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Northern Ireland Electronic Care Record, including patient portal

The NIECR is a web-based portal system using Orion Health technology which gives health and social care professionals a single, secure overview of key information about their patients or clients. It extends to the entire Northern Ireland population of 1.8 million. Previously, information was held on paper and a variety of electronic systems across Northern Ireland’s Health and Social Care system, which meant that health and social care professionals had a fragmented view of service user information. NIECR solves this problem by aggregating the information already held on clinical systems across Northern Ireland without the need to replace those existing source systems. This aids better, faster, safer decision making and improves the quality and efficiency of the services provided. NIECR enables the secure communication and sharing of key patient data by integrating 500,000 daily messages in real-time from the following HSC systems across acute, community, primary health and social care: • 8 Patient Administration Systems - Encounter details • 8 clinical documents systems • 10 Emergency Department systems • 5 Out of Hours providers • 6 Laboratory systems • 3 Radiology systems • 350 GP systems – Drugs, Allergies and eReferrals • Master Patient Index A patient portal facility is currently being implemented as part of NIECR. Known as My Care Record the portal gives patients access to view specific information regarding their healthcare in a digital format. Through the portal patients can view hospital appointments, have access to a relevant health library, engage with clinicians in goal-setting and document-sharing and view personal information on medication and laboratory results.
Background
Geographical scope: 
Regional level
Region involved:
Countries involved:
Organisation
Organisation name: 
Business Services Organisation
Organisation address: 
2 Franklin St. Belfast BT2 8DQ Northern Ireland ...
Kind of organisation: 
Regional public authorities
Viability
Time for deployment: 
More than three years
Preparation of implementation: 
There were a number of steps involved in developing the ECR solution. These included; • A robust specification design and procurement process fo identify a 3rd party suppler to partner HSC on the project • Identification of clinically led Project Board and work streams to manage the project. •...
Investment per citizen / service user / patient: 
Between 100 – 1.000 EUR per targeted citizen / patient
Cost calculation: 
The total cost of the project over 9 years was £22m (approx. £11m capital expenditure and £11m revenue). Within the Northern Ireland health and Social care service there are currently 1.1m users registered on the system. This equates to approximately £20 per user. ...
Evidence of practice: 
Documented evidence. Evidence is based on systematic qualitative and quantitative studies
Evidence creation: 
Pre project research _ Proof of Concept • 94% of clinical ECR improved the quality of patient care; • 89.5% of users ECR improved patient safety; • 83% of doctors reported a better clinical outcome • Evidence of a reduction in unnecessary admissions and appointments; • Reduction in duplication...
Maturity level: 
The practice is “on the market” and integrated in routine use. There is proven market impact, in terms of job creation, spin-off creation or other company growth.
Maturity level detalis: 
NIECR has now been fully implemented across all Trusts and primary care providers within the NI HSC. Review and refining of the information is ongoing, and the legal basis for consent is being reviewed given recent changes to legislation. Additional roll outs to NI Ambulance Service and...
Time of impact: 
Long term and sustainable impact – e.g. a long time after the pilot project ended and routine day-to-day operation began
Kind of impact: 
Better care integration (economic and societal)
Aspects time of impact: 
An NIECR Benefits Review has been commissioned. A snapshot of this research includes; • 98% of service users felt that NIECR had improved patient safety • 97% felt that NIECR had improved the quality of patient care • 96% felt that the project had resulted in a better clinical outcome at least...
Transferability level: 
Ready for transfer, but the innovative practice has not been transferred yet. The innovative practice has been developed on local/regional/national level and transferability has been considered and structural, political and systematic recommendations have been presented. However, the innovative practice has not been transferred yet.
Transferability details: 
Discussions are ongoing to explore transferring the NIECR solution to a Diabetes Strategic Solution in a NHS Foundation Trust in England. These discussions are at a very early stage
Initiative
Type of Practice: 
Good practice
Stakeholders concerned: 
Hospitals
Primary care centres
Specialised physicians
General practioners
Pharmacists
Nurses
Regional public authorities
Reach of initiative: 
> 100,000
Age group: 
Irrelevant
Baseline information: 
The Northern Ireland Health and Social Care service (HSC) makes use of a wide range of clinical information in order to allow clinicians to make the best decisions about care or service. Much of this was in an electronic format, including laboratory results, radiology, admission information, GP...
Source of funding: 
Regional funding