EMIS Health technology is supporting pioneering new work on the Fylde Coast that aims to radically transform the care of thousands of frail elderly people and reduce unnecessary hospital admissions.
The ambitious programme – one of 14 vanguard sites across England to test the multispecialty community provider (MCP) model – brings together six organisations: Fylde and Wyre Clinical Commissioning Group (CCG), Blackpool CCG, Blackpool Teaching Hospitals NHS Foundation Trust, Lancashire County Council, Lancashire Care NHS Foundation Trust and Blackpool Council.
A key part of the programme is a new extensive care service which supports patients with multiple complex conditions who are at high risk of admission to hospital. A multidisciplinary team that includes care coordinators, advanced practitioners, wellbeing support workers, pharmacists, consultants and GPs works together to meet both the health and social needs of patients. A significant part of the service is supporting patients in their own homes and helping them to learn more about their conditions so that they can self-manage their health.
The vanguard programme is using the EMIS Web clinical system to:
- generate data to help identify the top five per cent of patients at risk of hospital admission;
- deliver secure, shared access to patients’ medical records – enabling GPs, other community health services, out-of-hours and hospice services to view the MCP team’s community record and vice versa.
Clinicians say the new ‘paper-lite’ system is already saving them time, and supporting safer, more co-ordinated care.
The integrated service also gives A&E doctors access to a detailed medical record summary via Healthcare Gateway’s MIG interoperability solution, to inform emergency care and discharge patients home as quickly as possible.
Consultant geriatrician Andrew Weatherburn, who leads the extensive care service, said: “This is a fundamentally different way of delivering care to frail elderly people. It focuses on the individual’s needs and cuts across all aspects of health and social need to break the current cycle of what is often perceived as fragmented and reactive care.
"EMIS Web is allowing us to provide more integrated care for our patients and make better-informed decisions. Having access to all the information in one place saves us valuable time too. Patients were telling us that their care was not coordinated and that they often had to repeat their story to different carers. EMIS Web is helping us to stop that happening.”
Matt Murphy, managing director of primary, community and commissioning at EMIS Health said: “We are very proud that EMIS Web is helping this vanguard site to implement new ways of working which improve patients’ quality of life. Frail elderly patients have complex health and social needs that require the sophisticated, user-friendly data sharing that EMIS Health offers.”