NHS Interoperability and EPRs

EPRs, Shared Care Records and Interoperability in the NHS

In June 2026, Chris Gillies, Pre-Sales Application Specialist at iMDsoft, joined clinical and digital health leaders from across the NHS to discuss a persistent problem in healthcare technology: the gap between systems that are technically connected and systems that are truly interoperable.

The session was hosted by the EPR Network and HIC as part of the InsightHive webinar series and included perspectives from BridgeHead Software, FDB UK, and Orion Health. The full recording is below, along with the key points for critical care.

What You’ll Learn

• The difference between connected and interoperable systems.
• Where interoperability gaps show up in real clinical workflows, and what they cost.
• Why accountability for interoperability is shared across vendors, providers, and the broader system.
• What good interoperability looks like in practice, and where it already works.

Connected Isn’t Interoperable

You can have two systems passing data back and forth and still hit a wall when someone tries to actually use it.

That’s the gap the panel started with. Chris gave the critical care view: data moving from one system to another has to land in a usable state, keep its meaning, and not pile more work on the people receiving it. As he said: “It should be a smooth, safe transfer of information. We shouldn’t be having clinicians having to duplicate information or work on that information again on the other side.”

For clinicians: Data showing up on a screen isn’t the same as data you can act on. If you have to re-read, re-enter, or reconcile it by hand, the systems are connected but not interoperable.

For IT and informatics leaders: Transfer is the easy part. The hard part is holding onto meaning and context so the system on the other end can use what it gets, not just show it. Integration that stops at transfer leaves that undone.

The Cost in Critical Care

Chris illustrated this with his own background: the handover between the ward and the ICU, and back again. It’s a high-risk moment for a patient, and it’s precisely where interoperability can break down.

Consider medications. When that data doesn’t move cleanly between a critical care system and the wider trust EPR, someone has to re-enter it by hand. That takes time, and it opens the door to error. As Chris put it: “The transcription process that clinicians endure causes frustration because why should you have to do it again? But also, causes a risk of interruption, which leads to mistakes.”

The consequences follow the patient. A medication gets stopped when someone comes into critical care, with a plan to restart it later. That plan lives in the critical care system. The patient then moves back to a ward that’s running on a different system, and the plan doesn’t come with them. Follow-up instructions, imaging, rehab plans, the same thing happens to all of it at the point where the two systems meet.

That’s the shift Chris was pushing for: interoperability isn’t only an IT issue. When it’s missing, in his words, it’s “actually a clinical risk by not having it.”

Accountability Is Shared

When the panel was asked who’s responsible for interoperability, the answer was everyone. That’s what makes it so difficult. Ian Binks of Orion Health named the trap: if it’s everybody’s responsibility, it can end up being nobody’s.

The point was that every party has a role. The center has to set standards and hold the market to them. Vendors have to build to those standards and open up their data instead of locking it away. And the people using these systems have to think about how their work affects the next person in the chain.

For clinicians: When data is missing or misread at the point of care, it’s the clinical team and the patient who feel it first. That’s what makes the problem so crucial to solve.

For IT and informatics leaders: No single party owns the outcome. Progress needs standards from the center, open data from vendors, and clinical leaders driving the specifics, which was the combination the panel kept tying back to the projects that actually work.

Shared Records Need Shared Standards

A shared care record is only as good as the data inside it. If that data isn’t consistent, the record can’t be trusted the same way across every place that reads it.

The panel’s take was that the standards mostly exist: FHIR, SNOMED, dm+d. The challenge is getting data into that shape in the first place. A standards-compliant wrapper gets the data from one system to another, but the receiving system still has to understand it and act on it. That’s where the real effort sits.

For clinicians: A shared record only helps if what’s in it means the same thing everywhere it’s read. Getting the data right at the point where it’s entered is what makes that possible.

For IT and informatics leaders: The NHS interoperability agenda rests on data quality at the source. Critical care, where documentation is constant and highly structured, is well placed to feed that agenda rather than hold it back.

Where It Already Works

One of the more useful things to come out of the session: interoperability already works in plenty of places. And when it does, nobody notices, because the data is simply there when it’s needed. The panel’s point was that it’s worth studying where it works and why, not just where it breaks.

The projects that succeed tend to share a few things: strong clinical leadership, real adoption of standards, and close, ongoing work between NHS organizations and their suppliers. The ones that get it right aren’t trying to fix everything at once. They’re taking practical steps, with a clear sense of where they’re headed.

When evaluating a clinical system for a connected environment, it helps to look past whether it can send and receive data. The more useful question is what happens once the data arrives. Does it keep its structure and meaning, and can the receiving system use it without asking a clinician to re-enter what’s already been recorded? Sending and receiving is just the starting point. What the data looks like on the other end tells you more.

FAQs

• What's the difference between connected and interoperable systems?

  Connected systems can exchange data. Interoperable systems go further: the data arrives usable, keeps its meaning, and doesn't require clinicians to re-enter or reinterpret it. That distinction is central to how EPRs and shared care records function across the NHS.

• Why does interoperability matter most at the ICU-ward handover?

  The handover between critical care and the ward is a high-risk moment for patients, and where interoperability gaps often surface. When medication and care plan data doesn't move cleanly between systems, clinicians end up re-entering it by hand, adding time and risk of error.

• Who is responsible for NHS interoperability?

  Responsibility for NHS interoperability is shared across the system, which is part of the challenge. The center has to set and enforce standards, vendors need to open up their data, and clinical teams need to consider how their documentation affects the next system down the line.

About the Speakers

Chris Gillies, Pre-Sales Application Specialist, iMDsoft. Chris spent 15 years nursing in the NHS, including 12 in critical care at Sheffield Teaching Hospitals NHS Foundation Trust. He now uses that clinical background at iMDsoft to bridge clinical and digital workflows, running live MetaVision demonstrations for clinical teams across the UK.

Maria Moors, Account Director, BridgeHead Software. 25 years across healthcare and health IT, and a former A&E nurse with 11 years on the NHS front line.

Amy Smith, Market Manager, Secondary Care, FDB UK. 15 years in digital health, focused on medicines intelligence and clinical decision support across NHS EPRs and shared care records.

Ian Binks, Business Development Director, Orion Health. Nearly two decades in health technology, focused on connected and personalized care.

The EPR Network and iMDsoft

This webinar was produced as part of the InsightHive series by the EPR Network, an industry-funded community founded by HIC (Healthcare Innovation Consortium) to improve digital integration across the NHS. iMDsoft is a member, alongside Alcidion, InterSystems, System C, Orion Health, and others. Learn more about the network here.

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