Electronic Health Records for the UK Government
A department of the UK Government administers the country's health care services. With the aid of a network of Primary Care Trusts, it operates hospitals, clinics and other facilities, besides providing medical, dental and optical care through a host of practitioners and specialists.
The Electronic Health Records (EHR) project is a massive one and so a demonstrator was to be built for a particular county. This would function as a test bed for proving the concept and the operations would yield new ideas for actual fulltime implementation. Technically, the EHR would enable the General Practitioner (GP) to view a patient's full details and also help doctors giving emergency treatment to quickly determine the allergies and previous history of diseases but until a demonstrator was built and deployed, the actual evidence would not emerge. Infosys had to build a demonstrator to show what was actually possible and also suggest improvements.
A demonstrator serves as a dry run for a project and is important because it clearly identifies the shape of things to come. A good demonstrator, which clearly highlighted the benefits would ensure ready acceptance and achieving this was Infosys' biggest challenge. Additionally:
- The inherent complexities were overwhelming and the ownership of the patient was confusing. The demonstrator had to remove the uncertainty by making all relevant information available
- Patient care services were impacted by rising costs and so the demonstrator had to show that it was possible to cut costs and improve effectiveness by streamlining processes
- An increasing proportion of the ageing population had long-term diseases and the system Infosys developed had to prove useful when it came to treating them. Changes in the disease profile also needed to be handled
- The data provided would come from disparate legacy systems and all this data had to be integrated to generate a clear and concise record of the patient's medical history
- Getting the EHR demonstrator was only the first step. Infosys had to identify, define and test standards and provide feedback, which would ensure that the actual system would deliver benefits to patients and doctors alike
Infosys relied on the Global Delivery Model to conclusively depict the benefits of EHR. As a first step, Infosys analyzed the existing high-level user requirement documents and assisted in preparing requirements for defining the solution of the EHR demonstrator. After this was achieved, the team created the detailed design specifications.
To enable doctors to keep abreast of the latest developments, Infosys developed a Knowledge Management (KM) portal subsystem. An import subsystem was also developed to enable data to be introduced into the EHR system from the legacy applications. These entities were stringently tested to ensure watertight execution.
Since various legacy systems were involved and could not be seamlessly integrated, Infosys used a Web Services model. This meant that legacy systems did not need to interact with each other; they merely needed to provide data in the required Web format, and then the EHR could utilize the information without any problems.
Once the portal and import subsystems were proven to deliver accurate results, they were integrated with the Open EHR Record Server and the local database. Subsequently, they were deployed in the required environment, and proof of capabilities demonstrated to the participants.
The biggest advantage was that Infosys proved unmistakably the fact that EHR could be fruitful for patients and doctors alike. Other benefits included:
- The ability to use Web Services to integrate the legacy systems assured the client that it would face no difficulties in implementing the solution. This was critical to the success of the actual execution
- Infosys helped to identify, define and test standards and this paved the way for the actual realization of the project
Most importantly, the demonstrator proved beyond a shadow of doubt that tangible benefits could be accrued by modernizing healthcare and showed that the experiments could be reproduced nationwide.