Leeds Teaching Hospitals NHS Trust ensures region-wide excellence in renal care

Leeds Teaching Hospitals NHS Trust ensures region-wide excellence in renal care with InterSystems HealthShare®

The UK’s National Health Service (NHS) has established a “Putting Patients First” mandate to improve the patient experience. Each patient has a unique identifier so that Trusts across the UK can integrate care records and patient indices to improve data sharing and efficiency. Leeds Teaching Hospitals NHS Trust (LTHT), as one of the largest Trusts in the UK, is a good example.

As the centre for many specialist services in West Yorkshire, LTHT’s Health Informatics team has a clear vision to be the best in specialist and integrated care for over 4 million patients across the region. In particular, LTHT’s specialist renal care unit manages data for its patients receiving renal care in West Yorkshire, while also treating 35,000 renal patients within the Trust itself.

Eileen Jessop, Deputy Director of LTHT’s Health Informatics team, knew that LTHT needed a robust, scalable and reliable technology platform to manage its growing informatics needs. “Our patients expect the highest quality of care, and we know that high quality goes hand in hand with efficiency. It was important to us to find a solution that could work with the diverse systems already in use across our
Trust, and across the region as a whole, which could grow with our needs as we work towards achieving our strategic vision.”

Identifying the need for regional integration

Leeds Teaching Hospitals NHS Trust has a well-established reputation for excellence in healthcare informatics. However, it recognised a need for greater integration to improve the flow of information between both LTHT’s six sites and the other Trusts providing information to Leeds within the broader West Yorkshire region.

“As a centre for specialist renal care, we treat over 35,000 patients every year, many of whom require haemodialysis. Therefore, they interact with our services on a daily basis. These patients generate a high volume of data, and it is essential to manage and analyse that data properly to improve their care. What’s more, because our patients are seen in a number of different clinical settings, their clinicians need to access accurate, up-to-date information across these many settings,” Jessop commented.

“Additionally, we’re the regional hub for renal information, so it was important for us to develop an integration platform that could pull patient information together in Leeds and make it accessible for clinicians across the West Yorkshire region. We realised we needed a solution that would provide market-leading interoperability. Our informatics team found three challenges that needed to be addressed to achieve regional integration: lack of standardisation, identifying relevant information, and sourcing accurate demographic data.”

Tackling the challenges of regional integration

Leeds Teaching Hospitals NHS Trust needed to manage large volumes of patient data while also providing better demographic matching on patients, with faster NHS number tracing. This would enable clinicians to quickly access the large amount of data on renal patients received on a daily basis by the Trust, across the region.

For a number of years, LTHT has used InterSystems Ensemble®, the rapid integration and development platform for connectable applications, and the InterSystems Caché data platform for its patient administration system (PAS). It decided to implement InterSystems HealthShare®, a health informatics platform that enables strategic interoperability and analytics for action, to support the development of a regional integration engine within the renal care specialist service.

“We evaluated the interoperability capability we already had internally, and we found that the InterSystems solution provided the greatest flexibility,” says Jessop. “We are a multi-disciplinary specialist care centre for West Yorkshire, and integrated care is at the heart of our vision for patients. Our renal service handles some of the greatest volumes of data. Therefore, when we wanted real time patient number tracing, HealthShare was chosen to ensure our renal specialists receive patient information that adheres to the highest standards of data quality and governance.”

Standardising information across West Yorkshire

There are eight Trusts in Yorkshire that share information with LTHT as part of its role as the central specialist services provider for renal care. The data that the different Trusts feed to LTHT includes information such as haemodialysis updates, lab results, and information from consultations. However, there is no standardised informatics system across the region with which each Trust must comply.

“The other Trusts who send us their information each use distinct formats for the messages they send. The receiving system, our regional integration engine, has to be able to interpret and standardise the different message formats so they can be interpreted and shared correctly,” commented Jessop.

The Leeds Teaching Hospitals Trust Regional Integration Engine (RIE) project is powered by HealthShare, which takes each of the messages received and converts them to internationally recognised HL7 v.2 format.
Jessop added, “We receive a considerable number of messages from other Trusts every week. HealthShare allows us to ensure that the information is accurate, and that our renal systems are not overloaded with interpreting non-standardised, irrelevant information.”

Creating greater relevance

Additionally, the labs that feed data into the renal system are also processing tests across a broad spectrum of clinical departments. Messages sent to the renal hub must be appropriately filtered to ensure that the renal system only contains relevant and up-to-date patient data.

“When you have a number of Trusts all contributing information to a central database, non-relevant results and data may also be shared. Filtering results so that relevant information is highlighted, and the rest is discounted, can either be done at the source or when the information is received. However, if every Trust sent us unfiltered information, it could overload our systems. The RIE allows for Trusts to filter the messages themselves prior to sending them through to our system; and if they’re not able to do this, it will also automatically filter the messages received so that only renal patients are flagged. This ensures that the most up-to-date and pertinent information on a patient is available for our clinicians when they need it.”

Improving demographic patient matching

The Trust’s implementation of HealthShare included the InterSystems Spine Mini Services Platform (SMSP) packaged service, which integrates with the national Spine 2. Through this, LTHT is able to access patient demographics in real-time, further helping to ensure the Trust has the right information about the right patient at the right time.

“The NHS number is the only identifier unique to each patient, and it is obviously incredibly important for data accuracy. In the past, when patients visited a different care setting, they were sometimes required to provide their details in full at each location. This information was verified via batch tracing, so it was not always immediately connected to existing patients. It was possible for a patient to see a clinician before the demographic data was sourced, leading to test duplication and administrative mistakes. SMSP ensures that our patient demographic data can be checked almost instantly, with less duplication and nearly 100% compliance.”

HealthShare’s Spine Mini Services has been accredited by the national Health and Social Care Information Centre (HSCIC) as one of a handful of services permitted to connect to the National Spine 2 to deliver patient demographic data.

“With the SMSP, patient information collected across the region can be made available to clinical staff regardless of their location, and we can be sure of the quality of the data the clinician receives,” Jessop said. “With the large number of renal patients that we treat every week, we have a very real need for accurate and up to date demographic data. We can now be sure clinicians have complete visibility of the care and treatment patients are receiving, regardless of which clinic in the region the patient attends. HealthShare makes this possible.”

Looking to the future

The Trust originally intended to use the HealthShare SMSP solely with renal services, but realised that its functionality could benefit many other services. While the renal project was in development, SMSP was also implemented by the haematology department. HealthShare has shown the ease with which different departments can be connected to Spine Mini Services, and the platform can grow with the Trust to fit its changing needs. Leeds Teaching Hospitals NHS Trust is now assessing which other specialist services could benefit from a more integrated approach to region-wide patient demographic services.

“We have worked closely with the clinical teams to deliver a regional integration engine for our renal unit. Our internal informatics team were able to do most of the development work themselves. HealthShare is having a transformative effect on our patient information, enabling us to offer a much better experience for those for whom we care.”

“InterSystems’ partnership approach is helping us drive forward our health informatics vision across our sites,” Jessop said. “We have many more projects and opportunities to improve patient data and our governance processes. InterSystems HealthShare will be central to achieving our vision for Leeds Teaching Hospitals and maintaining the hospitals’ reputation for having some of the most advanced technology and best patient survival rates in the UK.”

About InterSystems

InterSystems develops advanced software technologies that enable breakthroughs. With a passion for excellence and a focus on client success, InterSystems provides data management, strategic interoperability, and analytics platforms used in healthcare, financial services, government, and other industries. In selected countries, InterSystems also offers unified healthcare applications, based on its platforms that deliver on the promise of connected healthcare. Founded in 1978, InterSystems is a privately held company headquartered in Cambridge, Massachusetts, USA.
For more information, visit InterSystems.co.uk.

About Leeds Teaching Hospital NHS Trust

Leeds Teaching Hospitals is one of the largest teaching hospital trust in Europe. It offers a range of high quality hospital services for the people of Leeds and is one of the largest providers of specialist services, with more than 100 different specialties, for patients from across the country. It has an enviable international reputation for excellence in specialist care, research, and academic training. The Trust covers a large area of Yorkshire, and beyond, and comprises of approximately 2,000 inpatient beds together with critical care and day-case beds. It has more than 15,000 dedicated staff across seven hospitals who treat around 1.5 million patients a year. The Trust’s annual budget is £1 billion.

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