Our test manager Vinay Gunwant looks at some of the functionality linked to releases in the Dorset Care Record, highlights some of the issues posed in dealing with multiple systems and charts benefits to clinicians during the current COVID-19 pandemic.
I have been part of the Dorset Care Record (DCR) for the past four months and having been involved in the Gloucestershire shared care record (JUYI) I had a fair idea of the interoperability programmes and the potential issues and pitfalls that can affect the programme.
However, each programme has new stakeholders, different systems and suppliers and I felt it was important to get to know the personalities involved with the DCR and re-adjust to working smoothly with them.
Technically, the DCR is a challenging set up – there are seven different system owners/partners running clinical systems from multiple suppliers. They are trying to provide data according to a common specification with two different system suppliers – Orion Health (portal) and Nextgate (EMPI/Matching) – involved in processing and presenting the accumulated data.
Partner systems are sending data using XML, HL7 or CSV formats and the DCR portal is capable of interacting with the data coded in SNOMED, READ, dmd+ or FHIR standards.
Test planning
For test planning, it’s important to visualise the system as a whole, with a good understanding of the interactions and information exchanges between different systems as well as the clinical and safety risk of each interaction. We needed to ensure that the delivery continues while improvements are identified to the release and testing processes and better use is made of the tooling available.
The key issue for me have been to –
- Start with good processes and a common tool to manage issues
- Set up a central team that validates the common functionality and coordinates the testing activities with partners and suppliers
- Being in a stable position, we can apply the processes to each release as it gets delivered
This enables us to deliver new features at a better pace and with higher confidence in the system.
Recent successes
Within the last month, the DCR has successfully integrated with the national spine, which was a significant milestone. It has meant that demographic data quality has significantly improved and the roll-out of Single Sign-on across more partner organisations is making access to DCR easier for users.
Compared with Gloucestershire’s JUYI, the DCR provides direct access to the stored data via the DQM and this is a very powerful tool to look at data quality issues, duplicate records and manage records at lower levels of details.
Out of the box reporting and integration with Tableau will provide useful reporting capability and dashboards for the Business As Usual (BAU) team. JUYI has an advantage in terms of use of Smartcards for user logons which allows easy Single Sign-on from clinical systems and also direct access to NHS Summary Care Records (SCR). But the forthcoming delivery of clinical document (Discharge summaries and clinical letters) into DCR will make it richer in terms of available data.
Feedback
The value that shared care systems can deliver can be seen in the following from an acute hospital clinician: “Over the weekend, I was on duty in Emergency Department (ED), assessing the patients and was able to look up their medications and allergies without having to call the GP Practice – brilliant.”
In the current situation, where the clinical community is dealing with COVID-19, quick access to patient’s records is vital and the shared care systems can make the combined records accessible at one place, saving the trouble of having to contact multiple care providers to get the details recorded on a local system.
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