Tuesday 16th December 2014
Mac Voice, the magazine for Macmillan professionals: Winter 2014
Andrew Brittle looks at the technical development of eHNA and how information governance (IG) has informed it so far
One of the main drivers for developing the eHNA was to help deliver the components of assessment and care planning identified in the Introduction to eHNA and care planning. Making the assessment and care planning process easier for the person affected by cancer and their healthcare professional allows more assessments to be carried out, more care plans to be written, and potentially more needs to be met.
A key decision at the start of the pilot project was to use tablets for the assessment process. This allows the person to complete the assessment on their own with express consent, and to highlight concerns that would be difficult to bring up in a normal conversation. Keeping the focus tightly on the needs of the individual in this way is one of the main benefits of the eHNA.
Although Macmillan took this innovative approach in using tablets, many of the pilot sites had no policies in place to manage and control their use, meaning that the teams trying to pilot eHNA were pioneering this technology in their trusts. The reliance of the tablets on the availability of a WiFi signal was another unexpected area of difficulty. In many areas of trusts, clinical areas were not covered by WiFi at all, or the coverage was patchy at best. Trusts worked hard to overcome this, and tablets and WiFi are now more widely accepted and established, so many of these earlier difficulties have now been overcome.
Being a pilot project, both the eHNA assessment tool and the care planning website have been developing and growing, as new requirements have arisen and new suggestions have been made. Macmillan has worked closely with a third party supplier to develop these tools, and we are continually assessing and updating them, taking into account some of the ideas and good practice we find within the trusts.
Alongside the technical issues faced by prototype sites, information governance (IG) requirements around storing identifiable NHS data within the NHS network prompted further development to ensure the eHNA met with trust and national policies. We continue to work with trusts to make sure that these standards continue to be met.
IG has been one of the biggest challenges in the development of eHNA. Each trust has a responsibility to protect the confidentiality of individuals' data, while at the same time sharing it appropriately in the interest of each person's care. As the national requirements change, we're working with the trusts, and the Health and Social Care Information Centre, to make sure eHNA takes these changes into account and continues to give the assurance that the trusts and the public need.
Macmillan sits outside of the NHS network, and consequently has no access to individual identifiable data - this is restricted to the trust that carried out the assessment. However, it is recognised that there is tremendous value in having access to aggregated data to identify areas of concern, and more importantly to highlight potentially unmet needs. This data is an exciting new area that could in time lead to the delivery of a more timely and effective range of services to the people who need them the most.