum in the firm.
But dbMotion’s boss can offer a detailed analysis of the NHS marketplace, where he predicts the company is on the brink of signing its first UK customer.
He says that with the reorganisation of the English NHS that is now underway, one of the biggest challenges will be to deliver care in locally integrated healthcare systems, as close to the patient as possible. And this will require local integrated patient records to support local healthcare delivery networks.
“People like care in their local community or home, and it’s these local healthcare networks that need to be the focus of interoperability,” he says.
Foundation trusts and independent providers will be at the core of delivery networks, in many cases taking over the provider arms of primary care trusts, he adds. To deliver new models of care effectively, they need to rapidly make use of technologies that enable them to connect systems together.
“The challenge for these organisations is to manage the healthcare of local populations. That’s not at the national or regional level, but above the level of local providers.”
Once healthcare providers have begun to integrate multiple clinical and patient administration systems, Ofek adds, they can start to put in more analytics.
“Essentially this enables them to use population level patient data to answer questions on outcomes and effectiveness of care. Trusts are saying to us that they need to take control and build on top of what they have and help them to take control of some of the chaos.”
Financial challenges and opportunities
Ofek argues that the UK healthcare IT market is only now opening up again, having been largely shut-down during NPfIT. He passionately argues that it needs to be educated that that new technologies and approaches are now available that can help address many of the new challenges faced by the health service.
“Looking at the UK market, many people are unfortunately sceptical about the value of IM&T investments. But healthcare providers who want to succeed need to very quickly come up with a plan to make strategic use of IM&T.”
He accepts that as the NHS is not only reorganised but asked to save £20 billion over four years, making the case for investment may get even harder. “I’m very clear we have to show foundation trusts and affiliated [commissioners] we can deliver value.”
However, the severe economic pressures that NHS organisations are under may actually prove a spur to innovation, he says. “I’m optimistic. I think the economic pressure helps us. We have a terrific story to tell NHS trusts and can deliver real benefits to them.”
