Table 2 Current state of EHR interoperability

“You can't rely on it having a complete set of data, so you still need to talk through with the patient, but it does alert you to things which are there. There are still risks. You still need to check that medications are correct because there's holes in the medication record there, because that's just the GP record, but it doesn't tell you anything about someone who might be under the drug and alcohol service for example, because that's a different service and doesn't feed into our record. It doesn't tell you if a secondary care physician, even in the same hospital, has given them medication on an outpatient discharge or anything like that, so the risks are more about the data that isn't there, and not being aware that that data isn't there.” – Participant 10

“Yes, so we have lots of sticking plaster interoperability. […] I can view some of your healthcare information online. I may see some of your primary care information, I may see that you've had an episode of care at another site. I wouldn't be able to see the details of it. So, we're creating ways to view information, but it's not interoperable. We're not sharing the information. That's pretty much the state of play. It's very limited data transfer.” – Participant 12

“We are in a position of the absence of information is not instructive. It didn't mean you didn't have your blood pressure checked, it just means that the GP might not be sharing that yet, or something like that. […] I don't know what I don't know. There is no meaningful information sharing between secondary care sites.” – Participant 12

“If we had a fully national interoperable approach to data, then I would be able to change the way I work, because I would be able to look at your record, in confidence, and know that is a single version of the truth. I therefore do not need to do all these things. At the moment, because I do not have that trust, and no one has that trust, we look at it, but we still do the full A to Z assessment.” – Participant 12

“I think if you were to say the word 'interoperability' to most clinicians, they would have no idea what you meant. Certainly, the interoperability of data, if you took it away, they would certainly understand what you meant by it because they would suddenly find that the electronic health record, without that interoperability—the order communications and results section of our EHR would disappear.” – Participant 13