Thread by @DavidHancock6

1/12 Yesterday, @NHSEngland #Transformation #Unit announced that #integratedcaresystems should, through a process of managed convergence, standardise on their #electronicpatientrecords #EPRs. What does that mean? How might this be achieved? A short🧵

2/12 Firstly this is intended to be managed convergence of EPRs across the same types of Trust. Convergence of an EPR for #Acutes, and it can be a different EPR for #Community and another EPR for #MentalHealth etc. So what are the options to achieve this convergence?

3/12 Every Acute could use the same EPR. However just because there may be multiple acutes in an ICS using the same #EPR it doesn’t the mean the #EPR works in the same way in each Acute.

4/12 Every instance of even the same #EPR will be configured differently – different data/coding and supporting different workflow – so they will not work together directly. Even those who have the same #EPR will need to reimplement and configure them in an identical way.

5/12 This is a large new change process and orgs may have been through one of these recently already! How do they feel about that?

6/12 If you have one or more Trusts without an #EPR in your #ICS how do you get them to improve their digitisation and lay down a capability that lets them work with other Trusts? What is more important – digitisation of the individual Trust or waiting for a convergence strategy?

7/12 Can you build #interoperability into an #EPR implementation? It definitely can and indeed must be, but is not something that was tackled in the #GDE programme save for examples like @UHSFT

8/12 An ICS can manage the convergence through interoperability. It needs a strategy to manage data at rest and data in-flight to do this. Would this be easier than ripping and replacing EPRs? Is it a practical way to deal with collective action dilemmas? Ask @CompareSoftware

9/12 Managed Convergence sounds simple, low-impact but is complex, messy and disruptive. #ICS needs to assess how much change and disruption their participating organisations can take-on. Have @NHSEngland consulted @CIOnetwork, @CCIONetwork and @CNIONetwork and @techUK ?

10/12 ICSs need to also understand how they will support collaboration across #ICS boundaries? Managed convergence will not solve that. There is therefore a huge need for ICSs to have an interoperability strategy around integrating data and clinical workflow across organisations

11/12 I hope this is the main topic of conversation at @DHRewired . Managed convergence is too big a subject for us not to ask searching questions. It will shape NHS IT for the next 5 years, at least, and has the danger of replicating some aspects of the old #NPfIT

12/12 I will be happy to discuss any of this with attendees at @DHRewired. Come and visit me and the @InterSystemsUKI team at stand B18 and we can discuss over coffee. Would love to know your plans, ideas, fears, etc on managed convergence of #EPRs

@DHRewired @InterSystemsUKI PS As @e17chrisfleming said how does this managed convergence align with Procurement Rules?

https://twitter.com/e17chrisfleming/status/1498956653244424193?s=20&t=H_yh6pWE4FMTZcLL49q7MQ