Connecting a Nation: How HSCNI Unified Digital Care Across Northern Ireland to Reduce Medication Errors by 35 and Deliver £12M in Projected Annual Savings 

Health and Social Care Northern Ireland (HSCNI) is leading one of the most ambitious digital health transformations in Europe through the encompass programme; implementing a single, unified electronic patient record across an entire region.  

To support this effort, HSCNI deployed the Rhapsody integration platform as the interoperability backbone connecting more than 60 systems, 625 communication points, and over 2.5 billion messages across hospitals, community services, laboratories, imaging systems, and care settings throughout Northern Ireland.  

The initiative successfully migrated more than 85 million patient records with 99.8% accuracy, integrated 1,478 medical devices and 44 legacy systems, and now supports more than 850,000 daily healthcare transactions.  

Today, encompass provides a unified digital care record across all Trusts in Northern Ireland, helping reduce time to access patient records by 60%, decrease medication errors by 35%, and support projected annual operational savings of £12 million from legacy system retirement.

Northern Ireland is advancing toward a unified, digitally connected health system. 

Through the encompass programme, HSCNI is replacing fragmented legacy systems with a single, region-wide electronic patient record, designed to support clinicians, improve care coordination, and create a consistent experience for patients across all care settings. 

This “once for Northern Ireland” approach represents more than a technology upgrade. It is a fundamental shift in how care is delivered, connecting hospitals, community services, and care teams through a shared, longitudinal view of patient information. 

“Our goal was to create a system that works seamlessly across the entire region, connecting people, processes, and data to support safer, more efficient care,” said Dr. David Wilson, encompass Senior Responsible Owner and Consultant Physician within the HSC 

Delivering on that vision required more than selecting a new EHR. It required building the infrastructure to support data exchange at national scale. 

Unlike many healthcare organizations, HSCNI was not modernizing an existing integration environment, it was building one from the ground up. 

The challenge was not legacy complexity, but coordination, data volume, and risk management.  

The programme required coordinating integrations across: 

• 11 acute hospitals
• 13 community hospitals 
• Hundreds of community care sites 
• 44 legacy systems 
• Thousands of end-user and medical devices 

All while maintaining operational continuity during phased regional go-live events. 

“When you’re delivering a transformation of this scale, there is no margin for error. Every integration, every workflow, every data exchange has to work as expected, because patient care depends on it,” said Dr. David Wilson. 

With a four-phase regional go-live approach, even minor delays or integration issues could create significant operational pressure. 

This required an integration strategy that was not only scalable, but predictable, resilient, and tightly governed. 

From the outset, integration planning was treated as a critical enabler of the encompass programme. 

HSCNI established a structured approach focused on: 

• Early identification of integration scope and dependencies 
• Close collaboration with Epic and delivery partners 
• Strong stakeholder alignment across Trusts and vendors 
• Clearly defined milestones and delivery governance 

At the center of this strategy was the selection of an integration platform capable of supporting a regional rollout at scale. 

Following evaluation, HSCNI selected the Rhapsody Integration Engine to underpin its interoperability architecture. 

“We needed a platform that could operate at enterprise scale, deliver consistent performance, and provide the resilience required for a transformation of this magnitude,” said Fergus Wills, Senior Solutions Architect, encompass. “Rhapsody gave us the confidence that we could build and scale our integration environment in a controlled and reliable way.” 

Rhapsody now serves as the core integration infrastructure for the encompass programme, connecting systems, enabling data exchange, and supporting clinical workflows across Northern Ireland. 

The scale of the deployment includes: 

• 60+ connected systems 
• 625 communication points 
• 250+ bespoke interface translations 
• More than 2.5 billion messages processed 

This level of scale required not only performance, but sustained reliability across all phases of deployment. 

“The volume and complexity of data exchange across the programme is significant. Having a platform that can handle that scale while maintaining stability has been essential to our success,” said Fergus Wills. 

Through each phase of go-live, Rhapsody enabled the team to manage integrations with confidence, supporting both new and evolving workflows as the Epic environment expanded. 

The encompass programme is already delivering measurable operational and clinical improvements across Northern Ireland’s Health and Social Care system. 

Reported outcomes include: 

• 60% reduction in time required to access patient records 
• 35% reduction in medication errors 
• More than £12 million in projected annual savings through legacy system retirement 
• 99.8% data migration accuracy across more than 85 million records 
• Integration of 1,478 medical devices and 44 legacy systems into a unified digital environment 

The initiative also established a single EHR platform across all Trusts, improving visibility, coordination, and continuity of care across acute, community, and social care environments. 

Rhapsody played a critical role in supporting HSCNI’s phased go-live strategy, ensuring a smooth transition to the new integration landscape without disruption to clinical operations. 

“The ability to transition safely between phases while maintaining continuity of care was fundamental. The integration platform provided the stability we needed at every stage,” said Fergus Wills. 

With continuous monitoring and strong architectural design, HSCNI maintained high levels of system availability throughout deployment, mitigating the risk of downtime and ensuring consistent performance under load. anded. 

As a newly established integration team, HSCNI quickly ramped its capabilities using the Rhapsody platform. 

The intuitive development environment and structured workflows enabled: 

• Faster interface development 
• More controlled testing cycles 
• Increased team confidence 

“Our team was able to move from initial builds to structured testing much faster than expected. As familiarity with the platform grew, so did our confidence in delivering complex integrations,” said Fergus Wills. 

Beyond go-live, Rhapsody has become a foundational component of HSCNI’s digital ecosystem, supporting not only current operations, but future innovation. 

With Epic now live across all Trusts, HSCNI is focused on expanding and optimizing its digital capabilities. 

Rhapsody continues to serve as the national integration layer, enabling: 

• API- and FHIR-based interoperability 
• Seamless data exchange across systems and care settings 
• A unified, longitudinal digital care record 

“We now have a national-scale digital foundation capable of supporting future interoperability, analytics, patient engagement, and AI-driven innovation across Northern Ireland,” said Dr. David Wilson. 

Looking ahead, HSCNI’s priorities include: 

• Optimizing Epic across all Trusts 
• Expanding patient access through the My Care portal 
• Strengthening cross-sector integration 
• Advancing analytics and digital workforce capabilities 

At the same time, the organization is continuing to invest in: 

• API and FHIR adoption 
• Integration monitoring and resilience 
• Internal capability development 

Delivering a single digital care record for an entire region requires more than a modern EHR. 

It requires an integration foundation capable of operating at scale, maintaining stability under pressure, and supporting continuous transformation. 

With Rhapsody, HSCNI has built that foundation, enabling not only a successful Epic rollout, but a future-ready platform for connected, data-driven care across Northern Ireland.