Interweave FHIR health and social care data sharing use case
Interweave’s use of FHIR for enhanced health and social care data sharing
In this in-depth use case, see how Interweave, a platform designed to facilitate data sharing between health and care providers, has successfully applied Fast Healthcare Interoperability Resources (FHIR), the global standard for exchanging healthcare data.
FHIR supports organisations to improve the efficiency and accuracy of information exchange across Integrated Care Systems (ICS). This case study highlights how Interweave has harnessed FHIR to address health and social care data interoperability and standardisation challenges.
Context
Interweave began as the Yorkshire & Humber Care Record (YHCR), part of NHS England’s Local Health and Care Record Exemplars (LHCRE) programme. The success of the YHCR in supporting data sharing drew attention from various regions, prompting the development of Interweave, which has become a modern shared care record platform that supports six ICS’s using a partnership model.
The Interweave platform is NHS-owned and managed by Humber Teaching NHS Foundation Trust, with FHIR now as its backbone which is central to its support for data sharing between health and social care organisations.
Why FHIR?
Interweave aimed to tackle several common challenges that impact data sharing for health and social care:
- Data interoperability: how do you ensure smooth data exchange between disparate systems, including legacy technology?
- Standardisation: how do you establish a common language to represent health and social care data?
- Security: how do you protect sensitive patient information?
Having looked at several potential approaches, Interweave looked to FHIR for a modular, customisable, and open standard to support its objectives and provide a foundation for collaboration and innovation.
FHIR provides a well-defined framework that supports data consistency, interoperability, and secure data sharing. Interweave’s Exchange product fully implements the FHIR standard and allows for the exchange of data using a federated data model.
Organisations providing data via the Exchange also need to be FHIR compliant. To support this, Interweave offers a solution called Connect. This FHIR-compliant server, following data mapping procedures, serves FHIR resources to the Exchange, ensuring data consistency.
Challenges in integrating health and social care data
ICSs are tasked with integrating health and social care services, and data sharing presents several challenges.
Social care now routinely record NHS numbers which enable patients to be matched reliably across settings. However, with social care professionals performing a highly responsive person-centered practice, they rely more heavily on capturing rich narrative rather than structured data. Sharing data held in this way can be difficult.
With multiple organisations involved within an ICS, determining what data needs to be shared in a unified care record and finding common ground between the differing systems across a region can be a significant challenge.
Terminology often differs, and the lack of nationally defined coding systems for social care can make standardising data more complex. In addition, FHIR is primarily designed for healthcare, and there is no direct equivalent for social care.
How Interweave tackled health and social care data sharing
The first step in addressing these challenges was establishing a working group that included health and social care experts, FHIR specialists, technical experts, and representatives from both consumers and providers. Stakeholders, suppliers, and inter-regional representatives also participated.
The group started by developing a Minimum Viable Dataset (MVD) to identify the essential data for sharing in a care record, as shown in the diagram below. Defining consistent terminology and approaches was critical, as inconsistent naming conventions between healthcare and social care often posed challenges. Once such terms are agreed upon, the team can establish their attributes and relationships.
Interweave found that, whilst there is some commonality between terms, there are differences that must be considered. A flag on a patient record or a team resource are comparable between health and social care, for example. However, what constitutes an episode of care differs between health and social care.
To overcome this challenge, Interweave created a separate Episode of Care profile for social care and changed its description to explain things accurately, whilst also staying FHIR compliant.
Using and adapting FHIR profiles to meet social care needs has seen Interweave working with professionals to ensure alignment with real-world scenarios. Specific use cases have been developed to demonstrate how people can apply FHIR resources in practice, and a supporting implementation guide is available to aid deployment.
How Interweave customers are sharing data to support health and social care
As a result of this work, Interweave’s partners are integrating health and social care data to meet specific requirements in areas that could have wider applications across both sectors. For example:
- Humber and North Yorkshire ICB – data sharing across health and social care services simplifies information flow and reduces administrative burdens. Key benefits include less reliance on third-party information in adult social care and hospice services, reduced emergency department admin time through digital ambulance transfer of care, and fewer unnecessary hospital admissions and ambulance conveyances by making patients’ end of life wishes easily accessible. Interweave also speeds up the exchange of information between primary care and acute services via GP Connect, while easing the administrative workload in primary care. These improvements boost efficiency, reduce delays and promote more coordinated, patient-centred care.
- Leicester, Leicestershire and Rutland ICB– Delivery of Social Care information as a priority workstream. Initial deliverables relate to representing adult social care service provision but data maturity work is progressing to include flags, assessments and social care needs information. This data provision has been aligned to regional discovery work to ensure benefits are maximised and new opportunities for sharing information are identified. Close relationships have been fostered between social care and health stakeholders to ensure that the provision of data meets with the needs of consuming organisations. A key to this success has been the development of information architecture groups, including different organisations to ensure that business rules and models are appropriately represented in FHIR data standards.
The potential for broader sharing of data between the two sectors is significant. If a clinician needs information about a patient’s social care interactions or care plans in an emergency department, this data can now be easily accessible. The patient would get the right care, at the right time, and the hospital may avoid an unnecessary admission.
A bold, pragmatic and repeatable approach
Interweave’s use of FHIR for health and social care data sharing showcases the power of standardised approaches to solving complex interoperability challenges. Interweave has enhanced data quality, interoperability, and security by using FHIR, ultimately improving patient care and outcomes.
The project reflects the shared values of Interweave and FHIR: bold, pragmatic, and repeatable. Interweave and FHIR are well-positioned to support the broader use of technology to create safer, more integrated care systems as the health and social care landscape continues to evolve.
Next steps
Interweave plans to expand its social care dataset further, guided by its partners’ needs. Progress is ongoing, with continuous development of health- and social care-specific profiles.
The platform is also planning an upgrade, migrating from FHIR’s STU3 to the R4 version, which offers enhanced functionality and stability. This migration will involve creating an adapter to convert STU3 to R4 and developing reusable components at the central and provider levels. Once in place, these converters will streamline the upgrade process for future version increases.
Further information
If you would like to know more about the work, please contact Sophie Lowsley at Interweave at sophie.lowsley1@nhs.net
Social Care MVD for the Shared Care Record
Notes:
- This list shows the resources which were newly defined for phase one of sharing social care data in the shared care record.
- Patient, Practitioner, Practitioner Role and Organisation resources – which have relationships with these entities – are not included in the list. They were previously defined during previous health data sharing exercises and needed little to no work to enable their usage within Social Care.
- Hierarchy and relationships left out of the diagram below for simplicity.
Resource | Resource | Resource |
---|---|---|
ContactDefinition: A notification to social services that a person may need their support – a contact can be made by the person themselves, a relative, health professional or any concerned member of the public. FHIR Resource: ReferralRequest |
AssessmentDefinition: A record of an assessment to determine a person’s support needs. An assessment maybe in the following statuses: – in progress; has taken place; or is planned to be performed. FHIR Resource: Task |
ServiceDefinition: A collection of activities which deliver support to a person funded by a Local Authority. FHIR Resource: EpisodeOfCare |
Equipment ProvisionDefinition: The occurrence of a physical item being requested to be placed or having been placed with a person to aid with support. FHIR Resource: DeviceRequest |
FlagDefinition: Active information or a warning, about a person or their situation, which may affect how their support is delivered. FHIR Resource: Flag |
Related PersonDefinition: A person who has a relationship with another person who is receiving support (e.g. Spouse, Relative, Friend etc )and who optionally plays a role in the persons support (e.g. Key holder, Main carer etc). FHIR Resource: RelatedPerson |
Support ReasonDefinition: The reason why a person is receiving support. FHIR Resource: Condition |
Organisational TeamDefinition: An organisational sub-unit of workers which act as a team within an Organisation FHIR Resource: Organization |
Social Care Shared Care Record Data Model
