A new case study, published on E-Health Insider, looks back over the history of information sharing initiatives in the pursuit of more integrated health and social care, and asks what lessons can be learnt from what has happened so far (hat tip to the ever helpful James Freed at Public Health England for highlighting it). The case study highlights that more integrated records (to improve patient experiences, and reduce inefficiency) have been a long term goal in the health service, but that changes in priorities and approach have led to a ‘patchwork’ of initiatives across the country. Some of these initiatives are profiled in the case study, and there are a few key lessons and themes to come out of them all:
- Pilots are all very well, but you need to reach critical mass
While we’ve seen evidence that starting small minimises the risk in innovative information sharing projects, there comes a time when the service needs to be embedded into normal service in order to be sustainable. The case study’s authors say
This may be one reason that so many national and local projects have failed over the years; they never managed to cover enough people, include enough information, and get well enough embedded into local workflows to succeed.
For me, the key point is the last one. So often information sharing becomes an ‘add on’, which could make a difference to the way professionals do their job – if only they would use the new service / approach / system! We all need to be realistic about the likelihood of people using any approach which needs complicated additional security, logging out of one system and into another, or remembering to check a box that can normally be safely ignored.
- Information sharing projects need time and commitment
This is definitely borne out from the experiences we’ve seen – as the authors rightly say, information sharing can help deliver better, more joined-up services – but it isn’t a quick fix. Anyone who has seen Stephen or I present on the Leicestershire Multi Agency Information Sharing Hub will remember the slide “Give it time” is closely followed by “Give it some more time”.
- Sorting out information sharing agreements take time
Again, this echoes with what we know. But here my experiences diverge from those of the authors. The authors suggest developing
sample business cases, data sharing profiles, and model information sharing and consent agreements
Some of those things already exist here on the website, and more will be shared as we work with more areas on a broader range of topics. But each area develops agreements or documentation which meets their specific needs – because often it isn’t the agreement that needs working on, but the relationship. That takes time to develop – not just the paperwork.
- There is surprisingly little evaluation of what works, and what it delivers
This is definitely something that rings true. In fact, early ideas for how the Centre of Excellence might develop were modelled on the ‘What Works’ centres, with a focus on sharing evidence of the impact of information sharing. We rapidly realised that the evidence is thin on the ground, so it is one of the key things we will be working on with local places: how can we demonstrate the impact that information sharing has had for them? And how did they do it? We look forward to sharing that evidence as it develops, but in the meantime, if you have evaluated the role of information sharing, why not get in touch, and help develop a case study of your own?