Electronic health records firm Epic Bristol bags £454m in UK deals as creaking care sector chases digital transformation Epic Bristol, a specialist healthcare software company, has won a brace of UK public sector contracts worth a total £454m. In the first, the software company has been awarded a deal to support and develop an integrated electronic health and care record system across acute, community, social and primary care settings for Health …
Intuitively this is a good idea, but how beneficial is this in reality? NPfIT was a right expensive dogs dinner and if I recall the need to call up remote patient data was relatively rare...
From an information security perspective, aggregation of odd bits of lowly classified information to form a highly informative whole is a right headache that at least the GDPR has tried to address in some form. But including a population-wide centralised database of whole life history, surely that would be heading up to secret classification in aggregation?
Really?
Remote patient data? Pffft
I spent the last 10yrs of my NHS secondary care trying to call up remote data on patients admitted to our ITU
Try asking patient with an ET tube in situ...
Try asking the traumatised next of kin
..
Try asking their GP..("closed until Thursday 10am; send us a secure fax: "you're from where?"
We DO need a proper, joined up NHS patient system like yesterday.
Sadly no one seems to ask users or care; apart from pocketing the cash
what is really interesting is that the clowns in NHSX last year declared that EPIC did not play nicely (interoperability was poor) and this was supposed to prevent it developing any more contracts in the UK
It has since agreed terms with Exeter, Manchester and Northern Ireland for some big juicy contracts.
i.e. NHSX 's rules about usability have just been ignored (as has NHSX)
After the COVID app disaster, how much longer are they going to leave NHSX twisting in the breeze?
whoever was on the pannel should be taken out and given some tea because clearly they cant be sane
A 2014 report by the RAND Corporation described Epic as a "closed" platform that made it "challenging and costly for hospitals" to interconnect with the clinical or billing software of other companies.[18] The report also cited other research showing that Epic's implementation in the Kaiser Permanente system led to efficiency losses.
does it link to anything else without costly "variations" ?
good luck
From my experience of NHS related procurement chances are they gave "assurances" that APIs etc would be created to help with integration with other systems.
These assurances are likely not part of the contract though or come at considerable cost with no fixed timescales.
Disclaimer - not part of the process for these products but it sounds like it's going to be a complete disaster already.
However, in the UK, Epic has been implemented at University College London Hospital, Great Ormond Street and Addenbrookes, Cambridge. All university teaching hospitals, and one is a major trauma centre. There were lessons to be learnt (and indeed Addenbrookes was put in special measures by CQC, in part due to its EHR).
However, those bugs seem to have been worked out, and as an occasional user of the UCLH Epic, it is miles better than the rubbish they had before. I think Manchester and NI will pay handsomely, but it will be something that works.
If you want something that does not work and costs a fortune, try L*renzo by DXC. Developement funded by the UK taxpayer and then sold back to the NHS to use.
By all means, have a secondary care EHR developed that uses OpenEHR standards throughout (https://openehr.org/), but then you have to go to small vendors with fragile company stability.
Which begs the question why they have to develop anything. Unless if have missed something, surely this is not far off a turnkey solution, a patient records system should have the same requirements regardless of the hospital.
Epic may have interoperability issues with other systems but the one thing it should be able to do is integrate with itself.
I haven't much experience of EPIC but the platform it is built on has interoperability and Healthcare data technologies built in so I would doubt very much if this really was a closed system. Additionally, it very much has to play nicely with other systems in the US.
I suspect there were some niche bad experiences with a UK implementation that have now been ironed out.
My own experience of US Healthcare software being brought to the UK is that initially there are teething problems as the NHS functions very differently to US Private Healthcare.
Healthcare implementations are what the latter part of my career was.
I've found Epic one of the better healthcare systems.
It is so widely used in the US that pretty much any integration that you can think of has already been implemented and has some years of improvement behind it.
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