Urgent need to update health’s record system

Electronic health records are digital versions of the old paper charts and they mean that information is available instantly and securely to authorised users.

The best systems include patient details such as symptoms, payments, X-rays, prescriptions, allergies, hospital stays and social worker visits.

Guernsey already uses a digital system, but the current one has been described as ‘ageing and increasingly vulnerable’ with ‘operational risks for vital services’.

Because of the way most electronic health record systems are built, it can take a clinician a long time to get a clear picture of the patient in front of him or her.

That is because a patient’s electronic health record can be split into different sections.

Some information can be under the problem list, some under medications, some under imaging, and so on.

The essential timeline of health data can be lost and this may mask underlying vulnerabilities because it is difficult to reassemble a patient’s data into a cohesive narrative, causing an incorrect view of the patient’s risk for Covid-19.

Data sharing across platforms and with patients is also regarded as essential, especially during a disease outbreak.

Information from diagnostic tests, the locations of confirmed positive cases and treatment results are all streams of data which should flow as freely as possible without sacrificing privacy or other essential elements of ethical care and research.

Health & Social Care was already looking at updating the existing electronic system, and the global pandemic has accelerated those efforts.

The current system being used is called TRAKcare 2012 and is provided by a company called Intersystems, but the support contract is due to end on 31 March next year.

Within the plans submitted by HSC, the importance of a good digital system is underlined.

‘Without the urgent identification of a new EPR solution, the States is at risk of not having an effective and reliable means of resolving a potentially increasing frequency of system issues.

‘The possible impact that any resulting downtime might have on crucial services and patient care would be unacceptable at any point but given the evolving global picture in respect of Covid-19, it is particularly untenable at this time.’

A procurement process is under way and it is anticipated that the capital cost – including software, hardware and implementation – would be between £15m. and £20m.

HSC has recommended that the funding could come from the island’s capital reserve account, which currently has a balance of more than £200m.

It is asking the States to sign off delegated financial authority to itself and Policy & Resources so that issue is not held back by bureaucracy.

A key improvement would be that islanders would have access to their own health data.

The new system would not be simple to implement and the idea is that it would be rolled out in phases over 18 months.