Enabling patient-controlled NHS records with AWS: An Insight from NWSIS

For several years, discussions around patient-controlled records have promised to lay the foundations for better informed, more engaged patients; a more mature doctor-patient relationship, shorter consultations, fewer errors, and a means of integrating services—in short, that holy grail of modern healthcare; improved outcomes at lower cost. In the UK we’ve yet to see this this level of patient control rolled out nationally, but is this all about to change?

The North West Shared Infrastructure Services (NWSIS) is proposing a whole system development under their Wellbeing Person Record Exchange Service programme (WelLPRES) designed to link citizen health records to applications and monitoring devices. This will empower the citizen to own their own record and provide real time data on deterioration in health to clinicians. It will also -enable real-time clinical intervention via tele monitoring to avoid secondary care admission. The outcome being a digital highway that will support both care professionals and patient access to the individuals clinical record and provide a service that approves applications for use across clinical pathways (E.g. COPD, diabetes, long term conditions).

NWSIS have initiated a proof of concept for WelLPRES to provide citizens access with an initial clinical pathway for a cancer recovery programme and patient access.

Cancer Recovery Programme

As part of the first phase of the WelLPRES programme, NWSIS will implement a digital pathway to support the breast cancer recovery programme.

Currently a manual process is in place to manage the remote surveillance element of the 5-year programme. The programme itself comprises of a consultant/nurse led follow up and/or supported self-managed follow up (SSMFU).  This means that a risk stratified assessment, based on the individual’s health and wellbeing outcomes, is undertaken to determine the level of follow up required.  Follow up requires completion of a mammogram and review appointment in the hospital setting and therefore, tailoring follow up requirements to patient need results in more meaningful interactions between care professionals and patients.

NWSIS also recognised the opportunity to improve the patient experience by preventing unnecessary appointments and directing professional resource to manage demand on services.  A standardised questionnaire will be completed by the patient and returned to their named care professional. Once completed, questionnaires will play an important role in increasing return rates and appropriate follow up actions, automated risk stratification and will lead to increased communication routes between care professionals and patients to enable clear advice and guidance and timely re-access when it is required. This questionnaire will also act as a remote monitoring tool, which prompts action from care professionals should it be required and is part of SSMFU.

Ultimately, the main objective of the project is to digitalise and optimise the processes of the breast cancer recovery programme to improve patient care engagement, compliance and process effectiveness.

After successful implementation of the digital pathway, the aim is to extend the solution to support prostate and colorectal cancer patients.

Patient Access

Currently, medical data resides in different systems (hospital information systems, oncology information systems, general practitioners’ systems and many others) at any time and any place. In order to unify the integration of these systems, they must be connected to the health information exchange backbone.

To host this platform, NWSIS partnered with ANS and IT solutions provider, Parsek to host the platform on the AWS public cloud.  This decision was made in line with national NHS and government policy to embrace safer, more efficient and secure cloud technology, rather than traditional data centres.

ANS delivered the project using Cloud Start, an outcomes-based service focussed on delivering a production ready Public Cloud capability for organisations based upon the AWS and ANS best practice framework. Cloud Start follows a proven methodology that provides a bespoke design for NWSIS whilst ensuring all best practices and key requirements are met. The key outcomes will provide NWSIS with:

A Production Ready Platform – suitable for hosting production workloads with alignment to the organisation’s compliance, security and architecture standards.

A Defined Operating Model – ensuring all required tooling is operational and processes/ skills are in place.

Enterprise Governance – providing transparent costs and a highly governed configuration to ensure known and controlled spend.

The Platform Provision will provide NWSIS with a comprehensive capability that covers:

Core Platform – Leveraging both ANS and AWS best practice to deliver a robust and stable provision that aligns to NWSIS’ governance requirements.

Network & Platform Topology – Utilising Enterprise Grade topologies that ensure performance, availability and cost efficiency throughout the foundations of the platform.

Core Services – Providing services such as Authentication, DNS Resolution and Data Protection to ensure that all elements of the capability are in place.

As a result of hosting the platform in AWS, patients will benefit from greater access to health information, data and knowledge about their condition management, helping to maintain health and wellbeing and not just providing treatment for illnesses when they occur.

Patients can also expect a reduction in unnecessary admissions to hospital and the provision of treatment can be delivered in the most appropriate care settings as information can now be accessed when it is required.