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Northern Ireland plans to go live in November 2023 with its national integrated care record system, dubbed Encompass, with South Eastern Health and Social Care Trust being the first to begin using the system.
The four other trusts in the region are anticipated to follow in a phased approach during 2024/25.
The £275m Encompass programme aims to create a complete digital health and care record for every citizen in Northern Ireland, streamlining patient journeys through linking information across different healthcare settings as well as social care.
The region’s health service has, like the NHS, struggled with legacy systems, both in the community and hospitals across Northern Ireland, resulting in several data entry points and the associated risk of poor data quality and inaccuracy.
The care record project, which is clinically led, will provide clinicians with real-time information from primary, secondary, community and social care, making it easier for healthcare professionals to make efficient and effective decisions.
The Encompass project is part of Northern Ireland’s health and social care transformation programme “Health and Wellbeing 2026: Delivering Together”, which was launched in 2016.
Dan West, chief digital information officer (CDIO) at Northern Ireland’s Department of Health (DoH), said the roll-out of the Encompass project across the whole region “will be a critical enabler of the wider transformation programme for health and social care”.
“While it is seen as a technology programme by some, it is really about people - our staff and people in Northern Ireland,” he said.
“It will support with work on things like waiting times; actions around mental health; reconfiguration and rebuilding of hospital services; the development of day case elective centres; and delivery of transformed cancer services. It will help to digitise some aspects of social care and it will support community engagement and co-design.”
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In May 2020, Northern Ireland signed a 10-year contract with US-based electronic patient record (EPR) supplier Epic, to provide the clinical software for the integrated care record.
As the Encompass programme took off, in 2022 Health and Social Care Northern Ireland (HSCNI) also signed contracts with healthcare technology specialist Tegria and digital health consultancy Cloud21, to provide strategic guidance, programme readiness and EPR implementation expertise to the programme.
DoH permanent secretary Peter May said that since May 2020, when the contract with Epic was signed, a “massive amount of pre-implementation and planning work has been undertaken which has provided us with a once-in-a-generation opportunity to replace outdated systems and transform how we provide care”.
“Central to this transformation is the introduction of a new, comprehensive EPR system. Our new EPR will mean that care providers will no longer need to rely on paper-based, admin-heavy processes,” he said.
“It will also allow patients, clients, and service users to book appointments, review test results and letters, and communicate with those providing their care using our new patient portal.”
The integrated care record is one part of Northern Ireland’s three-phased approach to digital transformation, set out in its digital healthcare strategy published in July 2022.
The focus of the strategy’s first phase is to implement “foundational technologies”, such as Encompass, but also work on Northern Ireland’s Picture Archiving and Communication System (Pacs) by delivering a single enterprise imaging solution for health and social care, as well as its regional Northern Ireland Laboratory Information Management System.
The second phase is to ensuring the country makes the best use of the technology available, and developing new capabilities, which the third is to invest time and resources in new technologies and initiatives, ensuring the right stills are in place to embrace innovation.