The NHS Electronic Patient Records Revolution
Are electronic patient records living up to their early promise?
History of EPR
Electronic Patient Records (EPR) first came to prominence in the late 90s in the UK. These software systems combine electronic healthcare records and admin features to make life easier for patients and medical staff. The stored data ranges from prescriptions and test results, to contact information and imaging informatics. There are currently eight accredited EPR suppliers in the UK, with more joining as the technology evolves.
EPRs replaced traditional ‘paper bundles’ which used to be the typical format for patient records used by hospitals or GPs. EPRs, however, shouldn’t be confused with Electronic Health Records — or EHR — which cover all patient records from ‘cradle to grave’, including public sector and social service records.
EPR Benefits
EPR systems offer many advantages. Interoperability between different clinical systems can dramatically speed up patient diagnosis and treatment. Real time information and decision support management also provide better patient care along the chain. These digital records also reduce paperwork and deliver an auditable trail of patient care for quality control.
For patients, EPRs allow for much easier appointment booking and reduce delays in treatment. They also help with patient privacy through the use of robust security permissions. With the ongoing increase in the number of trust mergers, EPRs are also perfectly placed to scale as patient numbers rise in each region. These trusts can then easily share the vital clinical system data that’s needed as patients move home or change providers.
Challenges of EPRs
That’s not to say that EPRs are without problems. Despite a government target to install EPR systems in 90% of NHS trusts by the end of 2023, there are still parts of the country where this has not happened. According to Tim Ferris, director of transformation at NHS England, almost 20% of the country’s acute trusts still don’t have an EPR in place.
This lack of digital maturity can be even worse at the GP level. Many doctors find it difficult to get to grips with the demands of managing the technology. There have also been delays in integrating key parts of the systems properly. The thorny question of patient confidentiality has also reared up in recent months. The Royal College of GPs recently wrote to NHS Digital voicing concerns about plans to share patient records with third parties. As a result the plan is currently under review.
The Future of Electronic Patient Records
Despite these issues, most people forecast a bright future for EPR systems. In 2015 a BMC study of 59 health trusts highlighted perceived benefits of safety, convenience and diagnostic support. Unsurprisingly, the more technology aware trusts felt most comfortable with the benefits of EPR systems.
There are already a number of improvements being developed and deployed to make EPR even more valuable for all stakeholders. The ‘smart clinical asset’ approach adds admin automation with AI rules to existing EPR features.
Natural language processing and other tools will also make patient access to their personal data more intuitive. And the FHIR (Fast Healthcare Interoperability Resources) standard will improve the integration of patient records across different systems.
Finally NHS England’s Global Digital Exemplar (GDE) programme will create a blueprint for other digital systems in the future. Rather than each trust reinventing the wheel, trusts can share knowledge and insights to smooth out any roll-out issues. This should save time and money for all the parties involved.
Despite a rather uncertain start and a few government mistakes along the way, the future of EPR technology looks very promising.
