To support Primary Care Networks (PCNs) in England and enable integrated clinical services, an Electronic Patient Record (EPR) system must be designed to connect seamlessly with GP systems (e.g., EMIS Web and SystmOne), third-party tools (e.g., triage, telephony), and key NHS infrastructure such as the NHS Spine. Additionally, the system should leverage AI tools to enhance efficiency, decision-making, and patient care. Below is a detailed breakdown of the required capabilities:

1. Integration with GP Systems (EMIS Web and SystmOne)

• Bidirectional Data Exchange:
  • Enable real-time, two-way data sharing with EMIS Web and SystmOne to ensure patient records are synchronised across systems including automatic SNOMED CT coding.
  • Share critical information such as medical history, medications, allergies, test results, and care plans.
• GP Connect Integration:
  • Use GP Connect to access and share appointment data, patient records, and tasks between the EPR and GP systems.
  • Support the Access Record: HTML and Access Record: Structured capabilities to retrieve patient data in a standardised format.
• Appointment Management:
  • Synchronise appointment booking and availability across GP systems and the EPR to streamline scheduling and reduce duplication.
• Shared Care Records:
  • Facilitate the creation and access of Shared Care Records to enable collaboration across PCNs and other care providers.

2. Integration with the NHS Spine

• Personal Demographics Service (PDS):
  • Connect to the PDS to verify and update patient demographic information (e.g., NHS number, address) in real-time.
• Care Identity Service (CIS):
  • Integrate with the Care Identity Service to authenticate healthcare professionals using NHS Smartcards, ensuring secure access to patient data.
• Prescription Management:
  • Work with the Electronic Prescription Service (EPS) to streamline prescription workflows and ensure medication data is synchronised across systems.
• e-Referral Service (e-RS):
  • Support integration with the NHS e-Referral Service to manage referrals between primary, secondary, and community care providers.
• Summary Care Records (SCR):
  • Access and update Summary Care Records to ensure critical patient information is available across care settings.
• Message Exchange for Social care and Health (MESH)
  • support exchange of documents across a clinical setting such as Pathology results and GP Connect Documents

3. Integration with Hospital Systems

• Interoperability with Secondary Care EHRs:
  • Enable integration with hospital Electronic Health Record (EHR) systems (e.g., Cerner, Epic, System C) to share patient data such as discharge summaries, referral letters, and care plans.
• Pathology Lab Integration:
  • Connect with hospital pathology systems to:
    • Receive and display test results (e.g., blood tests, microbiology, histopathology) directly in the EPR.
    • Allow clinicians to order tests electronically and track their status.
    • Ensure results are automatically linked to the correct patient record.
• Radiology and Imaging:
  • Integrate with Picture Archiving and Communication Systems (PACS) to access radiology reports and imaging results.
• e-Discharge Summaries:
  • Automatically import discharge summaries from hospitals into the EPR to ensure continuity of care in primary care settings.
• Referral Management:
  • Support seamless referrals to and from secondary care, ensuring referral letters, updates, and outcomes are shared with all relevant parties.

4. Integration with Third-Party Tools

• Triage Tools:
  • Integrate with digital triage platforms to streamline patient assessments and ensure triage outcomes are automatically added to the patient record.
• Telephony Systems:
  • Connect with telephony systems (e.g., VoIP solutions) to log call details, link patient calls to their records, and enable click-to-call functionality for clinicians.
• Telemedicine Platforms:
  • Support video consultation tools and ensure consultation notes are automatically saved to the EPR.
• Remote Monitoring Devices:
  • Integrate with wearable devices and remote monitoring tools to capture patient data (e.g., blood pressure, glucose levels) and feed it into the EPR for clinician review.

5. AI Tools and Capabilities

• Clinical Decision Support:
  • Use AI to provide evidence-based recommendations, alerts, and reminders to assist clinicians in making informed decisions (e.g., flagging potential drug interactions or missed screenings).
• Predictive Analytics:
  • Leverage AI to identify at-risk patients (e.g., those at risk of hospital admission or disease progression) and enable proactive interventions.
• Natural Language Processing (NLP):
  • Use NLP to extract insights from unstructured data (e.g., consultation notes) and integrate them into the patient record.
• Automated Triage:
  • Implement AI-powered triage tools to assess patient symptoms and prioritise care based on urgency.
• Population Health Management:
  • Use AI to analyse population health data, identify trends, and design targeted interventions to address local health needs.
• Workflow Automation:
  • Automate routine administrative tasks (e.g., appointment reminders, data entry) to reduce clinician workload and improve efficiency.

6. Support for Primary Care Networks (PCNs)

• Shared Workflows Across Practices:
  • Enable PCNs to share workflows, care plans, and patient data across multiple GP practices within the network.
• Collaborative Care Planning:
  • Allow multidisciplinary teams (e.g., GPs, nurses, pharmacists, social workers) to collaborate on shared care plans for patients with complex needs.
• Workforce Coordination:
  • Support PCN staff (e.g., clinical pharmacists, nurses, social prescribers) by providing access to relevant patient data and enabling task assignment across teams.
• Population Health Management:
  • Provide tools to analyse population health data, identify at-risk groups, and design targeted interventions to address local health needs.

7. Support for GP Practice Staff

• Simplified Appointment Management:
  • Provide an intuitive interface for staff to view, book, and manage appointments across multiple clinicians, locations, and services.
  • Enable staff to quickly identify available slots for urgent or routine appointments.
• Consultation Access:
  • Allow staff to easily view past and upcoming consultations, including notes, test results, and follow-up actions.
• Task Management:
  • Provide tools for staff to assign, track, and manage tasks (e.g., prescription requests, test follow-ups) across the practice.
• Streamlined Communication:
  • Enable secure messaging between staff, clinicians, and patients to improve coordination and reduce delays.
• Integrated Workflows:
  • Support workflows for common administrative tasks, such as registering new patients, updating records, and processing referrals.

8. Improved Access to Healthcare

• Patient Portals:
  • Offer patients access to their records, online appointment management (booking, rescheduling, cancelling), and secure messaging with their care team.
• Integrated Appointment Booking:
  • Allow patients to book appointments across the whole of the PCN - both GP Practices and PCN clinical services such as Enhanced Access
• Multichannel Communication:
  • Support communication via SMS, email, forms and phone to improve patient engagement and reduce missed appointments.

9. Data Security and Compliance

• NHS Digital Compliance:
  • Adhere to NHS standards for data sharing, including the Data Security and Protection Toolkit (DSPT).
• Role-Based Access Control:
  • Ensure that only authorised users can access sensitive patient data, with permissions tailored to their roles.
• Audit Trails:
  • Maintain detailed logs of all data access and changes for accountability and compliance.
• Encryption:
  • Use end-to-end encryption to protect patient data during transmission and storage.

10. Data Analytics and Reporting

• PCN-Level Reporting:
  • Provide analytics tools to track PCN performance against NHS targets (e.g., Enhanced Access, Quality and Outcomes Framework).
• Risk Stratification:
  • Identify high-risk patients (e.g., those with long-term conditions) for proactive care management.
• Health Inequalities Analysis:
  • Analyse data to identify and address health disparities within local populations.

11. Scalability and Flexibility

• Customisable for Local Needs:
  • Allow PCNs to configure the system to meet the specific needs of their local populations.
• Scalable Infrastructure:
  • Support growing patient populations and expanding PCN services without compromising performance.

12. Resilience and Continuity of Care

• Disaster Recovery:
  • Ensure the system can function during emergencies (e.g., power outages, cyberattacks) to maintain continuity of care.
• Offline Access:
  • Provide offline functionality for use in areas with limited internet connectivity.

By integrating with GP systems, the NHS Spine, and third-party tools, while leveraging AI and adhering to NHS standards, an EPR system can empower PCNs to deliver coordinated, patient-centered care. This will improve access to healthcare, enhance efficiency, and address the specific needs of local populations in England.

100% Web Based EPR?

Making an Electronic Patient Record (EPR) system a 100% web-based tool offers several advantages, particularly in the context of supporting Primary Care Networks (PCNs), GP practices, and integrated clinical services. Below are the key benefits:

1. Accessibility

• Anywhere, Anytime Access:
  • A web-based EPR can be accessed from any device with an internet connection, allowing healthcare professionals to view and update patient records from multiple locations (e.g., GP practices, hospitals, or even remotely during home visits).
• Support for Remote and Hybrid Work:
  • Enables clinicians and administrative staff to work remotely, which is especially useful for telemedicine, out-of-hours services, and during emergencies (e.g., pandemics or natural disasters).

2. Cost-Effectiveness

• Reduced IT Infrastructure Costs:
  • Eliminates the need for expensive on-premises servers and hardware, as the system is hosted in the cloud.
• Lower Maintenance Costs:
  • Updates, patches, and maintenance are handled centrally by the provider, reducing the burden on local IT teams.

3. Scalability

• Easily Scalable:
  • A web-based EPR can scale to accommodate growing patient populations, new PCN services, or additional users without requiring significant infrastructure upgrades.
• Flexible for Expanding Networks:
  • Supports the integration of new GP practices, hospitals, or third-party tools into the system with minimal setup.

4. Interoperability

• Seamless Integration:
  • Web-based systems are typically designed with modern APIs and interoperability standards (e.g., FHIR, GP Connect), making it easier to integrate with GP systems (e.g., EMIS Web, SystmOne), hospital systems, pathology labs, and NHS Spine services.
• Real-Time Data Sharing:
  • Enables real-time data exchange between different care providers, improving care coordination and reducing duplication of effort.

5. Ease of Use

• No Local Installation:
  • Users can access the system through a web browser without needing to install or update software on individual devices.
• Cross-Device Compatibility:
  • Works on a wide range of devices, including desktops, laptops, tablets, and smartphones, making it easier for clinicians and staff to use the system in different settings.

6. Improved Collaboration

• Shared Access Across Teams:
  • Multiple users can access and update patient records simultaneously, enabling real-time collaboration between GP practices, hospitals, and other care providers.
• Support for Multidisciplinary Teams:
  • Facilitates collaboration between GPs, pharmacists, social prescribers, and other PCN staff by providing a unified platform for shared care plans and workflows.

7. Automatic Updates and Upgrades

• Always Up-to-Date:
  • Web-based systems are updated centrally, ensuring that all users have access to the latest features, security patches, and compliance updates without manual intervention.
• Rapid Deployment of New Features:
  • New functionalities (e.g., AI tools, analytics dashboards) can be rolled out quickly to all users.

8. Enhanced Security

• Centralised Security Management:
  • Security measures such as encryption, firewalls, and access controls are managed centrally, reducing the risk of breaches due to misconfigured local systems.
• Role-Based Access Control:
  • Web-based systems can enforce strict role-based access, ensuring that only authorised users can view or edit sensitive patient data.
• Disaster Recovery:
  • Cloud-based systems typically include robust backup and disaster recovery mechanisms, ensuring data is protected and accessible even in the event of hardware failures or cyberattacks.

9. Support for AI and Advanced Analytics

• Cloud-Based AI Tools:
  • Web-based systems can leverage cloud computing to integrate advanced AI tools for clinical decision support, predictive analytics, and population health management without requiring local processing power.
• Real-Time Insights:
  • Enables real-time data analysis and reporting, helping PCNs and GP practices track performance, identify at-risk patients, and address health inequalities.

10. Improved Patient Experience

• Patient Portals:
  • Web-based systems can include patient-facing portals that allow individuals to access their records, book appointments, and communicate with their care team from any device.
• Telemedicine Integration:
  • Supports seamless integration with telemedicine platforms, enabling video consultations and remote monitoring.

11. Resilience and Business Continuity

• No Dependency on Local Systems:
  • Web-based systems are not reliant on local servers or hardware, reducing the risk of downtime due to equipment failure or power outages.
• Offline Access Options:
  • Some web-based systems offer offline functionality, allowing users to continue working during temporary internet outages and sync data once connectivity is restored.

12. Compliance with NHS Standards

• Centralised Compliance Management:
  • Ensures adherence to NHS standards (e.g., Data Security and Protection Toolkit, GDPR) through centralized updates and monitoring.
• Integration with NHS Spine:
  • Web-based systems can easily integrate with NHS Spine services (e.g., PDS, GP Connect, e-Referral Service) to support seamless workflows and data sharing.

13. Environmental Benefits

• Reduced Energy Consumption:
  • Cloud-hosted systems are typically more energy-efficient than maintaining on-premises servers, contributing to sustainability goals.
• Paperless Workflows:
  • Encourages digital workflows, reducing the need for paper-based processes.

Summary of Advantages

A 100% web-based EPR system offers significant benefits for PCNs, GP practices, and integrated care services by improving accessibility, scalability, collaboration, and security while reducing costs and administrative burdens. It supports real-time data sharing, AI integration, and compliance with NHS standards, making it an ideal solution for delivering patient-centered, efficient, and resilient healthcare.