The Northern Ireland Electronic Care Record

Desmond O’LoanHSCNI eHealth Programme

#NIECR Better, safer, faster care

• Journey to dateLeadership and navigation

• Current positionNational ECR

• Future directionNew Functionality

Who are we

•Northern Ireland 80 x 100 miles•1.82 million population•6 Health and Social Care Trusts•20 hospitals•350 General Practices•66,000 Workforce•557 in ICT support and Service Delivery•£4b Health expenditure

#NIECR Better, safer, faster care

#NIECR Better, safer, faster care

The challenge; Fragmented Electronic

and Paper Records

. . .

#NIECR Better, safer, faster care

The Aim; One virtual Electronic Care Record

#NIECR Better, safer, faster care

The journey

•Clinical Leadership, Political Leadership •Strategic Vision

– Electronic Care Records & Electronic Communications•Investment in Infrastructure

– Clinical applications, Network, Data Centres•Implementation of a National identifier•Create a critical mass of identifiable patient data•Navigate the Information Governance and Privacy challenges

#NIECR Better, safer, faster care

Alerts &AllergiesAlerts &Allergies

Lab ResultsLab Results

Rad reports &results

Rad reports &results

Special Factors &

Problem List

Special Factors &

Problem List

Meds & MedHistory

Meds & MedHistory

Clinical Documents

Clinical Documents

GP PracticeDetail

GP PracticeDetail

Demographics & ID’s

Demographics & ID’s

Diagnosis Diagnosis

Encounters Encounters

#NIECR Better, safer, faster care

Current position

•8 Patient Administration Systems•9 Clinical documents systems •10 Emergency Department systems•5 Out of Hours providers•6 Laboratory systems•3 Radiology RIS•2 Radiology PACS•30+ MDMs Oncology & Cardiology•350 GP systems•1 Electronic Referrals, GP •1 Master Patient Index

#NIECR Better, safer, faster care

Total Users = 12690Active Users = 8126

#NIECR Better, safer, faster care

#NIECR Better, safer, faster care

ECR since July 4th 2013• 400,000 Unique Patients’ Records Accessed• 2M Accesses to Patient Records• 350M Messages Stored• 4M Patient Centre Documents Accessed• 13,500 Drug Accesses per Week• 180,000 Print Requests • 600,000 Radiology Reports Viewed• 6.5M Cumulated Laboratory Results Presented• 1750 eReferrals viewed per Week• 2500 Immediate discharge letters views per Week

#NIECR Better, safer, faster care

Efficient, Effective, Safer Services•Improved Quality of Care

– Treatment based on up to date information– Reduce duplicate laboratory and radiology tests– Reduction potential clinical adverse incidents– Reduce transcription errors

•Efficiency– Reduce delays in “patient journey”– Increased capacity within Outpatient clinics– Reduction in delayed discharges– Reduce time taken in drug reconciliation

• Outpatient clinic audit - April to June 2014– Of the patients seen:– NIECR helped to avoid unnecessary

• laboratory tests in 27%• Imaging tests in 8%• additional review appointment in 3%

– NIECR Improved management in 37%

• NIECR use has potential to (yearly)

– Improve the management of approx 500,000 (37%)– Free approx 40,000 (3%) outpatient appointment slots

• Future Direction– Chronic Disease Management– E Referral triage and PAS update– Radiology Ordering – Problem list – Medicines Management integration– Immediate Discharge Letter function– Third party system launch– Community Contractor access– Care homes and Private hospitals

#NIECR Better, safer, faster care

Lessons Learned & Key Success Criteria

•Strong Political and Clinical Leadership

•Hybrid Leadership Skills essential •Don’t be afraid to try things

•Integrate rather than ‘rip and replace’

•Populate System before go-live

#NIECR Better, safer, faster care

“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 it regularly on a daily basis. In fact I would be lost without it now.“

- Specialist Nurse Lagan Valley