The Northern Ireland Electronic Care Record Gary Loughran ehealth Programme Manager (BSO ITS)
Who are we? Northern Ireland 80 * 100 miles Population = 1.82 million 5 Health and Social Care Trusts ~20 hospitals 350 General Practices Workforce around 45,000 5-600 in ICT support and ServiceDelivery
2005 DHSSPSNI Strategy identified 2 key intertwined strands: Electronic Care Communications And Electronic Care Records
What happened next: Infrastructure Required Network Data Centres Regional Health and Social Care Systems HSC Wide identifier Health and Care Number Critical Mass of identifiable information digitally accessible
Why we needed an Electronic Care Record? Most Patients think that information about their condition, treatment or service that is captured in one part of the HSC is available to other parts of the HSC! Until they have significant interaction with HSC when they find out! Information does not move between organizations Information does not move between functions The same information is asked for over and over again Service is not joined up but operates in silos
Proof of Concept - Explore and Investigate Single, secure, web-based clinical portal to view key information from multiple systems Patient-centred view information follows the patient, instead of being trapped in silos in different hospitals and different systems Improving the quality, safety and efficiency of care and practice Underpinning transformations in where and how services can be provided
... The challenge; Fragmented Electronic and Paper Records
The Aim; One virtual Electronic Care Record
NIECR Core Data Items GP Practice Detail Demographic s & ID s Lab Results Meds & Med History Diagnosis Clinical Documents Rad reports & results Encounters Special Factors & Problem List Alerts & Allergies
The Glue of the NIECR ECR MPI Has all casenotes, PAS numbers and HCNs throughout HSC Kept Up-to-date from Health and Care Number Index and all 8 regional PAS systems Data Matching Rules Message Identifier - HCN or PAS Internal Number (PIN) or Hospital Casenote AND Demographics Data- Surname and Date of Birth and Gender
ECR since July 4th - by the numbers 260,000 Unique Patients Records Accessed Over 14% of total population 1.175 Million Accesses to Patient Records 200+ Million Messages Stored 2.5 million Patient Centre Documents Accessed 13,000 Drug Accesses per Week 130,000 Print Requests 400,000 Radiology Reports Viewed 4+ million Cumulated Laboratory results 1750 ereferrals viewed per Week 2250 ECM Documents viewed per Week
Efficient, Effective, Safer Services Improved Quality of Care Treatment based on up to date information Reduce duplicate lab and radiology tests Reduction potential clinical adverse incidents Drug reactions Reduce transcription errors Efficiency Reduce delays in patient journey Increased Capacity within Outpatient Clinics Reduction Delayed discharges Reduce time taken in drug reconciliation
Lessons Learned & Key Success Criteria Ensure strong clinical leadership at every stage of the project, from Regional Project Board to design and testing teams Proof of Concept Don t be afraid to try things Integrate rather than rip and replace A phased approach works well delivering a view of a core dataset to users Allows benefits to start to be realised and the user community to mature before starting to maximise the potential of the portal as development platform
This project appears to have been driven by clinicians and the project delivery has been well directed by their requirements. The clinicians interviewed during the review have all expressed their support for the approach and the unprecedented added value provided by this solution. Many have cited this as a game changer and will transform how the care profession will be able to deal with patients putting more focus on the patient and not on chasing information. Gateway 4 Readiness for Service Review
ECR - Today A view of core patient information and results. Electronic Care Record in the early stages of maturity: Single view of core patient demographics, results, results sign off and documents. Platform is established and is first step towards enabling Collaborative, Integrated Care: Shared Integrated Care Plans Referral Triage Management Solution Key Information Summary Chronic Disease Management Pathways This solution is in the early stages of maturity, with many opportunities for further extension and development.
Used for the first time today in ED,Brilliant!, this will improve quality of care - ED Consultant Southern Trust Best IT spend in NI ever. Expect hospital secretaries phones will be quieter now. - GP The NIECR system is excellent. The best thing to happen to NI NHS in years! I think within a few weeks everyone I speak to will want to get on it. - Cardiologist Western Trust I really appreciate it and use if regularly on a daily basis. In fact I would be lost without it now. - Specialist Nurse Lagan Valley