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Electronic Health Records in the United Kingdom of Great Britain & Northern Ireland. Lorraine Nicholson MIHM, MRSH, FHRIM, President of IFHRO, Chief Executive IHRIM, Independent Health Records Consultant. The United Kingdom of Great Britain & Northern Ireland.

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Electronic Health Records in the United Kingdom of Great Britain & Northern Ireland

Lorraine Nicholson MIHM, MRSH, FHRIM,

President of IFHRO,

Chief Executive IHRIM,

Independent Health Records Consultant

EHR Conference, Amsterdam 12th June 2008


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The United Kingdom of Great Britain & Northern Ireland Britain & Northern Ireland

  • The UK is made up of the two countries of England and Scotland, the principality of Wales and the province of Northern Ireland.

  • Total Population is 59.6 million people: 

    ·         - England 49,805,700 (83.7% of total)

    ·         - Scotland 5,057,400 (8.5% of total)

    ·         - Wales 2,938,000 (4.9% of total)

    ·         - Northern Ireland 1,702,600 (2.9% of total)

  • Each country has a National Health Service (NHS) and in Northern Ireland there is integrated health and social care.

  • Each of the four countries has it’s own approach to the development and implementation of Electronic Health Records.

EHR Conference, Amsterdam 12th June 2008


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National EHR’s in England (1) Britain & Northern Ireland

  • NHS Care Records Service (NHS CRS), - key component of the National Programme for Information Technology (NPfIT), a £6.2 billion programme, which supports the delivery of the NHS Plan.

  • …"the world's biggest civil information technology programme".

  • An individual electronic NHS Care Recordevery NHS patient in England by 2010 (2 years behind schedule)

  • Parliamentary Inquiry in 2007 -estimates of the total cost of NpfIT ranged from £6.2 billion to £20 billion at the time of the inquiry.

EHR Conference, Amsterdam 12th June 2008


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National EHR’s in England (2) Britain & Northern Ireland

  • NHS Number is fundamental to the NPfIT & NHS CRS

  • A national unique patient identifier (10 digit number) to enable sharing of patient information across the whole of the NHS in England safely, efficiently and accurately

  • The Personal Demographics Serviceis the central, single source for patient demographic information in England

  • The Personal Spine Information Service (PSIS) is the central database containing clinical records for each NHS patient.

EHR Conference, Amsterdam 12th June 2008


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National EHR’s in England (3) Britain & Northern Ireland

  • NHS Care Records Service will provide all 50 million NHS patients with an individual electronic NHS Care Record

  • For the first time in the 60 year history of the NHS, information about patients will be mobile, as patients ar

  • will connect more than 30,000 GPs and 270 acute, community and mental health NHS trusts in a single, secure national system

  • two elements to the NHS CRS: Detailed Records (held locally) and the Summary Care Record (held nationally).

EHR Conference, Amsterdam 12th June 2008


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National EHR’s in England (4) Britain & Northern Ireland

  • The NHS CRS will enable each person's detailed records to be securely shared between different parts of the local NHS e.g. GP surgery and hospital.

  • Patients will also be able to have a summary of their important health information, known as their Summary Care Record, available to authorised NHS staff treating them anywhere in the NHS in England.

  • Patients will also be able to access their Summary Care Record using the secure website “HealthSpace”.

EHR Conference, Amsterdam 12th June 2008


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National EHR’s in Wales (1) Britain & Northern Ireland

  • The NHS in Wales is large and complex

    • Over 10 million face-to-face healthcare events per annum

    • Care delivered by a wide range of national, local, statutory, contractor and voluntary organisations

    • High levels of deprivation, an increasingly elderly population and poor lifestyle

  • Has an annual budget of approximately £3.1 billion

  • Wales needs a modern healthcare system with services integrated around the patient.

EHR Conference, Amsterdam 12th June 2008


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National EHR’s in Wales (2) Britain & Northern Ireland

  • Informing Healthcare (IHC) is a Welsh Assembly Government programme set up to improve health services in Wales by introducing new ways of accessing, using and storing information

  • IHC is working with NHS medical staff and consulting with the public to develop a national electronic health record; the “Individual Health Record” (IHR)

  • Secure web page - “My Health Online” to view medical history, order prescriptions, book appointments

EHR Conference, Amsterdam 12th June 2008


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National EHR’s in Wales (3) Britain & Northern Ireland

  • NHS in Wales cannot achieve a single universal care record immediately - therefore adopted a flexible incremental strategy

EHR Conference, Amsterdam 12th June 2008


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National EHR’s in Wales (4) Britain & Northern Ireland

  • Wales shares demographic services with England

  • NHS number is the unique identifier to provide a unique patient identifier for the Individual Health Record

  • Phased migration of all demographic systems to replacement systems provided by England's new Personal Spine Information Service (PSIS), which is part of the NHS Care Records Service (NHS CRS)

  • Negotiating with the NPfIT in England to use selected services including allocation of NHS numbers

EHR Conference, Amsterdam 12th June 2008


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National EHR’s in Scotland (1) Britain & Northern Ireland

  • Modernisation strategy “Delivering for Health” focuses on the EHR as a core feature in delivering pro-active care to the population of Scotland

  • Health Information System built around the EHR will facilitate a shift from the current care model to “anticipatory, preventative and continuous care”.

EHR Conference, Amsterdam 12th June 2008


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National EHR’s in Scotland (2) Britain & Northern Ireland

  • The Community Health Index (CHI) is a population register used in Scotland for health care purposes

  • The CHI number uniquely identifies a person on the index - Scottish equivalent of the NHS number in England and Wales

  • The CHI number is the unique patient identifier throughout the NHS in Scotland

EHR Conference, Amsterdam 12th June 2008


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National EHR’s in Scotland (3) Britain & Northern Ireland

  • Scotland and Northern Ireland have recently issued a joint tender to purchase a patient management system, with rich clinical functionality, worth between £30-120m over four years

  • Possible pilot sites - NHS Ayrshire and Arran, NHS Borders, NHS Greater Glasgow and Clyde, NHS Grampian and NHS Lanarkshire (all Scottish health boards)

  • After piloting system will be made available to all health service organisations in Scotland and health and social services organisations in Northern Ireland

EHR Conference, Amsterdam 12th June 2008


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National EHR’s in Northern Ireland Britain & Northern Ireland

  • Joint tender with Scotland

  • Population of 1.8 million people

  • Integrated Health and Social Services

  • Unique, very manageable and compact centralised organisation

  • Single Health and Care Number (equivalent of the NHS Number) to provide a unique identifier for national Electronic Health Records

EHR Conference, Amsterdam 12th June 2008


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In Summary… Britain & Northern Ireland

  • All four home countries are working actively towards national EHR’s

  • Each country has it’s own approach to development and implementation

  • All are using a unique identifier for each patient

  • The next four years will see considerable changes nationwide in the UK

EHR Conference, Amsterdam 12th June 2008


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Questions? Britain & Northern Ireland

EHR Conference, Amsterdam 12th June 2008


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Contact Details Britain & Northern Ireland

Lorraine Nicholson

l.nicholson@zen.co.uk

Tel & Fax: 01706 355957

Mobile: 07788 405910

EHR Conference, Amsterdam 12th June 2008