Reader in Social Informatics London South Bank University Occupational therapists and digital care records: exploring health and social care integration Dr Paul Sugarhood Dr Mark Rouncefield Senior Lecturer Reader in Social Informatics London South Bank University Lancaster University Wednesday 13 June 2018 RCOT 2018, Session 101.2

Coming up… Background, aims and objectives Methodology Findings Recommendations

flows between primary, secondary and social care providers seamlessly… Patient information is recorded once, digitally, at or close to the point of care… flows between primary, secondary and social care providers seamlessly… Transfers, referrals, bookings, orders, results, alerts, notices and clinical communications are passed digitally between organisations All patient and care records will be digital, real-time and interoperable by 2020 National Information Board (2014) NHS England (2016)

How do DCRs support or hinder integrated occupational therapy services across health and social care? How do occupational therapists use DCRs and to what purposes? How do DCRs influence work practices? What are the impacts on communication within and between organisations?

Methodology

Local Authority Social Services The setting Acute NHS Trust Local Authority Social Services Community NHS Trust

Findings Community NHS Trust Local Authority Referrals, triage, allocation Patient record-keeping Customer record-keeping Recording ‘outside the system’ Information-gathering (internal) Information-gathering (internal, external) Diary, monitoring and audit

1. Recording vs recoding Mismatch between the DCR and the concerns of occupational therapy Content Process Novice rather than expert

Data processing vs occupational therapy The demands of the DCR influence the nature of the clinical encounter Occupational Therapist, Community NHS Trust Can we get a balance between the system, the amount of things we need to record via the system, and the interaction that should take place between patients and staff?

3. Information vs communication Collaborating, but mostly not via DCR: telephone, email “people work” joint training and meetings collaboration agreement SharePoint and other electronic systems

So what? Recommendations: Be realistic about what DCRs are good (and not good) for Workarounds are everyday, effective and essential Influence organisational implementation of DCRs

Thank you for your attention p.sugarhood@lsbu.ac.uk @PaulSugarhood

References COT (2014) Managing information: a 10-year strategic vision for occupational therapy informatics. London: COT. COT (2015) Managing information: implementation plan 2015-2025. London: COT. Greenhalgh, T., Swinglehurst, D. (2011) Studying technology use as social practice: the untapped potential of ethnography. BMC Medicine 2011, 9:45. Hughes, J., King, V., Rodden, T., Andersen, H. (1994) Moving out from the control room: ethnography in system design. In CSCW ’94: Proceedings of the ACM conference on computer supported cooperative work, Chapel Hill, North Carolina, US, 22-26 October 1994. New York: ACM Press, pp. 429-39. McLoughlin, I.P., Garrety, K., Wilson, R. (2017) The digitalization of healthcare: electronic records and the disruption of moral orders. Oxford: OUP. National Information Board (2014) Personalised health and care 2020: using data and technology to transform outcomes for patients and citizens. London: Stationery Office. NHS England (2016) Sustainability and transformation plans. Available at: https://www.england.nhs.uk/ourwork/futurenhs/deliver-forward-view/stp/ [Accessed 6 January 2018].