Bringing eight IT systems into one single instance of CarePlus in Cheshire & Merseyside has proven there are numerous benefits from using a single CHIS IT system across the area; we have been able to maintain the accuracy of the child’s record and improve the data quality within the system.
SCW CHIS is skilled and experienced in mobilising several small county-level Child Health Information Service (CHIS) into one single service covering a larger footprint and using a single IT solution.
The benefit of this model for the customer is multifaceted:
- Reduced variation, by using standard operating procedures across the footprint
- More efficient tracking of the childhood population
- Single contract to manage the CHIS
- Economies of scale
- An IT solution designed and built for the specific purpose of supporting a high performing CHIS
- Standardised reporting enables the commissioner to view the data knowing that it has been processed and reported on in a consistent manner
The benefit and advantages of SCW as a provider of CHIS are also clear, as it enables us to follow our routinely-reviewed, best-practice, evidence-based standard operating procedures focused on the delivery of a high-quality service that is consistently reviewed by commissioners as excellent.
However straightforward and obvious the use of a single CHIS IT solution and standard operating procedures appears to commissioners and providers, we recognise that real concern is felt by some stakeholders, particularly those that have an integrated patient IT system used by community nurses, CHIS and GPs in their county. To these health care communities introducing a new IT system feels like a backward step, as though something is being broken. Stakeholders have told us that they are concerned that there will be a requirement for duplicate data entry; Health Care Professionals needing to access and learn a new system; community providers having to resource and train staff to undertake work that had previously been undertaken by CHIS staff on their behalf.
We take these concerns seriously and work with all stakeholders to support them through the change and to ensure that there is minimum disruption and, wherever possible, no lack of functionality.
The practicalities of the process were demonstrated in Cheshire & Merseyside where we introduced System C CarePlus as the single CHIS IT solution replacing eight instances of legacy systems.
Prior to CarePlus implementation, there were areas using an integrated system across GPs and Community providers. Our commitment to those health care organisations was to ensure that no functionality was lost as a result of the change and that the advantage of a single instance of CHIS across the whole of Cheshire and Merseyside would result in mutual benefits.
- Fact-finding workshops to which all relevant stakeholders were invited with the purpose of identifying every touch point between CHIS and other health and care organisations to understand each point of contact
- Process mapping exercises to identify all the “as is” steps, actions, data flows, inputs and outputs where there was interaction between systems and stakeholders
- Working in collaboration with stakeholders we jointly designed the new “to be” processes, replicating or, if possible, improving on the previous flows, sequence of events and actions
- Continuing to meet regularly prior to and post mobilisation to test and monitor the new process, applying improvements where necessary
- Establishing new electronic and automated data flows
- Training and read-only access to our preferred CHIS IT solution, in many cases as single sign on to all HCPs who have a legitimate reason to view the CHIS record
SCW implemented System C’s market-leading CarePlus Child Health system, which is a dedicated Child Health solution and currently covers 60% of children in England.
The CarePlus system complies with all existing interoperability standards (e.g., FHIR, CSV, XML, HL7 and ITK) and supports a range of interoperability capabilities for either fully integrating third-party systems, or providing access to data/communicating with other systems using data messaging techniques.
Using System C’s CarePlus IT system and our automated processes has enabled SCW to provide local providers, especially Health Visiting teams, with daily information such as new birth registrations and changes to demographic details, including movers in and out, which ensures these teams receive accurate and timely information.
As one of the first two pilot sites implementing the interface between a CHIS IT system and the National Events Management Service (NEMS), we were able to directly receive birth registration data in near real-time and GP registration data via Patient Demographics Services (PDS) including movers in and out and blood spot results, NIPE and newborn hearing results. Introducing CarePlus has also enabled us to integrate directly with the local shared care solution which has allowed for GP immunisation data to be captured once at the point of contact, extracted and directly uploaded into our system.
Bringing eight IT systems into one single instance of CarePlus in Cheshire & Merseyside has proven there are numerous benefits from using a single CHIS IT system across the area; we have been able to maintain the accuracy of the child’s record and improve the data quality within the system. The advantages provided by a single IT solution and the benefits of the functionality within CarePlus have ensured a high-quality child health record that would not be available in individual community systems. There is no requirement for trusts to replicate or maintain a separate solution, the system integrates with other clinical systems offering healthcare providers a platform on which they can view child health data from within their own system.
We provided read-only access to the CarePlus system to a large number of healthcare professionals, with all the necessary data-sharing agreements securely in place, and identified and maintained all cross-organisational data flows to ensure business continuity from day one.
The project enabled the following benefits:
- Knowing where every child in Cheshire & Merseyside is. An accurate 0 – 19 population - future-proofed to withstand the changing commissioning landscape
- Statutory and bespoke reporting is now standardised across the geography allowing for true comparison of immunisation and screening uptake
- Reducing variation across the area and increasing the accuracy of reporting which enables commissioners to make better-informed decisions
- All key stakeholders within Cheshire & Merseyside receive the same rich data source related to their movers in/out and new births, ensuring synchronised 0-19 population across organisations
- All Cheshire & Merseyside general practices notified of their 0-19 populations immunisation status including informing them of children missing immunisations, and immunisations that have come to us through other means such as school uploads, supporting a complete childhood immunisation record.