Bristol City Council
FHIR Interoperability

One of the challenges facing GPs is not knowing if a patient is being prescribed opioid substitutes outside of primary care. This is particularly difficult when working with vulnerable individuals with complex needs and lifestyles.

Recently we delivered a project for Bristol City Council that provides visibility to GPs of prescriptions issued by Drug and Alcohol teams.

Brief

Bristol City Council are a member of Connecting Care: a highly innovative and ambitious partnership between NHS Trusts, local authorities and other NHS services in the South West to enable secure sharing of patient information.

Patients in the region are often cared for by a number of different organisations, even when receiving treatment for a single condition, such as drug and alcohol addiction.

Our Theseus: Drug and Alcohol Caseload Management System has been in use by Bristol City Council for over 7 years and we have been proactive in exploring the benefits of enabling health professionals within the Partnership to access information held within Theseus.

Having joined INTEROPen in 2017 we were well placed to deliver a recent project that enables GPs to access prescription records stored in Theseus from their primary care systems using FHIR interoperability standards.

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What We Did

FHIR stands for Fast Healthcare Interoperability Resources and is a common standard being championed by NHS Digital to enable interoperability between health and social case systems - whether in use in Primary, Acute, Secondary Care or wider public health settings.

We were excited to use FHIR to deliver the project and collaborated with Orion Health to create a compliant API that empowers GPs to access Theseus caseload data from within their primary care IT systems.

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The interface created matches the client using their unique NHS Number in conjunction with additional client record information that serves as a built-in crosscheck.

If the patient exists in Theseus, the API then returns the details of all drug and alcohol prescriptions a client has received from drug and alcohol keyworkers outside of primary care.

Clinicians in hospitals can also see if prescriptions have been issued, as well as the source of the prescription. Having access to this information is of great benefit to patient safety and quality of care as it effectively mitigates the risk of duplicate prescribing.

The project was efficiently delivered using Agile development methodology and was implemented in just 7 weeks from design to go live.

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The Results

The work undertaken is one of the first projects delivered nationally using the Care Connect FHIR APIs championed by NHS Digital and INTEROPen.

The new interface is already in use by 27 organisations in the South West, including 85 GP practices, NHS hospitals, social care and emergency services.

The project has been regarded as an innovative model of best practice and we were recently invited to showcase the work undertaken at the inaugural INTEROPen Hackathon in London.

Mike Taylor, Lead GP for the region’s Homeless Health Service commented that “at last GPs... have a reliable, quick and efficient way of knowing whether the patient in front of them is receiving opiate substitutes from drug workers outside of practice based shared care... This has the real potential of saving lives and reducing drug related deaths”.

In addition the project is particularly significant as it opens the door for other systems to interface with Theseus using FHIR.

We see enormous potential for many other uses of FHIR with Theseus, including GP referral to Theseus caseload systems used to manage stop smoking, exercise on referral and social prescribing interventions.

You can read more about the project on the Digital Health website: FHIR Spreads to Bristol

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