Streams, rivers and data lakes: an introduction to understanding modern electronic healthcare records

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Editor – It is encouraging to read the works being undertaken to identify and analyse processes of digitalisation in healthcare systems.¹

The authors identify inefficient and inaccessible medical information between trusts through differing digitalisation models. Concurrently, they highlight a lack of mainstream facility to communicate and integrate these. This raises the need for insights as to why there is not a single unified digital system in place for the NHS as it seems to be the clearest solution for the issues raised in your article. Indeed, a recent article published by the Boston Consulting Group² references ‘core enablers for digital – physical patient care’, outlining six key enablers for successful digitalisation. Using these as a framework it becomes apparent that the NHS is in a strong position to adopt a unified system.

Of note, there is a clear ‘ecosystem’ in the NHS through the commercial medicines unit (CMU) which makes deals applicable for the entire service and is responsible for buying and securing the supply of medicines prescribed in NHS hospitals in England.³ Such deals ensure hospitals pay equivalence for medications within the NHS.

As such, would it not be feasible for the NHS to set up a parallel body to the CMU to ‘buy and secure’ the supply of electronic patient recording systems from one provider for all hospitals thereby creating a seamless service whilst ensuring clinicians have necessary access to patient history?

Another key strength for this is that the current crop of monolithic electronic system providers are well established, meaning they have real-world experience of creating easy-to-use systems with several iterations of improvement in user experience and interface (some have several apps in addition to their main platform, including for patients, eg for taking clinical images) leading to better user satisfaction for both patients and clinicians.

The opportunities raised from a comprehensive and fully integrated digital healthcare system in terms of research, efficiencies in clinical activity and (to be truly forward thinking) incorporation of AI technologies, amongst others, highlight it as an investment worth making and it will be interesting to see the path taken by healthcare providers.