Integrated systems – The primary challenge for Integrated Health and Social Care

Naturally the bedrock of achieving an Integrated Health and Social Care environment for Scotland is the integration of the systems involved.

However as the Auditor General reported a lack of these joined up systems is a primary contributor to progress not being made in achieving this goal.

Specifically in their progress report they identify, on p37 point 70 onwards:

“An inability or unwillingness to share information is slowing the pace of integrationThere are several areas which need to further improve to help IAs and their council and NHS board partners make better use of data. These include:

  • GP practices agreeing data-sharing arrangements with their IA
  • IAs being proactive about sharing performance information, ideas and new practice with other IAs
  • IAs and ISD agreeing data-sharing protocols for using data in national databases
  • IAs identifying gaps in data about community, primary care and social care services and establishing how this information will be collected. This is something we have highlighted in several of our previous reports
  • improving consistency in IAs’ data, making comparisons easier.”

This is mirrored by conclusions identified in the Technical Architecture report from Digital Health and Care Scotland:

  • “Most of the organisations surveyed have integration capabilities and the social care products in use do support APIs. However, the use of these APIs was found to be fairly low and system integration was often achieved using bespoke development techniques.
  • Interoperability is a key challenge for all health boards and integration is in all cases achieved using InterSystems Ensemble. The survey discovered the lack of semantic interoperability standards (such as SNOMED CT) lead to potential patient safety and clinical workflow issues due to incompatible systems being integrated together.
  • Data sharing agreements are common place among the organisations surveyed with most having data sharing in place with NHS boards, other Local Authorities, government and/or police. While the agreements were in place, practically applying it had come with its challenges.
  • Establishing data sharing agreements were cited as a key challenge to sharing data with other organisations.”


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