In an exclusive interview, senior vice president and global lead for EHR implementation at Nordic Consulting, Alison MacDonald, has told Digital Health News that the UK electronic patient record market will not be dominated by one single system, but that we will “start to see consolidation”.

Nordic Consulting is an award-winning strategic partner to health leaders across the globe, helping them navigate complexity and harness technology to create healthier systems, businesses and people.

As global lead for EHR implementation, MacDonald looks at end-to-end implementation of EPRs, which includes input in business case development, and because of her clinical nursing background, representing clinicians to make sure that the clinician voice is heard.

She provides advisory support to clients and has worked with all of the major venders, including MEDITECH, Cerner/Oracle and Epic, as well as some smaller vendors.

The EPR market in the UK is an ever-changing landscape, with more suppliers and vendors coming to the fore, much like in other areas of the world according to MacDonald.

“I’ve done EPR implementations across the globe and Nordic has a global perspective on it. I think when you look at what’s happening in the UK, I’m not shocked. It’s pretty similar to what we’ve seen the landscape look like across the globe, where you have some specialised vendors in the market that are really focused on the UK, but then you start to see some of the other vendors coming from North America,” she said.

MacDonald explained that because vendors from the US have had more time to mature their product, they are able to come into the market and have the ability to dominate because of the suite of functionality that they can offer.

How the UK EPR market will evolve

MacDonald stressed that there is no chance that one single EPR will dominate the market, but that various organisations will use the same system.

“I don’t think you’re ever going to see a situation in the UK where one system dominates, but I think you’re going to start to see consolidation. If you look at what’s happening with the ICSs, there’s a lot more benefit to having multiple organisations using one system, rather than trying to use interoperability solutions,” MacDonald explained.

Nordic’s senior vice president highlighted the news that came in November that the government has met its target of 90% of NHS trusts having an EPR in place ahead of the original December 2023 deadline, but pointed out that having an EPR in place is very different to having all of the functionality deployed.

“While they have EPRs, according to the criteria it is really only about 10 to 30% of the trusts using full functionality. What we’re going to see is similar to what we’ve seen in other jurisdictions, where the sites that really get it, you will see a lot more of what we would classify as ‘big bang’ in EPR implementation, so they take everything at once and then they optimise from there.

“Then I think the organisations that don’t have full functionality, you will see them playing catch up,” she added.

“I think the focus is really going to be on optimisation and making sure that you’re focused on adoption and then data quality,” MacDonald said.

She concluded: “I think the other thing we’re going to see, and we’re already starting to see, is around cloud and hosting. What we’re seeing in some of the more mature markets across the globe, is using that data and using that cloud infrastructure to come up with some really creative ways to solve clinical problems within the healthcare sector.

“So using that data, creating data lakes, doing really interesting things with AI and research. That’s what you’re going to start to see.”