- Smart Healthcare, Wednesday 11 November 2009 10.52 GMT
Red flag: interoperability benefits from the Welsh political approach to health, according to Informing Healthcare. Photo: jiunlimited.com
David Davies, director of engagement for NHS Wales' Informing Healthcare organisation, said that by 2011 the country was likely to have just two patient administration systems in use, compared with 10 in 2004.
Neither will be a commercially available system. Cardiff and the Vale is likely to retain its existing in-house system, while the rest of the country is set to move to the Myrddin (Merlin) PAS as a result of mergers, although Davies said healthcare organisations are not being forced to shift.
He told a session at the e-Health Insider conference in Birmingham on 9 November 2009 that by 2011, it was also likely that Wales will be using single systems for laboratory information, radiology, pharmacy and child health. There will also be a national GP systems contract.
"We still have what you could describe as socialist healthcare systems in Wales and Scotland," said Davies, in comparison to the competition and patient choice policies of England. "There's a statutory obligation in Wales to collaborate, not compete."
He said the Welsh NHS has access to more than 100 developers who work for its constituent organisations, whose work can be reused across the country. However, it is also prepared to buy IT where appropriate, as well as building on its legacy systems.
Wales has decided that GP records will act as the country's main patient records, but that they will be made available through the Welsh Clinical Portal, an online system. "It's what I call the Doctor Who concept," said Davies, in that a single portal will act as the gateway to numerous legacy systems. He added that Wales eschews replacing existing working systems.
He added that GPs are well placed to act as the guardians of their patients' data, partly as they are paid to maintain its data quality. "GPs control what goes into them, GPs control what goes out of them," he said.
The country is also introducing Individual Health Records, a limited set of data drawn from GP systems for emergency use, similar to Scotland's Emergency Care Summary system. These are already in use in Gwent.
Informing Healthcare is also working on My Health Online, which will provide patients with web access to their records. In addition, social care services will be able to link to the national infrastructure: providers already using health's network and set to share data centres as well. The arrangements are reinforced by the presence of Gwyn Thomas as head of Informing Healthcare and chief information officer for the Welsh Assembly Government.
Davies said that the country's national infrastructure depends on the Welsh Demographic Service and its master index of patients, which in turn relies in information from GP systems. He said that good demographic data is particularly important in Wales, where 10 surnames account for half of the population.
Asked about plans to exchange data on the 3-4% of Welsh patients treated by English institutions, Davies said it is working with NHS Connecting for Health on a gateway capability. The systems are not yet in place, although picture archiving and communication systems (Pacs) are a likely first area.
