Robust local data sharing agreements, strict information governance measures, strong audit trails, and the deployment of HealthShare technology will allow secure access across the four trusts involved. Covering a population of 3.4 million people, the trusts include Birmingham and Solihull Mental Health NHS Foundation Trust, Black Country Partnership NHS Foundation Trust, Dudley and Walsall Mental Health Partnership NHS Trust, and Coventry and Warwickshire Partnership NHS Trust.
The trusts, which have carried out extensive discussions to agree which information needs to be shared, will use InterSystems HealthShare to integrate real-time information from their different systems at the point of crisis. This means, for example, that if a patient from Birmingham presents in Wolverhampton, clinicians there will have an up-to-date understanding of the patient's needs without the need to repeat questions at what may be a distressing time.
Currently, when patients present to a hospital outside their immediate area, mental health professionals cannot access any information from the patient’s mental health record – including any risks for that patient or details of their medication.
Under the new initiative, MERIT will be the first mental health trusts collaboration in England to allow authorised professionals to share access to this essential patient data when needed, providing controlled access to mental health diagnoses, treatment, risk assessment plans, names of professionals involved in care, and the patient’s crisis intervention plan.
"Access to the right information can mean the ability to make potentially life-saving decisions for patients in crisis," said Professor George Tadros, Clinical Director for Urgent Care at Birmingham and Solihull Mental Health NHS Foundation Trust and lead for MERIT's crisis care work stream. "We are working to revolutionise how we care for mental health patients in crisis and to end a situation where they might show up to a hospital where professionals know nothing about them. If we know the patient's care plan, we will be able to deliver a far better service.
"Importantly, this will not mean creating a big new database, and it is not about sharing sensitive information without patient consent. But it is about being able to connect our individual systems in the West Midlands meaning that the right professionals can understand how to deliver the safest and most effective care possible to patients in urgent care situations, regardless of the hospital they visit. This could become a new model for the entire NHS."
Strict policies on access to data, as well as a strong audit of who has accessed it, at what time, and for what purpose, will also help to ensure that patient privacy is safeguarded.
Commenting on the future vision for the project, Dr James Reed, a Consultant Forensic Psychiatrist and Chief Clinical Information Officer at Birmingham and Solihull Mental Health NHS Foundation Trust, said: "Our vision for this is to provide a common mental health record across the West Midlands. This would be an enormous step forward, but with a clear vision, clear leadership and involvement of people throughout partner organisations, this is possible. We're starting with a clear clinical need, building trust together to share access to information and to start to remove gaps in mental health provision. But our work here in the West Midlands could also help to pave the way for new national standards in mental health."
Expected to go live in late 2017, the project is part of an important programme of work in the MERIT vanguard to improve mental health care provision. It complements a joint bed management policy across the trusts, so that patients can be treated locally, rather than being sent to distant parts of the country. A separate pathways project will also provide patients and professionals with online access to information about the best places available to access crisis care. And a training initiative will make sure the workforce across the West Midlands meets the same level of competences, so that wherever a patient sees a nurse or doctor, they will receive the same level of expertise.
"Projects often claim to be pioneering, but this is a powerful example of an NHS first in improving care for mental health patients," said Mark Palmer, Country Manager, InterSystems UK & Ireland. "Whilst technology can help to connect care, it is our customers and their patients that are the driving force, making sure it responds to real clinical need. We eagerly look forward to the go-live of this important work, and the benefits it could have for the wider NHS."
Four mental health trusts have come together to develop new ways of working to improve the way mental health services are provided for the future. The vanguard partners include Birmingham and Solihull Mental Health NHS Foundation Trust, (BSMHFT) Black Country Partnership NHS Foundation Trust, (BCPFT) Dudley and Walsall Mental Health Partnership NHS Trust (DWMH) and Coventry and Warwickshire Partnership NHS Trust (CWPT).
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