Yorkshire & Humber Care Record: Connecting data in the cloud to improve people’s lives
About Yorkshire & Humber Care Record (YHCR)
Yorkshire & Humber Care Record (YHCR) is a program kick-started by the United Kingdom’s National Health Service (NHS) to connect all regional patient data and make it easily accessible to health and social care professionals. By detecting illnesses earlier and treating them more consistently, patient journeys and outcomes can be vastly improved.
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About Deloitte
A four-time Google Cloud Global Services Partner of the Year, Deloitte specializes in assisting organizations throughout their digital transformation initiatives.
Google Cloud is fundamental in helping the Yorkshire & Humber Care Record (YHCR) program improve access to citizens' health and care data across the Yorkshire and Humber region of northern England.
Google Cloud results
- Help health and social care professionals provide better care more efficiently by providing them with digital access to important information held in differing health and care records
- Improve healthcare services planning and enhance patient care pathways for better health outcomes for the entire population
- Empower patients to make more informed decisions about their own care and self-manage their health more effectively
Connecting data via the cloud improves people’s care
Data is the lifeblood of any healthcare system. Tracking patients as they are examined by different doctors and nurses, undergo various tests, and are diagnosed and treated over the years is critical for supporting a healthy population.
Data is generally held in silos in proprietary systems in individual clinics and hospitals. Within the Yorkshire and Humber region of the UK, data is located across 74 different healthcare organizations, five mental health facilities, 12 universities, 1,450 care homes, and more than 770 general practitioner practices in the region. Altogether, these facilities are responsible for the health and care of more than 5.5 million citizens within Yorkshire and Humber. When patients move to a different area, or receive care from different care providers, physical (paper) records would typically have to be moved as well. Sometimes they arrived as needed, sometimes they didn’t.
The Yorkshire & Humber Care Record (YHCR) program was created by the United Kingdom’s National Health Service (NHS) England to address this challenge.
“With Google Cloud, we can ensure that patients would get the right care at the right time in the right place, safely and effectively.”
—Lee Rickles, program Director at YHCR and Chief Information Officer at Humber Teaching NHS Foundation TrustBased on a simple but urgent premise that data saves lives, YHCR was one of five regional “exemplars” in England given national funding to eliminate existing patient data silos within their particular region’s healthcare systems. The vision: to improve people's clinical care while making it more effective and efficient.
Of the five exemplars that received funding, YHCR was the only one that took a unique, build-up-from-the-bottom, pure-cloud approach. YHCR decided upon a 100%-cloud solution that would overlay the on-premises and hybrid systems that were already in place in the region.
YHCR selected Deloitte as the managing vendor and Google Cloud as the optimal platform to help achieve its vision of a population health management tool. “With Google Cloud, we can ensure that patients would get the right care at the right time in the right place, safely and effectively,” says Lee Rickles, program Director at YHCR and Chief Information Officer at Humber Teaching NHS Foundation Trust.
YHCR sets ambitious data goals
Kicked off in October, 2019, the YHCR program had three objectives.
The first was to integrate patient electronic patient records (EPRs) from the current fragmented systems.
The second objective was to create what Monica Jones, the population health management lead for YHCR calls the “Data Ark,” a safe, private, and de-identified collection of data taken from patients’ records across the entire region. Clinical researchers and data analysts could then analyze the data to identify trends and patterns that they could apply to overall population care pathways, treatment protocols, planning, and identifying people at risk of illness.
And the third objective was to allow people access to their own health and care records so that they could monitor their care and be more directly involved and empowered in maintaining their health.
Why Google Cloud?
YHCR was seeking four capabilities before it chose Google Cloud and its associated data and analytics solutions: openness, scalability, performance, and, above all, robust data security and governance.
First, openness: the platform had to be able to utilize the platforms already in place.
For example, clinics and hospitals in cities of Leeds and Bradford, and towns like Rotherham, all have their own EPR systems. “These organizations are our customers,” says Rebecca Nichells, Communications and Engagements Lead for YHCR. “Forcing them to change their systems for a one-size-fits-all approach was not an option.”
YHCR is using Google Kubernetes Engine to create a “federated“ data mode that gives healthcare professionals access to patient records from anywhere while keeping existing data where it currently resides. Cloud Storage is hosting the anonymized Data Ark in the cloud. And BigQuery is the cloud data warehouse that supports SQL queries from both clinicians into direct care records, and researchers into the Data Ark.
The YHCR team was impressed with the way Kubernetes worked seamlessly with BigQuery’s analytics capabilities while allowing YHCR to bolt on other vendors’ products to the platform. In addition to tools like Power BI and Tableau, YHCR needed to incorporate RStudio, Python, and other third-party products for its academic clinicians and researchers.
The second requirement was scalability. Given the size of the region covered by the YHCR, there are potentially many, many millions of rows of data that will eventually need to be stored for record keeping and analysis. Google Cloud’s capability to scale in real time increased the speed at which healthcare professionals could identify and test new protocols or care pathways. Rather than having to procure and provision physical hardware to get additional capacity, YHCR could simply commission more virtual resources.
“In Google Cloud, we can spin up a new virtual environment, perform an analysis on a specific subset of anonymized patient data, and when we’re done, spin it down,” says Lee Rickles. “That’s definite flexibility—and agility—that we simply didn't have before.”
Three: performance. Superior performance of big data and analytics was a critical requirement. “Not only can clinicians look up patient records in real time in the cloud far faster and more efficiently than before, there’s much less overhead and management required for us on the technical side,” says Rickles. Now queries that used to take five or six hours now come back in seconds with BigQuery.
Finally, security and privacy were essential aspects of the solution. The selected cloud solution needed to stand up to the rigor of the security and information governance standards of the United Kingdom. This was critical. Not only does the YHCR have to be compliant with the GDPR privacy directive, but all organizations that work with personal data must abide by strict rules and laws set out by the United Kingdom’s own Data Protection Act 2018.
For example, it was critical to YHCR that patient data stored within the Google Cloud is never used for any purpose other than that necessary to fulfill its contractual and legal obligations.
“At YHCR, we also had our own cyber-security requirements, in terms of conformance with ISO security standards, and we needed to have the ability to de-identify data, but also to link and encrypt it,” says Jones. “Google gave us all that functionality.”
The Google Cloud-based YHCR system today has very tight control of user access, rights roles, and approvals. With just minor modifications, Rickles’ team was able to use existing governance processes and comply with regulations.
For example, YHCR was able to make sure that both data at rest and data in transit are encrypted to ensure that data can only be accessed by the authorized roles with audited access to the encryption keys. Indeed, YHCR data is secured using the same infrastructure and security services Google uses to safeguard their own operations.
“Transparency is critical, as the NHS is a publicly funded body,” says Rebecca, adding, “the NHS is an incredibly trusted system. People love the NHS. So we have a lot to live up to.”
Benefits of the YHCR project rapidly accruing
Today, YHCR contributes to a dawning new era of connectedness and accessibility for the NHS in northern England. Individual citizens in the Yorkshire and Humber region are starting to view, control, and contribute to their own health and wellbeing data by accessing their personal health record from their home computers, or by using the NHS app on their smartphones. YHCR is part of a web of digital initiatives that allow clinical and care staff to access real-time health and care data across health and social-care providers and between different IT systems, securely. YHCR is one of the key pieces in this new health information ecosystem puzzle.
Additionally, by using intelligence from large-scale data that has been anonymized from patients’ records and stored in the cloud, analysts and researchers can better plan care pathways and treatments for the changing needs of the population, as well as identifying people at risk of illness.
An added bonus—but one with a huge impact—is being able to access data remotely. Pre-COVID, that was not a requirement for health and social care professionals, but with many public sites locked down, the ability to access data through Google Cloud has proven invaluable.
The results? Duplicate tests are avoided. Diagnoses are being made faster, and treatment is being delivered more consistently and quickly. And connections are being made between YHCR and other healthcare record exemplars—London, for example—for even greater clinical efficiency.
Looking ahead
The current funding commitment runs until 2024. Given the success of the project thus far, each of the regions that make up the Yorkshire and Humber patch has committed to a further seven years beyond that.
The latest directive coming from the U.K. government—specifically because of the COVID pandemic—is that all NHS sites must have a shared care record by September 2021. “A lot of people from other regions are knocking on our door, from Wales to the south of England, to the Midlands, telling us they might want to adopt our technology rather than starting from scratch,” says Monica Jones.
John Farenden, the Strategy program Director for the Shared Care Records program at NHSX, which is spearheading the digital transformation of patient care records for the entire NHS, says he sees the YHCR as a “continually developing” program. “We’ve started off by looking at the core activities of the NHS, but in the future we can see potential to extend this to professionals working in other organizations that provide health and care services, such as care homes, hospices, pharmacists, dentists, and opticians,” he says.
Tell us your challenge. We're here to help.
Contact us
About Yorkshire & Humber Care Record (YHCR)
Yorkshire & Humber Care Record (YHCR) is a program kick-started by the United Kingdom’s National Health Service (NHS) to connect all regional patient data and make it easily accessible to health and social care professionals. By detecting illnesses earlier and treating them more consistently, patient journeys and outcomes can be vastly improved.
About Deloitte
A four-time Google Cloud Global Services Partner of the Year, Deloitte specializes in assisting organizations throughout their digital transformation initiatives.