In 2005 the
National Health Service
The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
(NHS) in the
United Kingdom
The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the European mainland, continental mainland. It comprises England, Scotlan ...
began deployment of
electronic health record systems in NHS Trusts. The goal was to have all patients with a centralized electronic health record by 2010.
Lorenzo patient record systems
Lorenzo patient record systems are a type of Electronic health record provided by DXC Technology, originally as part of the United Kingdom government’s National Programme for IT (NHS Connecting for Health) in the NHS.
There is a long history of ...
were adopted in a number of
NHS trusts
An NHS trust is an organisational unit within the National Health Services of England and Wales, generally serving either a geographical area or a specialised function (such as an ambulance service). In any particular location there may be several ...
. While many hospitals acquired electronic patient records systems in this process, there was no national healthcare information exchange. Ultimately, the program was dismantled after a cost to the UK taxpayer was over $24 billion (£12 billion), and is considered one of the most expensive healthcare IT failures.
In November 2013
NHS England launched a clinical digital maturity index to measure the digital maturity of NHS providers but 40% of NHS managers surveyed by the ''
Health Service Journal'' did not know their ranking, and the same proportion said improving their ranking was of low or very low priority. in 2022 the 211 trusts progress was assessed. 43 trusts had an EPR meeting NHSE’s required standard, 138 had an EPR requiring “extension/optimisation” and 30 trusts did not have an EPR. Of those 30, 23 were procuring or developing plans to procure new EPRs and 7 were in the process of rolling out record systems.
Electronic palliative care coordination systems have been developed by
Marie Curie Cancer Care
Marie Curie is a registered charitable organisation in the United Kingdom which provides care and support to people living with a terminal illness and those close to them, and campaigns for better support for dying people. It was established in 19 ...
and the
Royal College of General Practitioners
The Royal College of General Practitioners (RCGP) is the professional body for general (medical) practitioners (GPs/ Family Physicians/ Primary Care Physicians) in the United Kingdom. The RCGP represents and supports GPs on key issues including ...
which mean that terminally ill patients no longer have to explain their circumstances afresh to every new professional they meet and are less likely to be inappropriately taken to hospital.
Personalised Health and Care 2020
The publication of ''Personalised Health and Care 2020'' by the Department of Health elaborated a new attempt to integrate patient records. Its stated ambition was that every citizen would be able securely to access their health records online by 2018 and make real time data available to paramedics, doctors and nurses. A real time record across health and social care is seen as the key to the provision of integrated care.
Hospital systems
Transferring hospital records to electronic systems has generally been much slower and more difficult than in primary care, apart from clinical imaging, which has been largely electronic for several years. In 2019 only 10% of NHS trusts claimed to be fully digitised. Plans for a paperless NHS by 2020 are clearly not going to be realised. The
NHS Long Term Plan
The NHS Long Term Plan, also known as the NHS 10-Year Plan is a document published by NHS England on 7 January 2019, which sets out its priorities for healthcare over the next 10 years and shows how the NHS funding settlement will be used. It was p ...
requires all hospitals to move to digital records by 2023, so clinicians can access and interact with patient records and care plans wherever they are. 62% of trusts have plans to digitise all their patient records.
GP Systems
GP2GP is an
NHS
The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
Connecting for Health project in the United Kingdom. It enables GPs to transfer a patient's electronic medical record to another practice when the patient moves onto the list.
In General Practice in the UK the medical record has been computerized for many years; in fact, the UK is probably one of the world leaders in this field. There are very few General Practices in the UK which are not computerized. Unlike those in the USA, UK GPs have not had to deal with billing, and thus have been able to concentrate on clinical care. The GP record is separate from the national Care Record and contains far more data. Shaun O'Hanlon,
EMIS's Chief Clinical Officer says that the legal framework around data sharing is the main problem in integrating patient data because the
Data Protection Act 1998 puts responsibilities on GPs to protect the confidentiality of patient data, but at the same time they have a "duty to share" when it is in the best interests of the patient. He says the quickest, easiest route to large scale record sharing is to put patients in the driving seat using smartphone technology. He quotes a
YouGov
YouGov is a British international Internet-based market research and data analytics firm, headquartered in the UK, with operations in Europe, North America, the Middle East and Asia-Pacific. In 2007, it acquired US company Polimetrix, and sinc ...
poll which found that 85% of the population wanted any medical professional directly responsible for their treatment to have secure electronic access to key data from their GP record, such as long term conditions, medication history or allergies.
Clinical IT suppliers are moving towards greater interoperability, already achieved with the GP2GP project allowing different systems to exchange complete medical records between practices. There are projects allowing access between hospitals & GP practices. The main Primary Care systems are
EMIS Health,
SystmOne
SystmOne is a centrally hosted clinical computer system developed by Horsforth-based The Phoenix Partnership (TPP). It is used by healthcare professionals in the UK predominantly in primary care. The system is being deployed as one of the accredit ...
,
iSOFT
iSOFT is an international supplier of software applications for the healthcare sector. Its products are used by an estimated 13,000 organisations in 40 countries for managing patient information and healthcare services. It was acquired by DXC T ...
, and
INPS Vision INPS may refer to:
* Istituto nazionale della previdenza sociale ( it, National Institute for Social Security, link=no) of Italy
* In Practice Systems Limited, British health informatics company
* Integrated Nepal Power System, a component of the ...
. The NHS in Scotland widely used
GPASS
GPASS, General Practice Administration System for Scotland, is a clinical record and practice administration software package that was previously in widespread by Scottish general practitioner, general medical practitioners. It launched in 1984 an ...
until 2012. From April 2014 practices are contractually required to promote and offer patients the opportunity to book appointments online, order repeat prescriptions online and provide online
patient record access
Patient record access in the United Kingdom has developed most fully in respect of the GP record, because computerisation in that field is almost universal. British hospitals were slower to move into electronic records. From 1 April 2015 all GP pra ...
.
The assistant coroner for inner north London has twice written to
Jeremy Hunt
Jeremy Richard Streynsham Hunt (born 1 November 1966) is a British politician who has served as Chancellor of the Exchequer since 14 October 2022. He previously served in the Cabinet as Secretary of State for Culture, Olympics, Media and Sport ...
warning that “future deaths could occur
ffurther action is not taken to facilitate secondary care access to GP records”.
Leeds was the first city to implement the
NHS Digital
NHS Digital is the trading name of the Health and Social Care Information Centre, which is the national provider of information, data and IT systems for commissioners, analysts and clinicians in health and social care in England, particularly th ...
programme GP Connect. This makes patient records available across care settings, including social care, general practice, community, mental health and hospitals.
Patient access
It has been possible for patients to access their own medical records online for some time. By 2013, the debates had moved onto discussing the impact of patient access on patient care.
Research
Prescription errors
A study in the UK tested the Salford Medication Safety Dashboard (SMASH), a web application to help GPs and pharmacists find people in their electronic health records who might face safety hazards due to prescription errors. The dashboard was successfully used in identifying and helping patients with already registered unsafe prescriptions and later it helped monitoring new cases as they appeared.
See also
*
NHS Connecting for Health
The NHS Connecting for Health (CFH) agency was part of the UK Department of Health and was formed on 1 April 2005, having replaced the former NHS Information Authority. It was part of the Department of Health Informatics Directorate, with the role ...
*
Patient record access in the United Kingdom
Patient record access in the United Kingdom has developed most fully in respect of the GP record, because computerisation in that field is almost universal. British hospitals were slower to move into electronic records. From 1 April 2015 all GP pra ...
References
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Electronic health records
Healthcare in England
Information technology organisations based in the United Kingdom
National Health Service (England)