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Efficient information exchange is key to ICS success

Epro's Jonathan Elliott says realising a bold vision for joined up service provision will require effective information exchange and true interoperability

The ICS vision, bringing together diverse organisations, consolidating services, eradicating inefficiencies and reaching out into the community to provide joined up health and social care, is a compelling one.

Every ICS has a complex mix of digital maturity within its Trusts, and that’s just a start. Multiple electronic patient record (EPR) systems are likely to be used, alongside many legacy solutions. Organisations will be at different stages in their essential migration to the cloud. 

Information needs to flow across ICSs, into social and mental health care services, as well as primary care. It needs to cross boundaries to support patients who need to access services across more than one ICS. It is simply not possible for ICSs to consolidate into just one system – certainly not in the short term.


NHS organisations have made significant technology investments, including in shared care records (SCR) and EPRs. Should a Trust be asked to ditch an expensive Tier 1 EPR investment implemented in the last five years, simply because its neighbour made a different choice? Should clinicians and administrative staff be expected to move away from a solution they like and value, and endure another round of change management and disruption? 

Should bold ideas for services sharing, such as pathology and radiology hubs, be compromised, or improvements in delivery delayed, by a decision to make a large scale, strategic IT investment?

Given the current problems caused by long waiting lists and staff shortages, the priority for the NHS is to drive efficiency and minimise errors. Clinicians will welcome digital change that can improve their ability to deliver better patient care. Whether that is by eradicating rekeying errors or providing immediate access to deep patient information at the point of care, the focus is on data and data flow. 

The key question for ICSs is how can systems be integrated in an effective way to present data logically, with embedded workflow that reflects NHS processes and enables clinical change that supports both patients and clinicians?


These goals can be achieved quickly and cost-effectively through strong integration between systems across primary, acute and social care that delivers an immediate flow of patient-centric data. Building on established interoperability standards, including HL7 [Health Level Seven is a global authority on standards for interoperability of health technology] and FHIR [Fast Healthcare Interoperability Resources is the global industry standard for passing healthcare data between systems], ICSs can maximise the value of existing investments and deliver the rapid access to patient data that underpins the NHS digital vision. 

With a commitment to interoperability, ICSs can ensure a safe, trusted, fast information flow throughout the extended organisation and achieve the rapid change required to address immediate problems. For example, integrating speech recognition can address the backlog in outpatient clinical correspondence that is leaving GPs and patients waiting weeks to receive post- consultation information and referrals. 

With interoperable solutions integrated into existing acute and primary care systems, the process becomes seamless, with end-to-end data flow and efficient, automated workflows ensuring clinicians have access to the information required and patients receive care more quickly.


Phenomenal innovations achieved during the pandemic have proved the value of fast change, but they also highlight how technology can be used to achieve immediate benefits in patient care.

ICSs are a bold vision tasked with achieving bold targets, including virtual wards and integrated clinical pathways. If they are to meet these goals, there is little room for extended projects and extensive change management. The priority must be to achieve effective, relevant data flow, embedded into workflows that truly accelerate the delivery of care across primary, acute and social services.

Large scale projects are expensive, disruptive and morale sapping. However, with a commitment to achieving interoperability across systems, successful digital transformation can be achieved in bite-sized chunks that deliver fast, incremental value, especially to those on the front line of patient care.

Jonathan Elliott is managing director of healthcare informatics provider Epro

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