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Creating the ultimate Electronic Patient Record system

Iouri Prokhorov
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Maintaining accurate medical records, and enabling you and your healthcare professionals to access them easily and quickly, makes perfect sense.

The manually administered, paper-based approaches of old clearly aren’t capable of meeting this objective. Yet switching over to a software-driven, paperless electronic patient record (EPR) system has proven to be anything but straightforward.

The NHS and its longstanding commitment to establish a ‘single patient record’ is a prime example. The infamous NHS National Programme for IT (NPfIT), launched in 2002 and eventually abandoned 11 years later at the cost of over £10bn, was a high-profile attempt to achieve this goal that ended in failure. Recognising that the NPfIT was overly ambitious in its aim to replace disparate record systems with a one-size-fits-all solution, the successor strategy is to develop a way of connecting existing systems together instead. An extra £1.8bn of UK Government funding was announced in February 2016 to support it, with a view to achieving an NHS ‘paperless at the point of delivery’ by the year 2020.

Whether it’s the entire NHS, one part of it, or a separate private healthcare organisation entirely, the key challenges of creating the ultimate electronic patient record system are largely the same. These are:

An accurate and realistic scope from the outset

As with any software project, EPR systems must be designed within fully investigated parameters and this is difficult when the boundaries between different providers and stakeholders are not clear. The myriad of hospital trusts, clinical commissioning groups, health boards, emergency care providers and other bodies reflect the reality that ‘the NHS’ exists as a concept rather than as one single, coherent organisation. The other scoping issue is the sheer scale of record/document digitisation still to be completed before an EPR system properly gets off the ground. A single NHS trust may need to scan hundreds of millions of medical documents, images and other files in a systematic fashion.

Cybersecurity and data privacy that balances locking-down with opening-up

Healthcare data is sensitive and personal, making confidentiality a fundamental driver for EPR systems. The challenge of keeping such data ‘locked-down’ for privacy reasons is made substantially harder by the insatiable demand to ‘open-up’ data access so that individual practitioners - and the patient themself - can interrogate or contribute to the record from any location or device. Large numbers of electronic records can also be immensely valuable to clinical research organisations, and this also presents wider confidentiality issues. Data protection problems are exacerbated further by the scourge of cyber attacks, which increasing target healthcare organisations and their data.

Fast efficient information exchange with other EPR systems

How Life would be easier for data architects and software developers if every patient received their cradle-to-the-grave care from one place and one medical professional. But the average person relocates frequently during their lifetime, accessing their right to choice and receiving care from many specialist centres. This makes it critically important that EPR systems are not only highly user-friendly, but also communicate with each other effectively, applying common data standards, open interfaces and other interoperability wherever possible.

Seamless integration with patient applications

The hyperconnectedness of patients is creating exciting opportunities for digital healthcare, but these are only possible with a robust, reliable EPR system at the heart of everything. Updates to medical records used to be the reserve of doctors and nurses, but that’s changing to one where wearable devices routinely monitor ailments and feed directly into the EPR system. Complementing this are other patient-driven ‘companion’ applications that encourage wellbeing through the interchange of dynamic data. Take a look at our MapMyHealth case study for an example of this.

Planning for big data analytics instead of bolting-on at a later date

One of the big selling points for EPR systems is the value of having such a large mass of structured data to analyse and base future planning decisions upon. ‘Big data analytics ’ is very powerful, but there are essential data management processes that organisations need to undertake in order to optimise it. Anyone who assumes that large data sets can be pillaged of all residual value simply by pointing an analytics engine at them, will only benefit from the top layers of insight rather than the deepest, cross-cutting intelligence.

EPR systems cannot be deemed successful merely by navigating the challenges above.

The overriding objectives for EPR systems are better outcomes for patients, and more efficient data management processes.

This is targeted through the minimisation of manual administration, and by facilitating more dynamic, inclusive and innovative ways of sharing, enriching and presenting patient information.

It’s a long tightrope and a difficult balancing act, but Helastel is one of the companies who know how to get to the other side.

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Topics: Software Development, healthcare

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