The following critical appraisal case studies have been sourced from recent exemplar implementations and cover a range of business capabilities. They provide an opportunity for CIOs, CCIOs, IT teams and others to study and learn from detailed analysis and research carried out on a variety of national and international exemplars.

United Kingdom


The Connecting Care Programme has implemented a read-only shared care record across Bristol, North Somerset and South Gloucestershire. The record is used to share information across a range of health and care settings and support the provision of integrated care.

The solution uses the Orion Health technology platform.



The Cheshire Care Record is an integrated care record solution that shares information across a range of health and care settings. The record is used to support clinical decision making and transfers of care. The former West Cheshire Record was extended across the whole of Cheshire in 2016.

The Cheshire Care Record uses Graphnet CareCentric v.3 software.

East London

The east London Patient Record (eLPR) shares ‘read-only’ patient records across health and community organisations in the 5 London boroughs of Waltham Forest, Newham, Tower Hamlets, Hackney and City of London, as well as with GPs in West Essex.

The Health Information Exchange (HIE) has been implemented to facilitate continuous improvement in the delivery of direct patient care.

Greater Manchester

The Greater Manchester Academic Science Network Partners (AHSN) have implemented a Lumira data sharing solution to support the devolution of health and care services to Greater Manchester. This is part of the regional interoperability programme called DataWell. At the current scale, the solution enables sharing of pathology information between healthcare organisations, viewable through mobile devices.

The solution implementation is in progress with a final Go-Live date of May 2018.


The Hampshire Health Record (HHR) is a shared care record that shares information about 1.9m patients across a range of health and care settings. The record is used to support clinical decision making and transfers of care. A second database was deployed with the solution which uses pseudonymised data to support research and population health planning.

The Hampshire Health Record uses Graphnet’s CareCentric software.

Lancashire Partners

The Lancashire Person Record Exchange Services (LPRES) allows sites to share patient documents with participating sites. LPRES also developed an online information governance tool for managing information sharing agreements between sites.

The solution deployed is a HIE Tiani Spirit Exchange platform and it connects 9 sites and 228 GPs.


Lincolnshire Health and Care (LHAC) have deployed a shared care record solution that currently shares information from 3 of their acute hospital trust’s systems. The Lincolnshire Care Portal will be used to support the delivery of integrated care through multidisciplinary teams. It will be fully operational in May 2017.

The Lincolnshire Care Portal uses InterSystems’ Healthshare Solution.


Connected Nottinghamshire is the interoperability programme for Health and Social Care in Nottinghamshire. The programme has implemented a Medical Interoperability Gateway (MIG) solution to share information from primary care with 9 other health and community organisations.

Connected Nottinghamshire has also implemented a solution for information sharing and risk stratification known as eHealthScope.


New York City

The Health and Human Services (HHS) –Connect programme was established by New York City to transform the city’s health and human services. The programme implemented a shared care management system to break down information silos between social care providers.

The platform shares citizen information between 10 different agencies and provides citizen access, to improve services for families.


Singapore’s Ministry of Health Holdings (MOHH) initiated the National Electronic Health Record (NEHR) program to improve healthcare quality and patient safety, lower healthcare costs and develop more effective health policies.

The NEHR currently enables patient health records to be shared across the nation’s public healthcare ecosystem.