Orion Health’s perspective on the NHS framework: What good looks like

The What Good Looks Like (WGLL) framework has been developed to support NHS leaders to accelerate digital and data transformation. The framework outlines what good looks like at both a system and organisational level and has seven success measures that we have reviewed based on our experience of deploying Shared Health and Care Record (ShCR), Care Coordination and Analytics technology successfully over three decades.

We hope you enjoy hearing from Orion Health’s experts on how to achieve ‘what good looks like’ and how it will impact your organisation.  

1) Well led  

Integrated Care System (ICS) leadership teams are challenged to promote digitally enabled transformation to efficiently deliver safe, high-quality care. The Shared Care Record is a key enabler to that strategy with the potential to have a huge impact on the health and care service if delivered correctly.  

It is important to recognise that developing a large scale shared care record is complex, challenging and takes time. Successful implementation does not work without collaboration between a wide range of different stakeholders. A well led programme needs strong governance and the right leadership at multiple levels to include executive, management, clinical and operational representation. It is important that these groups are engaged to go on the journey together, and that there is genuine support for the programme as a pragmatic solution for information sharing for the benefit of the wider community.  

It is essential to have a strong steering committee with health and local authority champions to support and help drive change management. Leaders in partner organisations should recognise that the Shared Care Record is critical to sustainable, efficient and safer care delivery. They should champion the programme, and proactively identify teams and services who will benefit the most to ensure that the Shared Care Record is embedded into their own local operational practices. 

2) Ensure smart foundations  

Knowing where to start can be daunting. At Orion Health we have developed an interoperability maturity model that helps to inform customer strategy. It is based upon ensuring ‘smart foundations’ through deployment of the Shared Care Record and adhering to industry standards such as FHIR, SNOMED and those recommended by the Professional Records Standards Body (PRSB). We support customers to not only extend the reach and depth of the Shared Care Record but to utilise the platform to promote collaboration across care settings by moving from ‘viewing to doing’ using our Care Coordination and Analytics products.  

Technology alone will not bring success. ‘What good looks like’ highlights the importance of “…a system-wide strategy for building multidisciplinary teams with clinical, operational, informatics, design and technical expertise…”.  Over the course of 17+ years of delivery to the NHS, we have developed an understanding of the necessary skillsets and structures to ensure project delivery. Our EMPOWER framework outlines the workstreams and activities required for success at both the customer and supplier side.  

Key to the model is ensuring that the citizen and end user experience are the focus of change management activities which in turn inform technical workstreams and ultimately drive adoption of the technology. To enable this, clinically led stakeholder groups should be able to determine how ‘Current State’ processes will evolve to become the ‘Future State’.

3) Safe practice  

Orion Health complies with relevant NHS Digital standards in respect of clinical safety. We have a certified Clinical Safety Officer and our services offer compliance with DCB0129 (Clinical Risk Management in the Manufacture of a Health IT System), and support for DCB0160 (Clinical Risk Management in the Deployment and Use of Health IT System). 

To give our customers necessary assurance, Orion Health products and services are compliant with the General Data Protection regulations (GDPR), assured by a continuous governance and oversight programme which maintains legal and regulatory data protection compliance for customers across Europe. Orion Health has a “privacy by design” program which ensures all new products and major new releases are designed to enable our customers to comply with global privacy law requirements, including the relevant requirements of the GDPR. 

We have successfully completed the Cyber Essentials Plus certification. The process involved a review of our security and IT controls (Policies, Processes and technology) as well as technical testing of devices and firewalls by the assessors. Cyber Essentials Plus is increasingly being made a mandatory requirement for UK Government, NHS and Defence contracts. 

4) Support people  

Our technology brings inherent benefits that support users by making appropriate data accessible to those who need to see it. Orion Health’s Shared Care Record and Care Coordination solutions enable users from different organisations to view and collaborate on citizen information according to their role. Irrespective of care settings our web based technology can be accessed securely. For example, GP users can use single sign on or care home staff can leverage multi-factor authentication to safely access the Shared Care Record to view information. 

As mentioned, we are mindful that technology alone does not ensure that users are fully empowered. The framework outlines the need to “…support all staff to attain a basic level of data, digital and cyber security literacy, followed by continuing professional development.” We recognise this and know how vital it is that citizens and health and care professionals understand both ‘how’ and ‘why’ they are being asked to use a new solution. To this end, we work with customers to provide and/or support training that is tailored to the use case. This can be anything from Train the Trainer (TTT) sessions, to direct end user training along with the provision of supporting materials in the form of e-learning and quick reference guides.

Once training is complete, ongoing support structures are required in the form of champion users; an enabled help desk and feedback mechanisms. Capturing user feedback at source and feeding it back into the solution in a timely manner is paramount! We view our customers as long term partners and are invested in their success.  

5)  Empower citizens 

The WGLL framework requires solutions to “ensure that people can access and contribute to their health and care data” and “Ensure that citizens have access to care plans, test results, medications, history, correspondence, appointment management, screening alerts and tools”. Using Orion Health’s Personal Health Record (PHR) citizens can contribute and engage through a consistent, easy to use, multi-channel interface, to access their complete record including Care Plan’s, appointments and test results. 

The framework highlights the need to “make use of national tools and services (the NHS website, NHS login and the NHS App), supplemented by complementary local digital services that provide a consistent and coherent user experience”. Orion Health has a proven track record of providing industry leading integrations across care settings and suppliers to ensure that citizens and health and care professionals have access to the information they need more readily. 

In providing technology for citizens to better manage their own healthcare and wellness Orion Health enables customers to put citizens at the centre of the Shared Care Record. Enabling citizens along with health and care professionals is at the forefront of our product strategy.  

6) Improve care  

Orion Health’s Care Coordination Solutions are currently enabling customers to “…redesign care pathways across organisational boundaries…” as outlined in the WGLL framework. Deployed alongside our Shared Care Record they enable multidisciplinary users to access and input to citizen centric pathways across multiple organisations ensuring that everyone is working from the same, consolidated record. 

The solutions that we provide are standardised to promote consistency. This further supports customers in pursuit of WGLL by aligning to the frameworks recommendation to embed “…digital and data within their improvement capability to transform care pathways, reduce unwarranted variation and improve health and wellbeing.” Pre-defined workflows and structured forms with built-in logic support health and care professionals to follow best practice.  

We are committed to building more ‘out of the box’ Care Pathways aligned to standards promoted by the Professional Records Standards Body and other organisations such as the Resuscitation Council who issued V3 of their ReSPECT form a few months ago. We’re also willing to partner with organisations to develop offerings under this umbrella. Our ultimate aim in this space is to enable our customers to improve patient care by providing solutions that drive standards and contribute to the removal of inequality. 

7) Healthy populations  

‘What good looks like’ states that data can be used to “…inform care planning and decision making…” and to “…contribute data and resources to the ICS-wide population health management platform…”. To reach this level of maturity requires the right data foundations in the form of access to high quality data. Data governance monitoring supported by training and standard operating procedures will support this by enabling users to input accurate data at source. 

From a technology perspective Orion Health’s Discover solution provides analytics to report on data persisted within our platform. Discover gives health and care professionals and other key stakeholders dashboards and visualisations of data to support operational decision making and to improve clinical outcomes. 

In the coming months and years we are committed to expand this capability to meet the needs of customers as is reflected in our emerging products. ‘Discover De-Id’ is a framework of tools covering end-to-end de-identification activities whilst the ‘Machine Learning Manager’ provides a platform from which data algorithms can be stored, administered and deployed. Once run against data the output of the algorithm can provide predictive insights for example a ‘risk of mortality’ citizen score presented within the Shared Care Record. 

We hope the knowledge shared by our Orion Health experts will add value to your digital health journey! If you have any questions or would like more information, please get in touch: