Platforms, not proprietary technology, must power integrated health and care
In the latest of our articles in Health and Social Care Week, Leeds City Council’s chief digital officer Dylan Roberts says the only way the integration of health and social care can succeed is by adopting platforms that allow us to bring different technology and information systems together
We know that the health and care system is broken and unable to cope with the exponential increases in demands put upon it.
In order to fix this, we need to flip the model from a one-size-fits-all public service approach to a whole system approach that enables people to become self-sufficient and if necessary cared for by a connected “circle of care”.
This should be made up of family, friends and community-based organisations as well as traditional health and care public service organisations. Together, these carers have capabilities that when combined deliver superior outcomes better-tailored around the individual’s specific and unique needs.
The problem is that these “whole systems” are made up of different combinations of carers with different capabilities. It is not homogenised.
The only way that integration of health and social care can succeed, is not through continued investment in the kind of proprietary technology which perpetuates silos but by adopting platforms which allow us to bring different technology and information systems together.
We should be confident that platform-thinking should work because it is this approach of providing standards and toolkits which have allowed developers to create solutions which powered the rise of Windows, Apple, iOS and Android. And the platform concept can be extended beyond technology to the wider context of business capabilities - that is the combination of what people do, the process and the technology – which gives us an opportunity.
A platform built on consistent standards will allow us to make better use of resources and develop complimentary solutions which enable us to support the health and care outcomes which matter.
Consider the example of the Person Held Record (PHR) capability that enables a person to manage their own personal health record information, being developed by the Ripple team in Leeds using the openEHR standard. The core of this is made up of sub capabilities such as the ability to register and verify identity that enables users to authenticate to external systems to access data only pertinent to them. This capability and others need only be developed once and then we can re-use them. Therefore, the opportunity for specific solutions to be developed to meet specific needs - e.g. the management of a specific condition - through a process of co-production with patients working with specific experts is possible.
If we are to move to the 21 st Century approach to Health and Care and in the delivery of better public service outcomes, we need adaptability, agility and an ability to integrate a diversity of different capabilities and organisations around different needs and demand.
In my opinion this open platform-based approach represents the best way to enable this within the current and future financial constraints. We certainly can’t do it with proprietary systems and the approaches of today.
The challenge is primarily one of helping local government, NHS and other health and social care leaders understand this as it is not a technical issue – it is one of accepting the need for common business and practitioner capabilities, in terms of people, process and technology.
Dylan Roberts is Chief Digital Officer at Leeds City Council. Dylan’s experience includes work on the Leeds Care Record and Ripple, a ‘demonstrator’ project hosted by Leeds City Council that is building an open source digital care record platform. Dylan contributed to Eduserv’s recent research on Health and Social Care Integration, including ‘The potential of digital’ report that expands on the concept of an OPEN platform approach and recommends digital principals.