Putting knowledge in the hands of clinicians through MIG integration

By Simon Jackson, Lead Technical Architect, Lorenzo Desktop Integration

There has been a push by National Health services in the United Kingdom and players globally, to improve the quality of care patients receive at both a population and individual level. Good quality care depends on access to accurate, up-to-date and complete information about the patients, their health and their current treatment.

Too often, however, clinicians struggle to gather all the necessary information about a patient. They waste valuable consulting time asking patients about their medical history, tests and other pertinent information, including interrogating multiple systems used within their hospital estate.

Providing clinicians with complete patient information is one of the primary objectives of the Medical Interoperability Gateway (MIG) from Healthcare Gateway, a subsidiary of EMIS Health. MIG lets primary care doctors publish patient treatment notes onto a third-party system, allowing other medical professionals and acute trusts to then request information about the patient, gain an end-to-end view of that individual’s treatment and previously prescribed medications, and assess any long-term health problems.

Ensuring integration

There is, however, more to managing access to patient information than simply setting up access to the MIG. When the MIG was integrated with Lorenzo, an official partner, through patient-based access to the MIG patient view, it was recognized that clinicians needed to connect to many different systems from Lorenzo. That includes various health reports, radiology systems, endocrinology reports and tests, document management systems, external result-and-request systems for labs, and other data. Access to all of these systems is needed to give clinicians up-to-date information so they can correctly treat their patients.

The traditional approach to integrating different health systems from the client desktop is to design and implement them separately on a case-by-case basis. However, given the many complex systems healthcare practices operate (which can vary from budget to budget), this can prove impractical and costly. Instead, the approach taken within Lorenzo was to implement a highly componentized framework that can be configured to enable almost any type of integration through configuration alone, without the need for repeated systems development.

Enabling any solution to easily interconnect — whether it is a web-based solution, desktop solution or web service — means clinicians can quickly and easily access information about their patient directly. For example, if documents have been stored in an external electronic document management system (EDMS), the physician can, with one click, look at all documents stored in the third-party document management system related to that specific patient, without the need to log on or search for the needed records. This reduces the risk of error, because the clinician isn’t required to log on to the system and search for the patient and the records, improving the overall clinical safety of the disparate systems.

The objective of the interconnection between MIG and Lorenzo is to improve health outcomes and empower clinicians to directly access information. As clinicians have limited time to assess a patient, view their history and review current health risks, they need to have quick and easy access to accurate and up-to-date information from the hospitals’ multiple information sources directly from the patient’s electronic patient record (EPR), no matter where it is held. This means clinicians are better placed to meet the broader healthcare objectives of better population health and improved individual patient outcomes within the time constraints they are required to work under.

Into the future

While the immediate objective is to empower the clinician within each consultation, the longer-term goal is to leverage the Lorenzo framework to go further — whether to access more systems, offer more patient-based information, or even enable patients to connect their wearable devices, such as Fitbits and sleep monitors, to the NHS trust’s managed health record. The framework’s reach is endless, and because of the componentized approach, if there is something it doesn’t yet support, it will simply involve a small amount of development work to integrate newer systems rather than rebuilding the entire integration from the ground up each time. As it is configuration-based rather than development-based, this means that newer integrations can be turned around more quickly, making it easy to react to changes in the hospitals’ software estates.

The MIG story has alerted the NHS to gaps that it faces in connecting health information, and it is now building a national solution called GP Connect, with the objective of not only providing other systems with summary data but also with structured clinical content. Other markets and countries, such as Australia and the Nordics, are also taking advantage of Lorenzo’s desktop integration capabilities because these capabilities are being provided within the core product, so in the future we envision greater, more global connections.

Enabling the MIG Viewer through Lorenzo desktop integration is just the start of a journey into enabling better healthcare connections.


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