Northern Ireland unveils plans for electronic records

Northern Ireland has announced plans to develop its own electronic care record in a move which has led to calls for a UK-wide IT programme.

The ten year plan for health and social services information technology in Northern Ireland was announced by Angela Smith, Northern Ireland health minister. Costs for implementing the strategy are estimated at £110m with £15m worth of annual costs. So far £95m has been earmarked for ICT in health and social services in the Northern Ireland Investment Strategy for 2005-2015.

One of the main objectives of the Health and Personal Social Services (HPSS) strategy is to establish an electronic care record for every patient. The strategy says the record will provide current and historic information on patients and contain structured data, text and images generated from a variety of sources.

Dr Jimmy Courtney, a GP in Holywood, County Down and deputy chairman of the British Medical Association’s General Practitioner Committee in Northern Ireland, said the strategy would help GPs’ to link with the rest of the wider service in Northern Ireland.

However he criticised the devolution of IT in the NHS which meant each of the four home countries was pursuing its own IT programme.

He said: “When it comes to the care record it strikes me as absolutely bonkers not to have a national structure for doing this. Patients have a habit of moving between the four countries and what happens if, for example, someone from London goes to Dundee to university and has a significant episode of care there that does not appear on their NHS Care Record?

“We need to ensure that any kind of record any easily be recognised or merged by the other three countries.”

Dr Courtney said he believed a prime example of the dangers of devolution in IT had happened with the development of monitoring software for the Quality and Outcomes Framework under the new GMS contract.

The original QMAS software was commissioned by the National Programme for IT for England only and the other three countries were left with the choice of buying it from the developers, BT Syntegra, or developing their own versions. Scotland chose to go with QMAS where Northern Ireland and Wales have bought alternative software from MSD Informatics.

Dr Courtney: ‘I think that is an example of the lack of joined up thinking that exists.’
He said the idea of an electronic care record in Northern Ireland was still at a conceptual stage and that Northern Ireland would watch closely at what was happening in England and elsewhere, particularly on issues such as confidentiality and consent.

The HPSS now plans to work on compiling and getting agreement on a roadmap of how Northern Ireland will progress towards an electronic care record.

Other elements of the strategy include plans for direct booking of appointments, greater use of video and tele-links, electronic prescribing in hospitals and electronic test requesting and results service.

The HPSS targets also include providing access to email and the internet for all GPs by the end of this year and access to email, internet and desktop services for all Northern Ireland care professionals by the end of 2010.

GP access to hospital patient administration system data is promised for the end of March 2006 with ICT support for the discharge process from the end of 2008.

A new strategic framework for primary care in Northern Ireland is due out soon which will include proposals to review and evaluate ICT needs across primary care and to develop a primary care ICT strategy and investment plan to modernise systems.