Islington CCG to deploy integrated digital care record after delays

Islington CGG is aiming to roll out its integrated digital care record this year, after months of delays.

The north London ”CareMyWay” project has been under development since the CCG signed a £7.4 million contract with supplier BT in September 2015.

Islington is one of NHS England’s 25 Integrated Care pioneer sites, chosen and funded to try out new approaches to joining up health and social care.

CareMyWay is designed to bring together the hospital, GP, social care, community and mental health records of 200,000 Islington residents into “one, readily accessible care record” for the first time.

It is generated by both information pulled in real time from some clinical systems and information duplicated, and updated daily, from others. It will include information from systems including Emis, System C, Adastra, Carecast and Liquid Logic.

As well as a “professional” clinical record, CareMyWay will eventually be accessible to patients through a “personal” version.

Project lead Chris Leebetter said a pilot version of the record had been turned on in the first Islington GP practice in January, combining GP, social care and the acute records of thousands of patient into one view.

The record was still under development, and has not yet being used in clinical decision making.

Leebetter said the pilot should be completed and the record rolled out clinically in the first half of 2017, but it would take longer if needed. Limited patient access to the record would hopefully be available in the second half of the year, he said.

“The pilot is make sure we have the best system we can, so it’s not being determined by any specific timescale but by the quality of the record.”

CGG board papers show MyCareWay was originally scheduled to be deployed in June 2016.

Since then,  there have been several delays, with deployments pushed back to August, and then October last year.

Board papers show that in May last year, BT issued a relief notice, informing the CGG it was reserving “its rights in respect of the delay to claim compensation”.

It is unclear whether any compensation was paid and the CGG declined to comment on the relief notice, or any aspect of the BT contract.

Leebetter said while the project was running “a little later that we originally hoped” it was more important to have a system that had been well tested.

When the record is fully deployed it will cover records from 34 GP practices, Whittington Hospital NHS Foundation Trust, Camden and Islington Foundation Trust and Islington Council.

Leebetter said other health and care orgnaisation would connect to the record when they were ready and, if it proved successful, could be expanded to a wider footprint across north central London.

CareMyWay has been built on a “model of implied consent”, meaning patients data will be automatically connect or uploaded to the record, unless they explicitly opt-out. However, explicit patient consent will be required before anyone can view a patient’s integrated care record.

“We have put a lot of time and effort into information governance to make sure we get it right.”

Leebetter would not comment on the technology behind the record, citing security, but last year BT told Digital Health News that it would build and manage a hosted interoperability service working with partners including InterSystems and Nanthealth.

CareMyWay’s success will depend on both patient buy-in and funding.

CCG board papers show the project in being funding primarily through a Department of Health capital grant, with most of the rest of the funding coming from the CCG and council’s existing capital funds.

However, one paper noted that it was “essential for funding to continue beyond implementation to ensure sustainability and that the proposed benefits were fully realised”.

Islington is part of the North Central London STP, a digitally ambitious plans that is asking for £180m in central funding for digital projects alone. NHS leaders have already suggested that figure is too high, potentially putting some digital projects in doubt.

While the North Central London STP notes the development of an integrated digital care record in Islington, it also raised concerns that it was being developed in isolation from similar, neighbouring schemes. This had resulted in “fragmentation, lack of joined up information flows and duplication of effort”, the STP said.