1. The document discusses interoperability between GP practices in Richmond, allowing clinicians to access patient records and provide appointments across practices through a centralized hub. 2. It describes how the current solution links different clinical systems to give clinicians access to a patient's full medical record regardless of their registered practice, and allows referrals and prescriptions to be generated. 3. Results so far show 15% of Richmond's population accessed hub appointments in the first year, with positive feedback and only one patient refusing consent for their record to be viewed. Next steps include addressing ongoing funding and expanding mobile access and secondary care involvement.

1. Interoperability
at
Richmond General Practice Alliance
(RGPA)

2. Grant Oliver
IT Project Manager
RGPA and Richmond CCG
Dr Neil Jackson
Richmond GP
RGPA Board Member

3. Every day, nearly 10,000 financial institutions send
approximately 24 million transactions - $14 billion

4. How difficult can it be?

5. Anything is possible!

6. Agenda
1. Background and Objectives
2. Solution
3. Next steps

7. Richmond General Practice Alliance
• Federation of 28 GP Practices
• Co-terminus with both Richmond CCG &
London Borough Richmond upon Thames
• Covering all the GP’s in the CCG and
Borough
• 205,000 patients in South West London
• 2 years old
• Prime Ministers Challenge Fund – 2nd Wave

8. Richmond is famous for ….

9. 1. Any patient registered with a Richmond GP will have access to the
appointments held in the hub clinics
2. These will be both GP and Nurse appointments
3. Could be face to face or by telephone
4. The clinician will have access to the full medical record of that patient but
only viewed by agreement with the patient
5. The Clinician can read-from and write-to the medical record
6. Referrals and prescriptions will be generated by the hub clinician as if they
were in the “home” surgery
7. Prescriptions can be printed or sent to pharmacy electronically
The Dream (July 2015)

10. Challenges (July 2015)
• Getting colleague buy-in
• Confidentiality
• Caldecott principles must apply
• Data sharing agreement
• Professional Indemnity
• Hub Location
• Public engagement and launch

11. 2. Solution

12. 6 x EMIS Web
22 x Vision hosted in
AEROS environment
Vision 360
Data Hub
Vision 360 shared access
presents a list of patients and
displays a web based view of the
selected patients record.
Information about the current
consultation is submitted by the
clinician into Vision 360 then
resynchronised with the local
practice data set on AEROS.
Using Vision
Shared
Access

13. 6 x EMIS Web
22 x Vision hosted in
AEROS environment
Vision 360
Data Hub
EMIS data is not streamed into
Vision 360. The addition of the
list of EMIS patients creates a
complete Richmond area index.
If an EMIS patient is selected
Vision 360 will use the Vision
Integration engine to translate
the request into a series of API
calls for EMIS Web. Data is
displayed in Vision 360 format.
Incorporation
of EMIS data
Vision
integration
EngineEMIS Patient list
NAME & ADDRESS
PRACTICE

14. RESULTS
• In one year 15% of the population of
Richmond were seen in Hub consultations
• 8am – 8pm 7 days
• One single patient refused consent to
view notes (of 50,000)
• 111 can refer into the hub at the weekend
• Bailed out a single handed colleague

15. RESULTS
1. Any patient registered with a Richmond GP will have access to the
appointments held in the hub clinics
2. These will be both GP and Nurse appointments
3. Could be face to face or by telephone
4. The clinician will have access to the full medical record of that patient but
only viewed by agreement with the patient
5. The Clinician can read-from and write-to the medical record
6. Referrals and prescriptions will be generated by the hub clinician as if they
were in the “home” surgery
7. Prescriptions can be printed or sent to pharmacy electronically

16. 3. Next Steps

17. On-going issues
• On-going funding
• Unable at present to read clinical correspondence

18. The Future
• Mobile communications between colleagues who can
read-from and write-to medical record now possible
• Genuine team working
• Better for the patient
• Better for the team
• BUT Community provider uses System One
• How would it be if secondary care had access too?

19. Hub Interoperability White Paper
Send an email to:
grantoliver@nhs.net