Your analysis is oh so close, but misses the primary point. I was one of the designers of the original NHS National Spine that was never implemented (Thanks, Richard Granger). The point of that design (the closest I have ever seen a government come to getting it right) was that health records need to be about PATIENTS and in the UK there should be only a record per patient, oriented toward that patient.
The conceit in your article is that having a single EMR will "fix" this. The problem with all of the systems you list is that NONE of them actually is modeled around an individual -- the are all modeled around encounters, beds, institutions, visits, GP Practices -- anything but a patient. So you could install one of these classic EMRs for everyone and things would hardly improve.
The solution is still an individual-centric overlay that UNDERSTANDS the data (not just moves it around) and that takes it from all sources and makes it, credibly, be about YOU -- for your sake and the sake of all your practitioners. The UK missed its best opportunity in the last 30 years to achieve that when the National Spine was neutered.
Now with the emergence of Cognitive-AI (NOT the LLMs and deep learning engines which are probabalistic/inferential and not qualified for patient care) the opportunity to build individual-centric (NOT venue centric) records for each patient will be come available again. If the UK (which, with the NHS, should have perhaps the easiest worldwide shot at doing this) is to go down a different pathway, moving to a knowledge-centric (not repository centric) individual records approach will provide many of the solutions you seek. The "Epic everywhere" approach does not do it because the information is never understood (none of the systems you list have the capability -- that is not their point) and therefore individual-centric outcomes are permanently elusive.
Wow... that's some serious vendor lock-in. Respect to the vendor salesman (or woman) who distracted the IT Manager and Clinical Information Systems Manager long enough for them to sign on to that!
That said, what other EPR are used in the hospital? In my experience here NHS Trusts seem to love having completely different systems in every area of the hospital (different system in ICU, Theatre, Maternity, A&E and so on). In the commercial world what you would have is a single system (say SAP) and different 'views' for areas that need to see something different on their dashboards. In Health IT in the UK you see different systems and often either absolutely no, or hugely expensive and bespoke, methods of interconnecting data from one to the other.
Your analysis is oh so close, but misses the primary point. I was one of the designers of the original NHS National Spine that was never implemented (Thanks, Richard Granger). The point of that design (the closest I have ever seen a government come to getting it right) was that health records need to be about PATIENTS and in the UK there should be only a record per patient, oriented toward that patient.
The conceit in your article is that having a single EMR will "fix" this. The problem with all of the systems you list is that NONE of them actually is modeled around an individual -- the are all modeled around encounters, beds, institutions, visits, GP Practices -- anything but a patient. So you could install one of these classic EMRs for everyone and things would hardly improve.
The solution is still an individual-centric overlay that UNDERSTANDS the data (not just moves it around) and that takes it from all sources and makes it, credibly, be about YOU -- for your sake and the sake of all your practitioners. The UK missed its best opportunity in the last 30 years to achieve that when the National Spine was neutered.
Now with the emergence of Cognitive-AI (NOT the LLMs and deep learning engines which are probabalistic/inferential and not qualified for patient care) the opportunity to build individual-centric (NOT venue centric) records for each patient will be come available again. If the UK (which, with the NHS, should have perhaps the easiest worldwide shot at doing this) is to go down a different pathway, moving to a knowledge-centric (not repository centric) individual records approach will provide many of the solutions you seek. The "Epic everywhere" approach does not do it because the information is never understood (none of the systems you list have the capability -- that is not their point) and therefore individual-centric outcomes are permanently elusive.
A mention to the EPR of the IT system: TRAK, implemented in NHS Lothian since 2010, and licensed until 2040!
Wow... that's some serious vendor lock-in. Respect to the vendor salesman (or woman) who distracted the IT Manager and Clinical Information Systems Manager long enough for them to sign on to that!
That said, what other EPR are used in the hospital? In my experience here NHS Trusts seem to love having completely different systems in every area of the hospital (different system in ICU, Theatre, Maternity, A&E and so on). In the commercial world what you would have is a single system (say SAP) and different 'views' for areas that need to see something different on their dashboards. In Health IT in the UK you see different systems and often either absolutely no, or hugely expensive and bespoke, methods of interconnecting data from one to the other.