Kainos Advances Patient Care with Next-Generation Interoperability Platform Supported by AWS

Kainos is an APN Advanced Consulting Partner

Building a Shared Care-Record System in the Cloud

In 2015, the county of Gloucestershire's health and social care system issued a procurement announcement for a new interoperability initiative to deliver a shared care-record platform that gives an overview of patient health and social care information in a single digital record. 

Kainos, an AWS Partner Network (APN) Advanced Consulting Partner and AWS Public Sector Partner, responded to the procurement request by offering something new. “We wanted to use AWS to create a cloud-native platform designed for the future,” says Alastair Allen, Chief Technology Officer for Healthcare at Kainos. Cloud hosting and storage, while ubiquitous in most business sectors, are often discounted in the public sector. Kainos demonstrated the value, security, and flexibility of building a cloud-native system. The solution also utilized Fast Healthcare Interoperability Resources (FHIR), a next-generation standards framework that provides a robust, extensible data model with open APIs to enable the rapid exchange of data between systems.

Patient Information in a Single Digital Record

“How do we share a useful patient health and social care story to those people that deliver care?” asks Úna Rice, Program Manager for the UK’s National Health Service (NHS) South, Central, and West Commissioning Support Unit (CSU). As Gloucestershire focuses on integrated care and population health management, that question plays a central role in the work she directs. Rice leads the shared care-record program driven by the Gloucestershire health and social care system.

In solving this challenge, Kainos prioritized user-centered design. Gloucestershire created ten likely user challenges and asked each bidding company to describe how it would solve them. A group of clinicians, the likely end users for the new system, voted on the responses. “Kainos offered a fresh approach and a refreshing presentation. Kainos stole the show by winning the hearts and minds of our end users,” Rice says.

Clinical systems are notoriously difficult to navigate and extract the relevant information from. Shared care-record systems securely connect medical and care records, making it easier for care professionals to see key parts of a patient’s medical record and thereby deliver better patient care.

A Cloud-Based, Future-Proofed Approach to Integrated Care

The underlying AWS infrastructure freed Kainos to focus on the needs of clinicians. “The breadth and depth of what AWS offers let us focus on the things we’re good at. We don’t have to worry about infrastructure. We can delegate storage, networking, infrastructure, data, and AI to AWS, while we focus on user needs and innovative solutions,” says Allen.

The Kainos solution uses Amazon Elastic Compute Cloud (Amazon EC2) as the primary infrastructure and Amazon Relational Database Service (Amazon RDS) to manage the underlying databases from which information is extracted. Amazon CloudWatch ensures the application and its infrastructure are available 24/7 and provides visibility across the application, infrastructure, and various other services.

AWS also helped Kainos solve issues specific to the new platform. Connectivity was an initial challenge, for example. The solution had to be accessed using N3, the NHS network, which required a close working relationship between Kainos, AWS, and other vendors. “We leaned heavily on AWS experts to help manage many of the networking and security challenges that we faced,” says Allen. AWS Direct Connect, a cloud service solution that enables a dedicated network connection to AWS, was essential in solving the networking concerns.

"AWS continues to build new services, extend existing services, and help us use them in the best way possible. That type of support from AWS is invaluable to us and to Gloucestershire.”

- Alastair Allen, Chief Technology Officer for Healthcare at Kainos

Increased User Adoption

Clinical records are big and messy. Extracting pertinent data and presenting it back to the end user without interfering with it, while still making it easy to sort and digest, is challenging. The user-centered focus by Kainos was critical in addressing that challenge.

Clinicians aren’t required to use the system, so it had to be easy to access and use in order to attract clinicians and drive its adoption. Feedback from users has been positive. “This new digital record means professionals are able to see people’s information in one place, 24 hours a day, 7 days a week," says Dr. Paul Atkinson, chief clinical information officer for NHS Gloucestershire Clinical Commissioning Group (CCG).

“The best care can depend on the best information. This new record means that if clinicians have key information readily available to them, they will be able to devote more quality time with their patients, which can only be better for everyone,” notes Michael Richardson, deputy director of nursing and director of infection prevention and control at Gloucestershire Health and Care NHS Foundation Trust.

There are currently over 630,000 patients in the region, and the system averages 4,500 clinician views per month. Since the platform went live in the fall of 2018, there have been over 40,000 patient-record views.

More Opportunities for Better Quality Patient Care

Allen is confident the partnership with AWS will continue to yield benefits for Gloucestershire and other Kainos customers. He says, “AWS continues to build new services, extend existing services, and help us use them in the best way possible. That type of support from AWS is invaluable to us and to Gloucestershire.”

Rice, too, sees more possibilities within the platform. “We hope to add more data sources, more users, and more information around pathology and imaging.” Rice focuses on the end goal for the project. “The ultimate benefit will be better quality patient care.”


About One Gloucestershire

One Gloucestershire' is the working name given to the partnership between the county's NHS and care organizations to help keep people healthy, support active communities, and ensure high quality joined-up care when needed.

In May 2018, NHS England announced that Gloucestershire was to become 1 of only 14 Integrated Care Systems (ICS) across the country. This is a welcome recognition of what the partnership has achieved to date and also of what it is committed to delivering in the future – truly integrated health and social care serving users, carers and communities better and responding to the challenges of the future.

About Kainos

Kainos develops digital technology that helps people work smarter, better, and faster. The company creates bespoke solutions for public and private organizations all over the world and builds innovative software platforms that make life easier for its clients and customers.

Published January 2020