National Electronic Health Record Program in United Kingdom
The National Health Service (NHS), United Kingdom’s publicly-funded healthcare system, has one of the most ambitious visions for the EHRs - the “National Programme for Information Technology (IT)”, established in October 2002 and aiming to provide an electronic NHS Care Record for every patient at the national level by 2010.
NHS Connecting for Health was set up by the UK Department of Health and started to operate on April 2005 to deliver the “National Programme” in order to implement an integrated IT infrastructure for all NHS organizations. This project, which is the largest of its kind in the world, will connect over 100,000 doctors, 380,000 nurses and 50,000 other health professionals; it will be securely accessible by healthcare professionals at any NHS location and by patients, and it will create an electronic record for 50 million patients.
The integrated systems and services consist of:
- The NHS Care Records Service (NHS CRS) – individual electronic NHS Care Records
- The electronic booking service (Choose and Book) - hospital or clinic appointments
- Electronic Transmission of Prescriptions (ETP) – between General Practitioners (GPs), pharmacies and the Prescription Pricing Authority (PPA)
- The HealthSpace web service - allows patients to access their NHS care records
- The National Network (N3) - IT infrastructure and broadband connectivity for the NHS
- Contact – a central e-mail and directory service for the NHS
- Picture Archiving and Communications Systems (PACS) – digital medical images
- IT supporting primary care - Quality Management and Analysis System (QMAS - collects national achievement data, and computes the points and payment value earned by GP practices); GP2GP (enables the transfer of electronic health records among GP practices)
- Decision support - the electronic prescribing program; online knowledge and library systems: integrated care pathways; e-referral support; support for ordering clinical investigations; etc.
- The national, central database (Spine) – stores the summary patient records and also indicates where the full local records are held
For implementation purposes, the “National Programme” is grouped into five geographical regions, known as clusters: Eastern, London, North East, North West, and Southern. Some of the major players of the projects include the UK Department of Health, NHS Connecting for Health, National Application Service Providers (NASPs) – deliver national applications (services), National Infrastructure Service Provider - provides networking and supports services, Strategic Health Authorities (SHAs) – deliver implementation of the projects at local level, and Local Service Providers (LSPs) - develop and implement IT related services in a cluster.
The UK national EHR strategy is currently ongoing and is expected to be finalized in 2010. In the meantime, several other European countries have established regional and national EHR initiatives, such as the FinnWell (2004-2009) in Finland, Personal Medical Record (2004-2007) in France, eHealthcard (2006) in Germany, National eHealth/IM&T Strategy for NHS (2004-2008) in Scotland, Carelink and Sjunet in Sweden, and S@mspill (2004-2007) in Norway.
Current deployment statistics: http://www.connectingforhealth.nhs.uk/delivery/servicemanagement/statistics/service
For more information: NHS Connecting for Health at http://www.connectingforhealth.nhs.uk