EPICare Project Overview
What is EPICare?
EPICare is an inter-disciplinary project designed and developed in collaboration with academics, lived experience members (PPI), clinicians and industry.
EPICare's goal is to create a secure, computerised, national database to improve national, local, and individual clinical decision-making.
EPICare recognises that there are disparities and variations in psychosis treatment. This is despite nationally mandated care for people experiencing first-episode psychosis by Early Intervention in Psychosis (EIP) services.
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?
EPICare will include all patients aged 14–65 years who receive treatment for FEP in EPI services. 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 EPICare look like?
EPICare is split into three components:
EPICare Dashboard
This trust-level dashboard will enable clinicians to view participant data and clinician caseload information. It will also use local indicators related to caseload to provide notifications when a patient reported outcome measure (PROM) is due or when NICE/NCAP targets are not being met, which will empower clinicians to make better care decisions.
EPICare National Registry
The data collected by you and your patients will flow into the national registry – a database of all the data pooled from all EPICare Trusts. The data in this register will be pseudonymised and standardised.
CareLoop EI App (or Trust-dependent alternative)
Depending on Trust, patients will be invited to download and use the CareLoop app to report their PROMs. Once collected, the PROMs data will feed into the EPICare dashboard, CDSS and registry. You can find out more about these PROMs above in the ‘What data will be collected as part of EPICare?’ section of this page. Your Trust may use a different app or method of collecting PROMs data.
3. How will EPICare affect my clinical practice?
Your day-to-day practice will be minimally impacted by your Trust’s involvement in EPICare. You will continue to use your existing Trust Electronic Health Record (EHR) system (e.g. RiO). The EPICare dashboard can be launched through your EHR, enabling you to view routine EIP data, including: patient demographic data, data related to eight NICE psychosis care standards, CROMs and PROMs. The only change to your routine practice is the addition of the new CROM (CGI-SCH) and PROM (DSST). However, the latter is to be completed by the patient.
Another change, and added benefit of EPICare, is the CDSS. This system will alert you when a PROM is due, or when NICE and NCAP standards are not being met. The CDSS with therefore provide you with timely information to support better clinical decision-making.
4. Will EPICare support research?
As well as the dashboard and CDSS, EPICare also includes the national registry which pools data from all of the EPICare trusts. Once open, researchers and policymakers will be able to apply to access the registry. This will enable the NHS and researchers to investigate care and treatment trends, identify areas for improvement - such as inequalities in treatment uptake/provision - and provide clinical recommendations based on data from a large, representative database.
5. What training will I receive for EPICare?
The data collected through EPICare falls into four categories
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 clinician dashboard
- An overview of the CareLoop EI app and the PROMs collected via the app
- An introduction to the CGI-SCH scale
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:
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 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 National Institute for Health and Care Excellence (NICE) psychosis quality standards
Clinician-reported outcome measures (CROMs)
Patient-reported outcome measures (PROMs) as indicated by NICE standards
You will be asked to collect the following NICE psychosis quality standards and CROMs data:
You will be able to collect this data during your routine EIP practice using your trust’s electronic health record system.
NICE psychosis quality standards:
- EIP referral date a
- First EIP treatment date a
- CBTp (offer) b
- Family interventions (offer) b
- Treatment with clozapine (offer) b
- Medication prescribing b
- Education & employment support (receipt) b
- Substance use c
- BMI c
- Blood pressure c
- Full blood count c
- Blood glucose c
- Lipid levels c
- Liver function c
- Healthy eating interventions (offer) c
- Physical activity programmes (offer) c
- Smoking cessation interventions (offer) c
- Carer support (offer) c
CROMs:
- Health of the Nation Outcome Scales (HoNOS) b
- Clinical Global Impression Scale – Schizophrenia version (CGI-SCH) b
a - At baseline only
b - To be collected every six months
c - To be collected every 12 months
Patients will also be asked to provide new information on their experiences of psychosis. These are referred to as patient rated outcome measures (PROMs):
- Recovering Quality of Life (ReQoL-10)
- Goal-Based Outcomes (GBO)
- DIALOG
- Positive and Negative Symptom Scale (PANSS, self-report version)
- Digit-Symbol Substitution Task (DSST)
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
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 using the contact form.