Delivering the optometry view of the Northern Ireland Electronic Care Record

Margaret McMullan, Clinical Optometric Advisor, Health and Social Care Board, Northern Ireland

The user base of the Northern Ireland Electronic Care Record (NIECR) has been successfully extended to include community optometrists. In this video Margaret McMullan, Clinical Optometric Advisor at the Health and Social Care Board details the journey the organisation has been on to deliver the optometry view of the Northern Ireland Electronic Care Record. This includes the motivation behind it, the information accessible to optometrists through the view and some of the feedback to date.

Transcript

What is the Northern Ireland Electronic Care Record (NIECR)?  

Within Northern Ireland, the Health and Social Care Board, Business Services Organisation, and partnership with Orion Health have worked to develop and implement an optometry view in NIECR. The Northern Ireland Electronic Care Record, and in particular the optometry view of that, is a single-point reference source, a repository if you like, of information both medical and ophthalmic. Which an optometrist in primary care can use to access information about their patient. Either for the purposes of planning and for an appointment or during a consultation. 

What were the drivers to open up access to the NIECR to optometrists?  

In Northern Ireland, there were several strategic policies and other drivers to rule out access to the ECR for primary care optometry. The Department of Health Policy document, Health and Wellbeing 2026, delivering together, has many commitments. One of which was to facilitate better integration between primary and secondary care and the optometry and NIECR work stream fell very well within that piece of work. In addition, the Health and Social Care Board’s e-health strategy and plan made provision for the NIECR and the rollout to primary care optometry contractors. Developing eye partnerships was another strategic policy document. A five-year plan to improve the provision and commissioning of eye care services. Last but not least of all, ophthalmology is a very high-demand specialty within health and social care. Created I suppose if you like, a momentum whereby primary care optometrists, as key stakeholders, within that specialty and feeding into that specialty benefited greatly from access to ECR. 

When an optometrist logs into the NIECR, what do they see?  

An optometrist logs into NIECR, using generally the patient’s unique identifier, their health and care number, and following receipt of consent, which is an important part of NIECR, the optometrist will be able to view relevant medical and ophthalmic information. This would include current medications, any known allergies that the patient may have, and any referrals that have been created to ophthalmology and eye care services within secondary care. It also contains information on clinics that a patient may have attended within secondary care, either as a perhaps a one-off or on an ongoing basis for chronic conditions. So, it’s a single-point source that they can access either during a consultation or in preparation for a consultation. An association with their patient enables them to obviously be afforded continuity of care for some patients who are already within the secondary care system but also for those who may require a referral, and that information within the NIECR will help the optometrist in their clinical decision-making and discussion with the patient. 

What feedback have you had from optometrists on the NIECR, and what are your future plans?  

To date, the feedback has been very very positive. We implemented NIECR in late 2018, about nine months at this stage and to date, about 268 optometrists, which is over 50 per cent of the workforce in primary care, have availed of access to a NIECR account. Last month, there were 1000 logins, individual logins to ECR. Which is a testament to the benefit that it is bringing to primary care. Feedback has been very positive. The optometrists have advised me that they have sourced information that previously they would have found very challenging to get information on patients who have attended eye clinics, perhaps on the treatments that they’ve had, the plans for future care, etc. So, it’s been a very very welcome addition to the armoury within primary care optometry and will further support better integration and quality improvement initiatives within Ophthalmic services.