Living data day: Informing Healthcare’s research labs

 Earlier this summer, Informing Healthcare, the organisation responsible for healthcare IT in Wales, opened new research labs at Swansea University. Lyn Whitfield paid them a visit.

A bright red sofa with gold scatter cushions, alongside a coffee table holding a copy of Good Housekeeping and a Christmas biscuit selection, is not the first thing you expect to see in an IT research lab.

But it is what greets visitors to Informing Healthcare’s new labs at Swansea University. The sofa forms the centrepiece of the “patient’s home” section of the labs, which have been set up to test new devices and software and explore how they might support existing healthcare services and new ways of working.

“This is where a patient might call NHS Direct, or their local out of hours service,” says Informing Healthcare’s public relations manager, Gill Friend – pointing out that the “room” also contains a phone, laptop, widescreen TV and range of telemedicine devices. “Or perhaps they will want to book an appointment, using My Health Online.”

Electronic records

Informing Healthcare is responsible for IT in Wales. Its remit is to improve IT infrastructure and develop new services to support clinicians and patients. A walk around the labs illustrates some of the main projects in hand and how they work together to improve the flow of information around the healthcare system.

Across the lab from the “patient’s home” is a workstation similar to one that NHS Direct telephone helpline staff, or out of hours service providers, would use. Ms Friend taps the computer: “The idea is that whoever is working here can try new systems, like the Individual Health Record (IHR),” she says.

The IHR will be drawn from records held by GPs. The idea of sharing details of GP visits, medications, allergies and similar information with out of hours services was trialled in Gwent and rolled out to other communities earlier this year.

Meanwhile, staff in the medical assessment unit of Newport’s Royal Gwent Hospital can also access the IHR, so they have information about patients who may be unconscious or confused when they arrive.

Patients will have access to the IHR through My Health Online – a secure web-service being trialled by five GP surgeries that will eventually allow patients to store and use health information, make appointments and carry out other transactions with the health service.

Linking up the healthcare system

A patient with an appointment will eventually end up in a GP or hospital waiting room; and a receptionist’s desk is the next “room” mocked up at the labs. “Our GP is very fortunate,” says Ms Friend. “He or she is one of the first to be using the care information gateway we are working on with Scotland.”

The gateway is a national system to integrate primary and secondary care systems and enable GPs and hospitals to exchange messages – such as referrals or discharge notes – electronically.

So far, two practices in the Cardiff and Vale area have agreed to take part in a “proof of concept” trial of the e-referral system. But eventually the gateway will be used to allow Welsh health services to exchange messages with their English counterparts.

Back across the lab from the reception “room” is a hospital ward, complete with a bed, screens, uniforms, a PC, laptop and other devices. “This is where we look at improving and linking up different hospital systems,” says Ms Friend.

One of Informing Healthcare’s biggest projects is a Welsh Clinical Portal; a web-based system that will give clinicians across the country access to different hospital systems (without those systems having to be ripped out and replaced) and to carry out tasks such as ordering tests and medications.

The very first versions of the portal were designed, built and installed on computers at hospitals in Cardiff and Carmarthen last year. New versions – with enhanced functionality – are being designed at the labs and will start to roll out soon.

Meanwhile, Informing Healthcare has been upgrading pharmacy systems. Ms Friend demonstrates at the “pharmacy” in the lab. “People can come in here and try out new systems in a realistic environment,” she says. “So if they are asked for their views, they have a better environment to think about things in.”

Indeed, whole healthcare communities can use the labs to trial ideas that require different health services to work together.

Testing, testing

The motor behind the labs lies on another floor, however. Servers in the server room run versions of all the IT systems in use in health services in Wales. This means Informing Healthcare can look for gaps and issues with them and at how new solutions might work with them.

“The labs have four functions,” says Gwyn Thomas, director of Informing Healthcare. “The first is to act as an accreditation centre. Lots of suppliers have good systems and ideas, and we can look at their impact both before and after procurement.

“Then, we know there are gaps in our existing systems and that we will need to develop our own software to fill some of them. If we can do that in a clinical setting, it should increase our chances of success. The third thing is that we can simulate and plan care, as you have seen.”

And the fourth thing is training. The labs were created out of some old “wet” facilities at Swansea University’s school of medicine. They have close links with its Centre for Health Information Research and Evaluation, and will therefore enable graduate students to hone their health informatics skills.

Meanwhile, Dr Thomas hopes that informatics staff working in the NHS in Wales will be seconded to the labs to work on projects; so they become the “home” of IT innovation for healthcare in the country.