Solving the clinical data puzzle: why NHS organisations need a CDR alongside the EPR

In this blog from Maria Moors, former NHS A&E nurse and now Senior Account Manager for the UK and Ireland at BridgeHead Software, she explores the valuable role a Clinical Data Repository plays in support of the Electronic Patient Record ecosystem. Maria suggests the EPR alone is not enough to overcome the clinical data management challenges faced by NHS organisations and offers insights that challenge conventional thinking in order to facilitate efficiencies and improved patient care on the frontline and beyond.

Does an EPR give you the platform to manage all of your clinical data?

We learned at the EPR Summit last week that 91% of NHS Trusts now have an EPR (Electronic Patient Record) – albeit at various stages of their journey. But does an EPR give you the platform to manage all of your clinical data? Let’s delve a little deeper.

If your NHS Trust is like most, the EPR has solved an important part of the clinical data jigsaw. But there remains a lot of pieces still scattered around – the EPRs that may have just been replaced; the various systems that used to provide the makings of an EPR (such as old PAS applications); then there’s the siloed data from live departmental and speciality systems; and more. All that valuable patient history is largely trapped – in many cases gathering digital dust and costing you money. Notwithstanding the clinical frustrations of getting the right patient data in a timely fashion (yes, we still see the porters shifting records around from department to department).

The truth is, up to 70% of patient data never makes it into the EPR. And it’s not the EPR’s fault! EPRs are designed to handle live, transactional patient records, not the mountain of legacy data from replaced, duplicate applications or the myriad of live patient data from specialist clinical systems. That’s where a Clinical Data Repository (CDR) comes in.

A CDR is a vendor-neutral home for all your clinical data – think of it as a virtual library. With a CDR, it makes patient data living outside of the EPR easy to access, easy to search, and easy to share – all without clogging up your shiny new EPR. Whether you’re prepping for a new EPR or want to get more from the one you’ve got, a CDR can:

• Simplify data access for clinicians and support staff
• Eliminate the pain of costly and risk-prone legacy systems
• Support your data-sharing goals for your ICS and regional/clinical networks; and
• Power your AI and analytics projects.

Let’s break down why a CDR is a smart move for every NHS organisation – whether you’re EPR-ready or already EPR-ed up!

1) Break down those silos: get all your clinical data in one place

Can your clinicians see a complete patient record from one place? For most NHS Trusts, the answer is a frustrated “No”. That’s because patient data is still scattered across:

• Old EPRs and PAS systems
• Imaging systems (PACS and RIS)
• Laboratory Information Management Systems (LIMS)
• Scanned documents and other digital archives
• And more.

This data comes in all different shapes, sizes, and formats. But it was never the EPR’s job to manage these disparate sources of data. Hence the statistic that 70% of data resides outside of the EPR.

A CDR solves this by:

• Pulling together data from your disparate systems into a single, searchable repository
• Making historical records accessible via your EPR interface
• Creating a full patient record – without multiple logins.

2) Retire costly legacy systems (and stop paying for nothing!)

Still paying to keep old systems running – just because they hold patient data? You’re not alone. The NHS spends an estimated £3 billion annually on delays and reset programmes across digital change initiatives, largely due to legacy systems. A CDR lets you retire those expensive systems without losing the data. You can:

• Extract, store, and protect legacy data securely and compliantly
• Cut the cost of maintaining outdated systems (and their pricey licenses)
• Keep your data accessible for audits, subject access requests (SARs), and compliance needs.

3) Free yourself from vendor lock-in: your data, your rules!

Nobody likes being held hostage by their technology vendor – especially when switching systems which often means huge fees for data extractions and migrations each time you change. That’s where a CDR gives you back control:

• Stores your data in open standards (FHIR, DICOM, HL7) – no proprietary traps
• Simplifies future EPR (or other system) migrations – making vendor changes less painful
• Works with any EPR (EPIC, Oracle Health, MEDITECH – you name it).

With a CDR, you can switch vendors, upgrade systems, or expand your ecosystem – without losing access to your own data.

4) Unlock the power of AI, analytics, population health and secondary use

The NHS is racing to embrace AI and predictive analytics, but here’s the catch: AI is only as good as the data you feed it. And, for the NHS, data is problematic – it’s often spread far and wide across an array of disparate live and legacy applications, in a variety of formats, sometimes with incomplete or poorly structured information, and with questionable interoperability.

In a recent article, Dr Joe Zhang, Head of Data Science, Artificial Intelligence Centre for Value Based Healthcare and London Secure Data Environment, described the situation as follows: “The NHS sits on a goldmine of clinical data, but much of its value remains locked away behind clinical records software, or in unstructured form – buried within clinical notes, letters, and free-text fields. The data we have available nationally are a poor quality and shallow representation of patients, poorly suited for AI or detailed research.”

Again, this is where a CDR comes into its own. A CDR provides the foundation for the smarter use of data in healthcare by:

• Aggregating and structuring data for AI and analytics models
• Normalising records into standards, like FHIR, for easy analysis
• Powering population health initiatives with clean, complete data
• Leverages data for secondary use, e.g. clinical research, drug trials and more.

5) Stay online when your EPR goes offline

EPR outages happen – and they’re more common than you think. Whether it’s a planned upgrade, an unexpected crash or a successful cyberattack, they have the potential to bring patient care to a standstill. A CDR provides a backup plan when your EPR goes dark, providing:

• Uninterrupted access to clinical records
• A reliable, read-only view of patient history – vital during downtime
• Continuity of care, so clinicians aren’t left guessing or relying solely on paper.

With a CDR, even if your EPR goes down – your care doesn’t.

6) Support ICS interoperability and NHS data sharing goals

As Integrated Care Systems (ICSs) bed down, strategies for data sharing across care settings are essential. But if your systems don’t talk to each other, how can you access or share what you can’t even see? A CDR is the cornerstone of interoperability, providing the platform to:

• Share data across the care settings within your ICS
• Support NHS data standards (FHIR, DICOM, HL7)
• Create a single, unified patient record for system-wide access.

Why NHS organisations choose BridgeHead’s HealthStore® for their CDR

BridgeHead HealthStore® is the proven Clinical Data Repository designed and built specifically for healthcare organisations, offering:

• Vendor-neutral clinical data management – no lock-ins, ever!
• Open standards (FHIR, DICOM, HL7) – with interoperability at the heart of the solution
• Seamless EPR integration – your EPR stays the front door
• Legacy system retirement capabilities – saves considerable cost, eliminates risks, and frees valuable resources
• AI-ready structured data – powering your analytics, machine learning and AI projects
• Leverages data for secondary use – enabling clinical research, population health management, and service planning.

BridgeHead is trusted by over 1,200 hospitals globally. BridgeHead’s HealthStore® CDR has helped organisations:

• Reduce financial, operational, security and reputational risk
• Save significant cost by retiring legacy systems
• Accelerate AI and analytics initiatives
• Improve care through better access to patient records.

The Smart Move: EPR + CDR = Complete Patient Care

So, in conclusion: is a CDR the missing piece to the clinical data jigsaw puzzle for your Trust? Absolutely – whether you’re rolling out a new EPR or trying to maximise the one you already have. To recap, with a Clinical Data Repository, your NHS organisation can:

• Unify patient records – silos gone, clarity gained
• Retire legacy systems – stop paying for what you don’t need
• Stay vendor-neutral – your data, your rules
• Power AI and analytics – smarter care, better outcomes
• Ensure continuity of care – even when your EPR is down
• Support ICS goals – with data that’s ready to access and share.

Maria Moors has over 20 years of experience in healthcare and health IT, combining clinical expertise with a strong background in healthcare technology. As Senior Account Manager at BridgeHead, Maria is working with organisations across the UK and Ireland to optimise their clinical data management strategies and drive digital transformation initiatives.

 

Maria began her career as an Accident & Emergency nurse, spending 11 years on the frontline of patient care. Before joining BridgeHead, Maria also worked for Philips, Hyland, and GE – specialising in Enterprise Imaging and healthcare informatics.

 

Maria lives in Berkshire with her husband and son. In her spare time, she enjoys walking her dogs, singing, and is the Welfare Officer for two local grassroots football clubs.