Electronic Health Record roll out puts patient at centre of British National Health Service

London 05 February 2001Over the next four years, every adult in the United Kingdom will be able to access their own at-a-glance "electronic health record", according to the British Health Secretary, Alan Milburn. The initiative to help redesign the National Health Service (NHS) around the needs of patients, is the centrepiece of a rolling programme of investment worth GBP 700 million in the next three years to overhaul NHS information technology under the NHS Plan.

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The electronic health record (EHR) will hold summarised key data about the patient, such as name, address, NHS number, registered general practitioner and contact details, previous treatments, ongoing conditions, current medication, allergies, and the date of any next appointments. The EHR will be securely protected, created with patient consent, with individual changes made only by authorised staff. As the initiative is rolled out, up to five million people are expected to have their own lifelong Electronic Health Record by 2003, rising to around 25 million by 2004. By March 2005, every person in the United Kingdom will have their own record.

Pilot studies are already underway to find the best way of allowing patients to access their EHR. Possible options include on-line access via NHS Direct and smart cards for use in information points in general practitioners' (GP) surgeries, hospitals and walk-in centres. Any option will allow patients to check their summarised and up-to-date health records. The EHR will have clear benefits for emergency care as important basic information about the patient can be accessed quickly by NHS professionals whichever hospital the patient happens to be in.

The Electronic Record Development Implementation Programme was set up by the British Minister of Health, Gisela Stuart, on 17 April 2000. It includes a programme of work exploring the different options for the Electronic Health Record in 4 local health communities. Two of the pilot projects, in Cornwall and South Staffordshire, are developing operational systems, whereas the others, in Tees and Durham, are undertaking other vital research work. The pilots will be subject to independent external evaluation and will be finished by December 2001 with a view to beginning implementation of a common national solution from April 2002 through to March 2005.

The EHR forms a part of a broader investment programme worth GBP 700 million, already funded in the three year health authority allocations, to give physicians, nurses, and patients a wide range of IT facilities to improve and speed up health care. As part of this broader programme, all patients will see benefits between 2002 and 2005. All NHS clinical staff will have Internet and intranet access including e-mail and on-line information services by the end of 2002, thus ensuring that they have access to up to date information and evidence-base. Physicians and nurses will be able to use their electronic network to order tests, getting results back faster. In some cases, results will be available a week earlier.

A national appointment booking system by 2005, will allow all family doctors to book hospital appointments on-line from the GP surgery, so that patients there and then can choose the time which best suits them, rather than wait to be given an appointment on a list. All local health services will have facilities for telemedicine by 2005. This will lead to new ways of working, including hospital consultants viewing patients in GP surgeries via electronic links or providing an e-mail or telephone service for patients to contact their practice nurse or GP for advice.

Alan Milburn commented: "The NHS is still in the last century when it comes to harnessing the benefits of new technology. The investment will help bring the NHS into the 21st century. The Electronic Health Record will help put patients in control. The sustained investment we are making in NHS IT will help redesign the health service around the needs of its patients. In the future, every patient will have easier access to their own health records. That will also help make the jobs of NHS staff easier too. At the touch of a button, they will be able to summon vital clinical data on a patient without having to wait for paper records to be found. New IT facilities in the NHS will make treatment faster and more convenient for patients and staff alike."

In the last two years an additional GBP 214 million has been made available to support modernisation of NHS information systems. This includes a recurring GBP 79 million and a further GBP 53 million made recurrently available to Health Authorities from 2000-2001. Additional sums are now being made available as part of the allocations for the next three years. An extra GBP 113 million will be given to the NHS for Information Management and Technology investment in 2001-2002, increasing to GBP 210 million in 2002-2003 with GBP 210 million also in 2003-2004. Additional sums will support centrally led initiatives, such as the Human Resource and payroll system.

Information for Health was published in September 1998 and set out a 7 year strategic framework for the modernisation of NHS information systems. Please, visit the Web site of the British Government to consult the Information for Health and Building the Information Core: Implementing the NHS Plan documents. More information on the British Government's information technology strategy for the National Health Service is available in the VMW February 2001 article British Government to announce large investments in telecare and launch of new Telemedicine Information Service.


Leslie Versweyveld

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