EPICare Project Overview
What is EPICare?
The Early Psychosis Informatics into Care (EPICare) programme is the first national data platform to support evidence-based Early Intervention in Psychosis (EIP) services in England.
EPICare consists of a clinical dashboard, patient smartphone app, and national core dataset to evaluate the real-world effectiveness of treatments on patient outcomes.
The clinical dashboard uses simple infographics to help clinicians quickly understand each patient's treatment status according to NICE/NCAP standards for EIP care, and patient progress on both PROMs and CROMs in easy-to-understand charts.
These insights can help clinicians work with their patients to make timely, informed and evidence-based decisions about the most appropriate treatments at the right time in their care pathway.
EPICare has been set up to:
Promote better clinical decision-making
Support timely and equitable delivery of evidence-based interventions
Tackle population-level disparities
EPICare FAQs
Find out more about what EPICare is and how it can affect your clinical practice by clicking on the questions below:
1. Who will be involved in EPICare?
All patients aged 14–65 years who receive treatment for FEP in EIP services in participating Trusts will be included on the EPICare platform. The roll-out of EPICare will be staggered by Trust and you will be notified if and when EPICare is going live in your Trust.
2. What does the EPICare Platform look like?
EPICare consists of three components:
EPICare Clinical Dashboard
This clinical dashboard will enable clinicians to view participant data and caseload information at-a-glance.
It uses simple infographics to help clinicians quickly understand each patient's treatment status according to NICE/NCAP standards for EIP care, and indicates when a treatment may be due, helping clinicians to ensure timely, appropriate delivery of care. It also shows patient progress on both PROMs and CROMs in easy-to-understand charts.
EPICare National Core Dataset
The data provided to the EPICare platform by your patients will flow into the EPICare Core Dataset to form a national registry capable of evaluating the relationship between treatments and outcomes in the real world, and identify potential inequalities in the offer and receipt of care.
This data will help inform fidelity of EIP services to NCAP/NICE standards of care, and strengthen the evidence base about which treatments worked for which patients at the right time.
CareLoop EI App (or Trust-dependent alternative)
Depending on Trust, patients will be invited to download and use the CareLoop EI app to report their PROMs. Once collected, the PROMs data will feed into the EPICare Clinical Dashboard and Core Dataset. Your Trust may use a different app or method of collecting PROMs data.
3. How will EPICare affect my clinical practice?
We want all clinicians in participating EIP services to use the EPICare Clinical Dashboard. This can be launched through your EHR, enabling you to quickly and easily view routine EIP data about your caseload, including: patient demographic data, and patient progress against the eight NICE/NCAP care standards, and CROMs and PROMs tracking over time.
You will continue to use your existing Trust Electronic Health Record (EHR) system (e.g. RiO) in the normal way.
We are asking clinicians in EIP services in participating Trusts to collect one new CROM, called the CGI-SCH, which is a brief 5-item assessment of symptoms. This can be completed within the EPICare Clinical Dashboard, and we ask that it is completed at baseline and then every 6 months. A reminder will be provided in the dashboard.
We are also asking patients to complete one new PROM, called the SSST, which is a short memory task that can be accessed from the CareLoop EI smartphone app, where used. You will be told about this by the EPICare team when it is available. More details about training you will receive and how to onboard patients on the CareLoop EI smarthphone app are provided below.
4. Will EPICare support research?
Yes.
The data provided to the EPICare platform by your patients will flow into the EPICare Core Dataset to form a national registry capable of evaluating the relationship between treatments and outcomes in the real world, and identify potential inequalities in the offer and receipt of care.
This data will help inform fidelity of EIP services to NCAP/NICE standards of care, and strengthen the evidence base about which treatments worked for which patients at the right time.
All data flowed to the EPICare Core Dataset is pseudonymised and held in a Secure Data Environment only accessible from approved researchers working in regulated environments.
5. What training will I receive for EPICare?
Each EIP team will receive training ahead of EPICare going live in your Trust. We will provide all the information you need to make sure that you feel confident.
The training will include:
- An introduction/orientation to EPICare
- A walkthrough of the Clinical Dashboard
- An introduction to the CGI-SCH scale
- An overview of the CareLoop EI app and the PROMs collected via the app
All of the training material is also stored on this website, available for you to use whenever you need.
6. How will I onboard patients?
There are three steps to onboarding a patient to use the CareLoop EI app:
1.
The EPICare team has created an onboarding video for you to show your patients to begin the onboarding process. You can find it within the Resources section and patients can watch the video on the Patients and Carers page.
2.
If your Trust is using the CareLoop EI app to collect PROMs, you should support the patient to download the app. You can find step-by-step instructions for this on the CareLoop EI App page. If your Trust is using an alternative means for collecting PROMs data, please follow their guidance.
3.
Once downloaded, navigate to your patient’s records via the EPICare Clinical Dashboard, and ask the patient to scan the QR code using their CareLoop EI app. This will securely link the CareLoop EI app to their records. If your Trust is using an alternative means for collecting PROMs data, please follow their guidance.
You can find further information and support for how to onboard patients within the Training hub.
7. What data will be collected as part of EPICare?
The data collected through EPICare falls into four categories:
Most of these data are routinely collected as part of your normal clinical practice (such as demographic and treatment data), however, some will be additions as part of EPICare.
Patient demographic data
Data corresponding to the eight NCAP / National Institute for Health and Care Excellence psychosis quality standards for treatment, including waiting time, psychosocial interventions, Clozapine prescribing and physical health.
Clinician-reported outcome measures (CROMs), including a new, brief symptom measure (CGI-SCH) and HoNOS
Patient-reported outcome measures (PROMs) collected in your EIP service, which could include DIALOG, GBO, ReQOL and/or QPR. Additionally, we will collect a measure of cognition called the SSST via the CareLoop EI smartphone app.
The EPICare Platform will record the following EHR data from your caseload for display in the EPICare Clinical Dashboard and evaluation in the EPICare National Core Dataset.
NCAP quality standards for EIP treatment:
- Waiting time between EIP referral date & first attended treatment
- CBTp (offer)
- Family interventions (offer)
- Treatment with clozapine (offer)
- Education & employment support (receipt)
- Carer support (offer)
- Annual physical health assessment, b to include:
- Smoking status
- Alcohol use
- Substance misuse
- BMI
- Blood pressure
- Glucose screening
- Cholesterol (lipid) screening
- Physical health interventions, to include:
- Healthy eating interventions (offer)
- Physical activity programmes (offer)
- Smoking cessation interventions (offer)
- Lipid lowering therapy (offer)
- Blood pressure referral
- Diabetes care referral, Metaformin therapy or diet modification
- CROMs
-
- Health of the Nation Outcome Scales (HoNOS) a
- Clinical Global Impression Scale – Schizophrenia version (CGI-SCH) a
a - To be collected every 6 months
b - To be collected every 12 months
Patients will also be asked to complete patient rated outcome measures (PROMs) that are collected in your Trust:
- Recovering Quality of Life (ReQoL-10) a
- Goal-Based Outcomes (GBO) a
- DIALOG a
- Process of Recovery Questionnaire (QPR) a
- Self-reported symptoms b
- Symbol-Symbol Substitution Task (SSST) b
a - Your Trust should specify collection of at least two of these three measures
b - Additional PROMS added for EPICare
Collection method of these PROMs will depend upon your Trust. Some Trusts will ask service users to record PROMs directly via the CareLoop EI app. The app will remind users to complete each of the measures at least once every six months.
If the patient is unable or unwilling to download the CareLoop EI app, the PROMs can instead be collected during routine practice and entered directly into the EPICare dashboard.
Your Trust may instead use a different app or method of recording PROMs. If you are not sure, please reach out to the EPICare team for help
This list is indicative. The exact technical specification to provide this data in the EPICare platform may vary slightly by Trust
8. What if I have further questions or need help?
If you have questions that cannot be answered by the resources and training materials available, please get in touch with us below.