Since its launch in 2012, CMC, hosted by The Royal Marsden NHS Foundation Trust, has provided opt-in urgent care plans for over 20,000 patients in London and Surrey Downs. The plans include information for the urgent care services to enable them to deliver bespoke care for individual patients during the out-of-hours period, which represents two-thirds of the week. Included in these urgent care plans are the patient’s preferred place to die (if appropriate) and do-not-resuscitate (DNR) orders. To date, 79% of patients with a CMC urgent care plan have been able to stay in their homes, in accordance with their wishes, rather than in hospital.
"The Royal Marsden is delighted to be working with InterSystems, supporting the move from paper-based clinical records to a fully integrated digital care record. Coordinate My Care puts patients in control of their own care plans, and this project will deliver great value and benefits to the clinical community, patients and carers," said Cally Palmer, Chief Executive, The Royal Marsden NHS Foundation Trust.
CMC will enhance and extend services using InterSystems HealthShare®, a leading health informatics platform that facilitates information sharing and care coordination. It will include the newly released Personal Community patient engagement solution to allow patients to access and read their urgent care plans as required. CMC will initially focus on delivering new HealthShare solutions for urgent care, encompassing a wide range of stakeholders with complex information-sharing needs. A new CMC Integrated Care Exchange, using HealthShare for information sharing, will facilitate interoperability across NHS and social care providers throughout London and beyond.
Dr. Julia Riley, Clinical Lead at Coordinate My Care, said, "CMC urgent care plans are created by clinicians in partnership with patients. CMC changes the emphasis of care from reactive, crisis management to anticipatory, planned care that the patient has agreed to. Many different healthcare professionals are involved in caring for people suffering from chronic conditions or serious illnesses. CMC joins up the care so that patients remain at the centre, and all the professionals respect and deliver the care that has been planned, 24/7. If a situation arises in which urgent care is required, the medical response takes into account the wishes of the patient and the personalised urgent care plan, which can mean the difference between staying at home and a protracted hospital stay. InterSystems HealthShare provides us with an unparalleled opportunity to deploy a solution that works for the London Ambulance Service, NHS 111, primary and secondary care providers and, most importantly, patients."
The CMC service integrates fully with the NHS 111 telephone health advice service. Authorised users include emergency departments, ambulance services, and out-of-hours GPs, which is important, as urgent care is needed around the clock. By ensuring healthcare professionals know a patient's wishes in an urgent care situation, CMC care plans can relieve pressure on emergency services. "As a paramedic and a manager, I know having a service like CMC makes a real difference to the quality of care," said David Whitmore, Medical Directorate, London Ambulance Service.
EOL care is one of the 12 work streams in the QIPP initiative - "Quality, Innovation, Productivity and Prevention" - which is focused on maintaining the focus of "High Quality Care for All" in the current economic climate. Most patients with a terminal condition have three unplanned admissions in their last year of life. Preventing a single unwanted admission for 10% of those patients could save £120 million, which is equivalent to funding 80 hospital wards.
"InterSystems is delighted to be partnering with Coordinate My Care to engage with patients so that they, with the advice from their doctor or nurse, can choose the care they want," said Steve Garrington, Vice President International, InterSystems. "Coordinating care across London's large and complex healthcare community is a significant challenge. HealthShare, with innovative shared care plan technology, will enable joined-up healthcare by enabling care professionals to understand and respect the patient's urgent care choices."
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- InterSystems' Profile
Coordinate My Care (CMC), established in 2012, is a shared clinical service that allows healthcare professionals to record patients' wishes and ensures their personalised care plans are available to all those who care for them. CMC is working to empower patients to have choices about the care they receive by linking up the organisations that provide care for a patient. A personalised urgent care plan can be prepared and recorded on CMC to enable all care providers, who have been trained and have a login in and password, to access this information all day, every day. Clinical Commissioning Groups, NHS Trusts, nursing homes, hospices and community providers all play an integral role in the successful coordination of care. As a team we bring extensive clinical experience to drive the cultural and operational change required to deliver integrated, coordinated, and quality care for patients.
InterSystems develops advanced software technologies that enable breakthroughs. With a passion for excellence and a focus on client success, InterSystems provides data management, strategic interoperability, and analytics platforms used in healthcare, financial services, government, and other industries. In selected countries, InterSystems also offers unified healthcare applications, based on its core technologies, that deliver on the promise of connected healthcare. Founded in 1978, InterSystems is a privately held company headquartered in Cambridge, Massachusetts (USA), with offices worldwide, and its products are used daily by millions of people in more than 100 countries.