Kent and Medway Care Record

Overview

The Kent and Medway Care Record is the shared care record for the health and care system in Kent and Medway, bringing GP, community, acute and social care information about a person into one place. In May and June 2018 the programme ran a market engagement, and I led the digital experience approach in our response: what a shared record should look like to the people it is about, and how it would be built and integrated. The approach document went through several master versions and was presented on 7 June 2018.

The idea

A shared record is usually designed for the clinician, and the patient gets a portal bolted on. The proposal turned that round. The same record has three front doors: a patient sees what concerns them today, a result, an appointment, a repeat prescription, in words written for a patient; a carer sees what the patient has consented to share, with the practical week ahead and who to call; a clinician sees the summary across settings, the encounters and the alerts. Persona-based landing pages, personalised messaging and personalised content were the experience layer, with a digital assistant as a future channel. The concept screens on this page were drawn for the portfolio to show that idea; they are not delivered screens.

The model

Channels for web, mobile, email and messaging, print and federated partner sites. An experience layer of reusable data-driven components in React, mobile first and responsive, assembling a page from the person's own record rather than from a menu. A personalisation layer: defined personas, rules-based and adaptive personalisation, experience analytics and profile. An integration and data layer reading from GP Connect and the Spine environment through an integration layer and a data lake, with a security, audit and data model designed for a record of this sensitivity. Sitecore was proposed for the platform and personalisation. We teamed with a specialist experience agency for the concept work, and the operating model was small agile teams with specialist partners for UX and for AI and machine learning, and APIs built in so the in-flight projects around the record could connect.

The plan

Discovery and UX design first, then the channel, integration and platform tracks built in parallel, a minimum viable product at month eight, project completion at month sixteen, a three-month warranty and support for three years with two more as an option. The design phase ran on the six-step framework: discover, strategy, design, implement, measure, optimise. The proposal was explicit about what it needed from the programme: agreed high-level requirements before discovery closed, dedicated governance and decision makers, access to specialists across the NHS in Kent and Medway, access to patients and the people who care for them, and reasonable access to GP Connect, the Spine and their documentation.

Status

Proposed in the June 2018 market engagement and presented to the programme. It was not taken forward with us. The work is shown because the design position, one record with three front doors and consent shaping what each sees, is the position I would still take on any shared care record.

Why it matters

Health records are the hardest case for personalisation: the most sensitive data, the widest range of readers, and the clearest need for each reader to see what they need and nothing else. The proposal treated that as a design problem with an integration model behind it, rather than an integration problem with a portal on top.