Why the NHS might never procure another electronic patient record

  • 9 July 2020
Why the NHS might never procure another electronic patient record

There is a new option for NHS digital leaders that is turning heads, that will re-energise the health tech landscape, and that will orchestrate digital strategies, writes Lynette Ousby, UK general manager for Alcidion.

Imagine you are the chief digital officer for one of England’s integrated care systems. Your mission is to create a cohesive flow of digital information across the providers in your geographical footprint. And then – rather than having that information just sitting in records – you want to turn it into something proactively useful for every healthcare professional and patient.

Extremely disjointed existing IT across your ICS footprint makes this challenge even harder. One NHS trust might have an ageing patient administration system and a best of breed digital strategy. Surrounding trusts might have implemented an array of electronic patient record systems, each with different levels of capability.

So, as the CDO, are you tempted to just start over with a new system across the region? Many might be.

But this temptation simply to go to market for a big new EPR is now starting to change. Why? Well, there’s another option available to the NHS that will not only enable the flow of information: it will automate clinical plans and pathways, proactively augment clinical decisions and orchestrate digital approaches across regions.

It’s called a smart clinical asset – and with NHS organisations already starting to use it to re-energise their digital programmes, it is about to become the core component of digital strategies across the NHS.

Enter the smart clinical asset

This smart clinical asset is not just a new generation of EPR, or an integration engine, some sort of population health portal, or a slightly better version of what came before. It is far more than any and all of these things and it is about to disrupt the health tech market, not the NHS.

The NHS now needs an alternative to being constrained by archaic healthcare technologies, whilst retaining and extracting value from those systems in which it has invested millions of pounds.

It needs a toolset that will allow it to remove the burden still faced by healthcare professionals who, despite decades of digitisation, still need to spend hours each day remembering to carry out hundreds of routine tasks. And the NHS now needs to be able to rely on its technology to automate and join up care plans and pathways in a manner specific to individual patient needs and conditions.

NHS leaders who want to move to the next level of technology adoption by providing intelligent tools clinicians actually want to use – will now be able to much more easily join together existing systems and overlay them with advanced clinical decision intelligence to create a system of engagement.

They will have the means to relieve the cognitive burden for healthcare professionals through the automation of those things they shouldn’t need to do. They will be able to bring mobility to complement their incumbent systems, and integrate citizen generated data with that from their existing systems in a consolidated clinical asset. They will have a smart and open platform capable of consuming information from other providers. And they will be able to deliver the best from machine learning, natural language processing, electronic observations, electronic prescribing, artificial intelligence, clinical coding, clinical noting, advanced standards, mobility, clinical and patient flow and more.

And rather than starting from scratch, technology leads will be able to draw on the smart clinical asset to unlock significant value and flexibility from existing EPR strategies across the NHS, whilst using it as a core accelerator for best of breed – making far more from existing NHS investments.

So, why might the NHS never procure another EPR?

To tender specifically for an EPR restricts the NHS’ ability to encapsulate the technology that now exists in the market. The remarkable response to Covid-19 has shown a willingness to shake things up. And we now need a sustained way of doing new things.

Healthcare leaders need to look at what is being created, and I’m thankful that many are.

It’s a conversation I have been having with chief digital officers, chief information officers, chief clinical information officers, chief nursing information officers and many frontline staff up and down the country.

Upon learning of emerging platforms like the smart clinical asset that show there is another way to getting enormous value from digital, minds are being changed.

And back to our ICS scenario – some are already starting to abandon their plans to rip and replace existing systems, recognising that they don’t need to start from scratch across their patch.

Instead they have been inspired by the capabilities of the smart clinical asset that can provide the orchestration layer needed to enable the interoperability that their incumbent systems cannot deliver, and to underpin a regional digital strategy that will harness and unleash the longevity and clinical capability of their combined digital armoury.

Miya Precision – the very first smart clinical asset for the NHS – will formally launch as a new approach to supporting digital in July 2020. It will help hospitals at every stage of digital maturity to quickly and safely advance their roadmaps, whilst intelligently making information the genuine asset of clinicians in order to make the right thing to do the easy thing to do.

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26 Comments

  • to me, the EPR gives hope that one day people, all people, will have access and control of THEIR data …

  • Basically – sounds like this poorly worded marketing waffle has turned into more of a headache for Alcidion than it was intended to be.

    However, exciting new solutions are welcome and I like the spirit of not just making something slightly better than what came before.

  • What is being described sounds like a health information exchange portal.
    Rather than going for a big epr that covers everything systems can be best of breed BUT as long as they have open api’s and follow common health model.

  • Some important questions being raised in this conversation. Clive, Mary, Sean, Warren, Felim and all who have responded – thank you for pressing me for more detail.

    Given the significant reaction to the article it is clear that more specifics would be helpful. We will therefore schedule a webinar for Digital Health readers who want to find out more. Please contact us directly at info@alcidion.com so that we can send you an invitation.

  • Glad it’s not just me ! I think we’ve wasted enough words on this and we have given them every opportunity to clarify.
    This is just hyper sales waffle in my mind.
    I’m out.

  • All links lead to sales contact harvesting, no links lead to any meaningful exposition of what problem is solved, and roughly how, this isn’t even an advert!

  • I read this twice and still don’t understand what a smart clinical asset is and how it helps? This is not an enjoyable article to read.

  • I am disinclined to believe that anyone can possibly understand what this article is saying. It might be clearer in Chinese, or perhaps Swahili.

    Unfortunately it is possible to make sage comments on something totally incomprehensible, because nobody dares say that the Emperor has no clothes and nobody can say what he is wearing.

  • NHS is so archaic.US/CAN are so advanced. Their hospitals were fully digitized 10 years ago

    • yep, but the real problem is that we are supposed to have a NATIONAL health service but: 1. digitally, hospital X, compared to hospital Y, is in a real bad way etc 2. digitally hospital X is NOT connected to hospital Y, you are right Peter, and it is all down to NATIONAL leadership …

  • Mary is correct, transparency is what is needed in the provision of H & SC. So I will try and engage the IT supplier and be fully transparent by asking a question … “in your solution where do pathways fit ?” by pathways I mean the pathway that is identified by the converted Unique Booking Reference Number (UBRN), pathways which recognize that people receiving care cross many different care setting, not just NHS care settings [there are many different organisations providing care], pathways which are the mechanism by which wait times are measured, wait times which are on the way up, wait times which is the thing of most concern to all the people]. Please be honest.

    • Or to simplify Clive, ‘can you please tell us what it does and how?’

      • Yes I can, but U R going to have to be (a) patient like everyone else is… Everyone is a patient on a Unique health journey with a Unique EHR.. All deserve access and control of THEIR UEHR, do U have access and control of yours?

  • Thank you to all for being honest about how this site is paid for, this site is not lucky enough to be funded by taxpayers money, it must “balance its books” or it would probably run at a loss and sink, there is no such thing as “free”, “fair” is a better word. I have no problems with articles like these just as long as I learn something from them, and in this case I, and I assume others, wasted my time reading it, honesty is the policy, thank you.

  • Llynette Ousby
    I agree with Sean: this should be discussed here – not privately: it is of general interest – & other readers probably have a broader understanding of the integrated records than I do (especially Sean).
    I have looked at the website. The scenarios quoted appear to be about very limited problems within single organisations – a far cry from integrated care records held across many different organisations & departments within those organisations.
    As far as I am aware the intention behind the integrated care record is to provide a record which can be used by clinicians for direct patient care.
    Regardless of the secondary uses agenda, could you tell us all, here, how your product would integrate dispersed *clinical* patient records into a usable form – as well as gathering all the data needed to run the NHS – & provide a data mine for other research & commercial purposes?
    Don’t get me wrong: maybe it can: just show us how – & what – it can do where everyone else is still struggling (since 2002 at least) to find an answer – so far with limited success.

    • The integration of H & SC, mental and physical health is now critical, and at the heart of this integration is the integration of H & SC DATA, this should be done nationally because that is the only “fair” way to DO IT for all. Count our kidz money and share it out fairly please,

  • HSJ allows paid promotional articles like this too, but they clearly call this out, you can search for the same company in HSJ website and find it. Digital Health should follow suit – it’s the difference between research driven journalism and paid promotion of a product or service.
    Am not against a company paying to promote their wares anywhere, but it should be in the form of advertisement and not ‘articles’ like this.

  • I too am confused by what does appear to be an advert short in detail. As Dr Mary H says, the use of the acronym EPR is in itself confusing as GP EPRs are a very different beast to the big often monolithic hospital EPRs.
    I think an explanation here is a far better option than a personal message as I am sure many readers would like to hear more detail of this exciting development.
    You say:’ Instead they have been inspired by the capabilities of the smart clinical asset that can provide the orchestration layer needed to enable the interoperability that their incumbent systems cannot deliver, and to underpin a regional digital strategy that will harness and unleash the longevity and clinical capability of their combined digital armoury.

    That sounds impressive but what exactly does it mean? A few more hard facts would be welcome.‘

  • Disclosure: I am an Alcidion shareholder.
    I became so for altruistic reasons, having held a view since 1985 that computers and A.I could improve patient outcomes. I have become proud that improvement in patient outcomes is evident in everything they do.
    I hope this article prompts readers to investigate Alcidion’s “Miya Precision – the very first smart clinical asset for the NHS – will formally launch as a new approach to supporting digital in July 2020. It will help hospitals at every stage of digital maturity to quickly and safely advance their roadmaps, whilst intelligently making information the genuine asset of clinicians in order to make the right thing to do the easy thing to do.”
    It has actually been in use for some years & “delivering the goods” as promised and as verified by user feedback e.g. independent NHS audits show cardiac event reduction.
    I look forward to learning of the “new approach” mentioned above.

  • “…writes Lynette Ousby, UK general manager for Alcidion”

    Alcidion being the company behind Miya Precision. This is literally an advertisement. Should we give the benefit of the doubt and assume they forgot the sponsored tag?

    • why because they trying to sell you something. All sales are to hospitals that do their own due diligence. As far as I can tell, its just letting public know about the launch this month.
      “Miya Precision – the very first smart clinical asset for the NHS – will formally launch as a new approach to supporting digital in July 2020. It will help hospitals at every stage of digital maturity to quickly and safely advance their roadmaps, whilst intelligently making information the genuine asset of clinicians in order to make the right thing to do the easy thing to do.”

  • This sounds like an advertisement: could we have more details & some links showing how it might work?
    Is an “EPR” in this context a PAS (Patient Administrative System) with or without a digital patient record module or an EPR (Electronic Patient Record) in the GP sense of the word?
    Just asking..

    • Google is your friend here. As an Alcidion shareholder, I must be biased but I have spoken face to face with the people at the top and can assure you they have a fundamental wish to help patient outcomes. Their website has a recent “commercial” flavour but it is all accurate info.
      In particular, try to think of the Miya “platform” as a big circle to which all sorts of bolt-ons are connected to the periphery. Within the platform lies A.I. which enables data from the bolt-ons to be sorted, correlated etc to in ways to suit users. Treatment suggestions and alerts are “pushed” from it. One feature they have which is improving with time and seldom mentioned is that by having access to the huge number of patient records they can supply statistically accurate info. like drug reactions, which treatments work best, etc and this info. is made available to e.g. researchers. When they win a contract they do not have to disrupt systems already in place as they can be bolted on, but with time be improved by relevant data from the platform. The more you understand about them I am confident you will be impressed. https://alcidion.com/

    • Hi Mary,

      I am more than happy to talk you through MIYA and it’s capabilities in more detail. This article was not intended to be an advertisement, more an alert to the market that an EPR doesn’t have to be the only route to digital maturity or taking out everything already in place which has taken significant investment in time. There are other ways you can now make the information more useful.

      Please drop me a line directly (on Linked In) and we can catch up.

      Take care.

      • Hi Lynette. Please see a couple of my comments on this site. Please correct any falsities in what I said and otherwise enlighten me and other readers. I fear I may be overenthusiastic and caused you to cringe.

  • It is heartening to find another voice which is crying out the same message as I have been advocating for the past year or more.
    The way the NHS, Social Care and Local Government is changing and the rate of the change clearly mitigates against investment I monolithic EPRs or EHRs.
    Keep up the good work.

Comments are closed.