Clinical portals: Stepping stones to the EMR

On Tuesday, members of our team attended the Healthcare Conferences UK event, “Delivering a Paperless NHS: Developing and Implementing a Clinical Portal” in London. The conference focused on case studies of developing and implementing clinical portals, which aggregate patient data drawn from different source systems.

Though the general consensus is that, for many hospitals, portal technology can reap significant efficiency and safety benefits at relatively low cost, portals are ultimately destined to be replaced by integrated electronic medical record (EMR) systems.

Learn more about the value of the EMR

“Business, not boundaries”

Dr Martin Murphy, the Clinical Director of the NHS Wales Informatics Service, spoke about developing the Welsh national clinical portal. A key lesson learned was to focus on the constant needs within the clinical business, such as correct patient identification, rather than building on “boundaries” such as administrative functions or old patient administration systems (PAS).

The clinical portal is being built around the five information services people need:

  1. Tasks: Help clinicians undertake day-to-day work e.g. identify the correct patient
  2. Records: View previous records e.g. view what people have previously done
  3. Analysis: Identify new problems, measurements, and inequalities
  4. Communication: Send documents such as referrals and discharges
  5. Knowledge: Access to correct and up-to-date knowledge e.g. provide quick access to best practices

In 2014, the aim is to slowly roll out services via the clinical portal, such as electronic referral and discharge letters, medicines lists, and discharge advice letters.

“Keep calm and carry on the long haul—it’s a journey”

Adrian Byrne, Director of IM&T at Southampton University Hospitals NHS Trust, urged against underestimating the task of implementing a clinical portal. The relatively simplistic front end of a portal often masks the amount of work needed to develop an effective system behind it. He highlighted the need for high-quality data with clear definitions, units, and sound data integrity, to raise awareness of data anomalies and updates.

Nick Bruce, Acting Divisional Manager ICT Shared Service for the Royal Wolverhampton NHS Trust, discussed the work behind developing his organisation's own in-house clinical portal. He highlighted the importance of early identification of clinical champions, strong executive support, robust business continuity and communication planning, and governance.

Beware: Going “paperless” is a red herring

The NHS's intense focus on going paperless by 2018 is a distraction if you don’t set yourself up to achieve the real focus: optimal clinical quality and patient improvements.

While a consolidated clinical portal is a positive step towards improving care quality and patient safety, the ultimate aim should be to implement an integrated EMR. The most significant benefits will come in the form of advanced Clinical Decision Support (CDS) and advanced analytics, but a clinical portal will remain useful, as there will always be the need to integrate more information from beyond the boundaries of your organisation’s EMR.