Exploratory Workshop: Enhancing data sharing in and between hospitals and between the care lines

Welcome back to the series, where we delve into the critical discussions and discoveries from the workshops hosted by InterSystems and Hack Lab Belgium. In this post, we focus on the first of three pre-hackathon workshops. We explore a fundamental aspect of problem-solving, which involves finding and understanding the source of our challenges. This is precisely the purpose of the Exploratory Workshop, which brought together professionals with diverse backgrounds whose discussions yielded invaluable insights. It is worth mentioning that this event was organised for a group of confident guests, including our partners and clients, whose collective effort helped shape the future of healthcare data systems.

As mentioned in the introduction post, the successful collaboration between InterSystems and Hack Belgium Labs opened the floodgates of creativity and brainstorming captured in a string of workshops. The outcomes of the Exploratory Workshop, which is the main subject of this post, laid the groundwork for two topics that served as challenges addressed during the third edition of Hack Healthcare.

The creativity flow was feasible thanks to 160 professionals from various healthcare ecosystems, like hospitals, government bodies, IT companies and business consultancies, that joined the Exploratory Workshop. Its primary objective was to discuss two of the three topics, that will be described in the next paragraph, and create a catalogue of challenge hypotheses within these topics. The goal was to find finely defined issues whose resolutions InterSystems would patronise at Hack Healthcare 2023.

After gathering the participants, InterSystems’ team divided them into two groups based on their expertise and experience and let each group work on one of three topics:

1. Improving data collection quality, in other words, gathering healthy data. Data is everywhere; however, it must be collected and tagged correctly. Otherwise, it is not exploitable.
2. Enhancing data sharing in and between hospitals within the shared hospital network and between different hospital networks for the direct benefit of patients, for example, by standards or streamlined protocols, etc.
3. Enhancing data sharing between the lines of care, meaning between the first and second lines of care - encompassing hospitals, patients, and GPs.

The groups have chosen to delve into the second and third topics: Enhancing data sharing in and between hospitals and Enhancing data sharing between the lines of care.

During the next phase, the participants identified the most impactful and urgent concerns in the healthcare sector. The results preceded by group discussions were based on individual experiences, which helped to cluster the problems together. Afterwards, the participants examined the previously identified topics in terms of:

- the urgency of the problem: based on its immediacy and the level of attention it garners,
- the impact of the problem: based on its scale and severity.

This analysis (exercise) laid the foundation for a problem selection that resonated with the audience. Thanks to the cooperation between the groups and the public, focussing on the topic of

Patient journey: the importance of transfer points in patient data sharing,

eleven already existing issues were recognised. They all were connected to the Enhancing data sharing problem… but from two slightly different perspectives. The group that concentrated on data-sharing in and between hospitals recognised the six following points:

1. There is a problem of care continuity in the same hospitals, for example, a patient transferred from the emergency room (ER) to another hospital department.
2. There is an issue of care continuity when the patients change from one hospital to another during their care journey. 
3. How do we avoid record duplication of patient tests in the laboratory (in the same hospital or when the patients move from one to another)?
4. How do we raise awareness among doctors on the importance of sharing patient data with their colleagues?
5. How do we create ownership and trust for the patients in sharing their data?
6. Medication scheme: It is crucial that a patient always has access to their medication scheme and can share it when necessary.

Meanwhile, the group focussed on data sharing between lines of care identified another five issues:

1. There is a problem in monitoring the medical parameters taken by the patient.
2. How can medical issues be identified and prioritised to be treated most efficiently? 
3. The laboratory results are not freely available in one place for the patients.
4. There is not an easy and efficient patient summary available for the patients to find their medication schemes.
5. The exchange of medication schemes among hospitals can be improved to provide patient care continuity.

The identified problems concern not only people who are ill or hospitalised but every single one of us. We can never be sure if we will not be the next ones on our way to the ER or, which is usually worse if we will not accompany our loved ones to the hospital. The hopeless feeling filling our chests at that moment can be nerve-racking. Unfortunately, we can only wait and place our confidence in doctors. When our lack of knowledge about medicine does not help us, there is one thing that we can do.

We can give physicians sufficient details of the patient's medication schemes and their health records. It is, however, critical that the medication scheme of each patient is available at the time of arrival. It allows us to avoid life-threatening drug interaction problems, allergic reactions, and other complications. The yellow box system is a great idea. Unfortunately, it is not meant to be carried with us, and not all accidents happen at our domesticities. Therefore, it is crucial to always have access to the digital copy of our health medical records.

Considering the identified problems, InterSystems’ team recognised a challenge that would fit into the framework of Hack Healthcare:

The accurate picture of patient journey: How might we collect, verify, augment, and analyse these data to build a precise picture of the patient journey, considering the patient experience and clinical data?

The group discussion yielded the following challenge hypothesis:

Availability of the patients' historical data is critical for ensuring optimal treatment. However, currently, patient data is not digitally transferable between hospitals in the same network or between hospital networks.

Those challenge hypotheses were followed by raised concerns and questions about the current situation:

From the Enhancing data sharing in and between hospitals group:

• How can patients seamlessly transfer their data between hospitals?
• How might we make relevant historical patient data accessible to all stakeholders in the healthcare journey?
• How can we use the 'portability' of patient data to improve the patient care experience without being dependent on specific hospital IT systems and technologies?

As a result of discussions, the Enhancing data sharing between the lines of care group recognised the following concerns:

• How might we provide a digital analogue of the yellow box that could be carried by a patient or by an accompanying family member?
• How might we quickly identify and contact the treating GP (or their immediate colleague who can access the necessary information) to get the full picture of the patient medication regime?  
• How might we design and deploy a checklist that the ER personnel can use to avoid most of the evident drug interaction issues by asking simple questions to the patient or their family member?

To tackle these problems, both groups have proposed several initial strategies:

• Adoption of a Unique Patient ID is a foundational element.
• Data structuration is the prerequisite.
• Improving access rights for all the actors would facilitate communications, bolster trust, and improve cybersecurity.
• Educating doctors about data sharing’s impact on patient care, assuring that it is not time-consuming.
• A solution should be unintrusive and cooperate with different hospitals' IT systems and technologies.
• Track patient medication efficiently daily.
• Design a relevant checklist upon entry into the ER to avoid critical situations.
• Improve access rights so the patients can always decide with whom they want or do not want to share this medical information.

Subsequently, InterSystems engaged in other workshops and brought the challenges to the Hack Healthcare 2023 event, where it, as one of the core partners held a brace of workshops: Connecting First and Second Lines of Care and Capturing and Using Patient Evaluations. Do they sound oddly familiar to you? Well, we hope they do because you have just read about the Exploratory Workshop that gave rise to those two.

The Exploratory Workshop let us verify if the themes of upcoming workshops were suitable. Since they were aimed at exploring the topics related to enhancing data access for patients wherever they are, identifying clusters of the healthcare ecosystem while determining finely tailored challenges to address during the hackathon, the Exploratory Workshop only proved the assumptions.