Understanding the NHS Systems landscape to deliver quality patient care
A healthcare setting is a complex ecosystem with a multitude of systems, both clinical and non-clinical, each playing a vital role. These systems, work together to ensure the smooth running of patient care. Understanding how these systems interact can help us appreciate the delicate balance that goes into delivering quality healthcare.
How NHS systems are separated, their roles and functions
There is a multiplicity of systems, clinical and non-clinical, in play in a heath care setting. Each system has a specific function, and all systems interact to a greater or lesser degree. Here’s an overview:
Trust integration Engine (TIE)
Typically, the interactions are facilitated by a Trust integration Engine (TIE) and systems communicate using messaging protocols developed to send and receive packets of data. These systems include HL7 messaging and FHIR.
Medical devices and their associated clinical systems handle patient information such as patient observations, these are often called e-obs systems. Management systems such as Theatre Management systems and bed management systems perform specific operations. Pathology systems deliver test results and are often linked to centralised path labs serving several hospitals.
Patient Administration System (PAS)
The common system is the Patient Administration System (PAS) which collates information including patient demographics, admission, discharge, transfer, and appointment data for each patient. Most clinical systems integrate with PAS through the TIE.
EPR
An EPR captures the output of clinical systems using HL7 and FHIR messaging integration, making the information available to all users in a patient context. It also accepts direct input, usually through specific modules, from clinicians and managers, about treatment episodes. Many EPR’s also have an integral PAS capability, making older (legacy) PAS redundant.
EDRMS
An EDRMS acts as a repository for patient information (in a clinical setting), providing the EPR with a “library” it can access to retrieve information (documents) relating to a patient. This is achieved by the EPR establishing a secure link to the EDRMS. This link is made in the context of a single patient.
Unstructured data
Unstructured data is information that does not follow a predefined data model or format. This makes it difficult to capture, store, and analyse using traditional databases and data processing techniques. In healthcare, unstructured data includes:
- Clinical Notes: Free-text notes written by clinicians during patient consultations, including observations, diagnoses, treatment plans, and patient histories.
- Medical Imaging: Images from X-rays, MRIs, CT scans, and ultrasounds. These require interpretation and analysis by radiologists or specialized software. Images are often stored in Picture Imaging and Communications Systems, or PACS.
- Laboratory / pathology results: Some test results are still generated manually and can be in various formats. They can contain detailed narrative.
- Correspondence: Emails, letters, and other forms of communication between healthcare providers, patients, and insurance companies.
Unstructured data is challenging to manage and analyse due to its variability and complexity, but it contains valuable insights that can enhance patient care and improve clinical outcomes.
Advanced technologies such as natural language processing (NLP), machine learning, and big data analytics can be used to extract meaningful information from unstructured healthcare data.
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Get in touchDigital Transformation for the NHS
Digital transformation in the context of the National Health Service (NHS) refers to the comprehensive integration of digital technologies into all areas of healthcare delivery, with the aim of improving the efficiency, effectiveness, and quality of services provided to patients. This can be achieved in a number of ways, including the following.
Electronic Health Records (EHRs)
Moving away from paper-based records to digital health records, ensuring that patient information can be easily accessed, shared, and updated across different healthcare settings.
Interoperability
Providing a federated view of a “patient” by improving the interoperability of healthcare IT systems and software applications.
Telemedicine and Telehealth
Exploiting the capabilities of newer technologies to facilitate remote consultations and gather patient observations without the need to attend clinics.
Patient Engagement and Empowerment
By using digital technology to provide patients with access to their healthcare record, the patient can be encouraged to engage in managing their care.
Digital transformation aims to improve patient outcomes, increase operational efficiency, reduce costs and support the sustainability of the healthcare system.
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