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Information flow to enable integrated health care: integration or interoperability

2018; Royal College of General Practitioners; Volume: 68; Issue: 668 Linguagem: Inglês

10.3399/bjgp18x694889

1478-5242

Rob Meaker, Simi Bhandal, C Michael Roberts,

Primary Care and Health Outcomes

Integrated care systems, supported by electronic information exchange, are seen as key enablers to the future of the NHS.1,2 The failure of a centralised NHS IT programme3,4 has been followed by a move to local and regional solutions that provide an opportunity for clinicians to influence strategy and design. However, although primary care has been at the forefront of electronic care record use, connectivity outside the practice environment remains challenging internationally.5 A recent World Health Organization report on digital connectivity highlights the need to inform clinicians by sharing experiences of developing electronic information exchanges if we are to come to an understanding of what is needed and what is possible.6 Successful information flow requires that information be recorded electronically, managed, governed, regulated, linked via a master index, and be made available to users through one or more interconnected software applications. Clinician input has helped provide solutions to most of these challenges7,8 but technological solutions to connectivity remain a mystery to most clinicians and yet are a key determinant of how data can be used for patient care. A broad understanding of the issues can promote clinician engagement in the choices that need to be made to support nascent integrated care systems. There are two main technological approaches for sharing information: