Customer Story | Calderdale transforms place level access to patient data with MIG record sharing

The Medical Interoperability Gateway (MIG®), is making vital GP, social care and community healthcare patient data available to hospital and other clinicians, increasing efficiency and improving care quality for over 550,000 patients across Calderdale and Kirklees.

“In 2017, Calderdale and Huddersfield NHS Foundation Trust (CHFT) implemented Cerner Millennium as their Electronic Patient Record (EPR), in the early days, we only had Secondary care data in there. We used MIG to provide a view of key GP data in context, in the EPR system. This was achieved quickly; by 2018, acute clinicians could see data from 300 GPs in the EPR. After seeing what the MIG could do, we wanted more.” Rob Birkett, Director of Digital Services for The Health Informatics Service (THIS) at CHFT

Designed to connect otherwise incompatible systems, the MIG rapidly became a critical enabler of Calderdale’s data sharing at place level. Following a textbook staged implementation, it now conveys primary care/GP, community healthcare, social care and palliative care data to acute users in Calderdale Royal Hospital and Huddersfield Royal Infirmary. The Cerner HIE then shares acute and other data back out to GPs and an expanding group of other users.

When patients admitted to hospital can’t provide medical and other historical details, the MIG plugs the gaps with patient data that ranges from demographics and diagnoses to social care plans, allergies, recent procedures, therapies and tests. That means Emergency Department (ED) and other acute clinicians can make informed treatment decisions faster, preventing unnecessary hospital admissions and duplicated tests.

“It particularly benefits patients who are unconscious or find it difficult to speak up for themselves – people with learning disabilities, special needs or dementia. We can see everything from their GP’s management plan to their social care contacts.” Hannah Wood, Professional Lead for Transfer of Care and SAFER Transformation Programme, CHFT

It lets us deliver care to the patient a lot more quickly – it has speeded things up massively.”

Amanda Mckie
Matron Lead for Learning Disabilities, CHFT

With real-time access to patient data when it’s needed most – at the point of care – acute clinicians can see what a GP or care worker noted down only minutes ago, ensuring patients receive their medication without interruption.

“I see a list of medications directly obtained from the GP record which is more up-to-date than the summary care record. It means prescribers are aware of all critical medications and helps the hospital avoid oversupplying medication with the potential for abuse or overdose.” Michelle Smith, EPR Pharmacy Technician

Rather than chasing up GPs or care agencies by phone, hospital clinicians can now see more patients and spend more time with them. They also access this rich information within their own applications; there’s no need to log into a separate portal, further enhancing care quality and time savings.

“If you have to find another computer and maybe a smart card, that eats up more time and discourages people from using it. We are so busy and stretched as an organisation, that any time you can give back to a clinician is really helpful. Accessing the data immediately also means I’m not ringing up GPs or other workers, so I’m saving them time too.” Hannah Wood, Professional Lead for Transfer of Care and SAFER Transformation Programme, CHFT

Social care and other real-time data are particularly valuable for hospital staff working out-of-hours, helping to speed admissions and make discharges safer while avoiding unnecessary admissions that take up valuable beds.

Social care and other real-time data are particularly valuable for hospital staff working out-of-hours, helping to speed admissions and make discharges safer while avoiding unnecessary admissions that take up valuable beds.

“This shared information makes sure safe, detailed social assessments can take place for discharge or admission avoidance. If you know what home care arrangements they have, you can be confident you can discharge them safely out of hours. It also avoids admitting vulnerable patients to a busy acute area. They can end up getting hospital-acquired infections which further increases their length of stay.” Louise Croxall, Chief Nursing Information Officer for CHFT

Access to palliative care data helps clinicians follow documented care pathways, medication plans or end-of-life wishes when time is short. For one very ill ED patient, her end-of-life plan made it clear she wanted to die at home.

“It was out of hours and extremely difficult to arrange but we did it. Sadly she did die shortly afterwards, but she was at home with her family round her, in line with her wishes.” Louise Croxall, Chief Nursing Information Officer for CHFT

Beyond acute, district nurses and other community health workers are also benefiting from a wider patient view.

Access to patient medical and medication history has streamlined day-to-day work working and ensures that patient management and safety is at the forefront of planned and unplanned district nursing care.”

Louise Byrom
Clinical Manager, CHFT Community Division

Once the MIG is in place, it can quickly extend its reach to many other systems. And as more data becomes available at place level, it’s increasingly attractive to users: Calderdale’s system now sees over 120,000 monthly views. Upcoming CHFT connections include mental health records and ambulance data, with social care also gaining access to EPR data.

“The MIG and the other systems all play their part in delivering access to data across pathways at place level in real time, in context, in the clinician’s system of choice. This is a great achievement and the benefits are far reaching, not just within CHFT, but right across Calderdale and Kirklees as places within the West Yorkshire Health and Care Partnership/ICS.” Rob Birkett, Director of Digital Services for The Health Informatics Service (THIS) at CHFT

Offering sophisticated and flexible integration technology, the MIG currently connects 5,200 health and social care providers in the UK, sharing a total of 30 million patient records. More are being added all the time.