Healthcare and Interoperability

The Challenge

At the turn of the century, the health records of UK citizens were often held locally, with the result that there was no coordinated system. “Although electronic health records (EHRs) are widely viewed as central to modernising the organisation and delivery of sustainable, high quality healthcare, the uptake of such records in hospital has tended to be slow. Approaches to deployment of EHRs vary from home-grown systems in single organisations with the necessary technical and managerial capacity; to interoperability standards for linking multiple information technology (IT) systems; to top-down, government driven, national implementations of standardised, commercial software applications.” [Source: CfPI]

Electronic Health Record

An electronic health record (EHR), or electronic medical record (EMR), is the systematized collection of patient and population electronically-stored health information in a digital format. These records can be shared across different health care settings. Records are shared through network-connected, enterprise-wide information systems or other information networks and exchanges. EHRs may include a range of data, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information.

EHR systems are designed to store data accurately and to capture the state of a patient across time. It eliminates the need to track down a patient’s previous paper medical records and assists in ensuring data is accurate and legible. It can reduce risk of data replication as there is only one modifiable file, which means the file is more likely up to date, and decreases risk of lost paperwork. Due to the digital information being searchable and in a single file, EMRs are more effective when extracting medical data for the examination of possible trends and long term changes in a patient. Population-based studies of medical records may also be facilitated by the widespread adoption of EHRs and EMRs.

UK Providers


Emis – Egton Medical Information Systems – has been central to implementing EHRs in the NHS, ever since it started operations in the 1980s when Dr Peter Sowerby and Dr David Stables wrote the software for their GP practice in Egton in North Yorkshire.

Today, the company claims that more than half of GP practices across the UK use Emis software, with more than 35m patient records being handled by the technology. In 2009-10, the firm was the sixth biggest supplier to NHS Connecting for Health, which spent £27.5m with the company in that financial year.


US-based Cerner has been working with the NHS for more than two decades and its flagship EHR system, Cerner Millennium, has so far been installed across 16 trusts and more than 70 hospitals since being launched in 2004, as the preferred NPfIT software for London. It also supplied the software for NPfIT’s Choose and Book appointment scheduling system, which processed more than 15m patient bookings during 2009.


The second major firm offering EHR systems to the NHS is Australian company iSoft Health, which is currently in the process of being bought by US IT firm CSC. They are a good fit: CSC has been installing iSoft’s Lorenzo suite in trusts across the north, Midlands and east of England under NPfIT, for which it holds the local service provider contracts. iSoft has a total customer base of more than 13,000 health organisations in more than 40 countries. [Source: The Guardian]

IMS Maximus

IMS MAXIMS is a supplier of electronic health record software to the public and private sectors in UK and the Republic of Ireland.

As of December 2016, its products were in use across 180 healthcare organisations, by 30,000 users each day for 13 million patients.

The Future – Interoperability

INTEROPen is an OPEN collaboration of individuals, industry, standards organisations and health and care providers, who have agreed to work together to accelerate the development of open standards for interoperability in the health and social care sector.

Two jigsaw pieces being put together INTEROPen aims to provide a forum to collaborate on the design and application of technical interoperability standards. The areas covered by the group include data exchange, data validation, defining APIs and governance. It is an action group whereby members commit to design, validation and demonstration using real systems.

See Also

API – Application Programming Interface