1. 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

2. Coming up… Background, aims and objectives Methodology Findings
Recommendations

3. 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)

5. 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?

6. Methodology

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

8. 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

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

10. 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?

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

12. 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

13. Thank you for your attention
@PaulSugarhood

14. References
COT (2014) Managing information: a 10-year strategic vision for occupational therapy informatics. London: COT.
COT (2015) Managing information: implementation plan 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, October New York: ACM Press, pp
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: [Accessed 6 January 2018].