Importance of equity in configuration of NHS electronic patient records

Nearly every hospital in England now has an electronic patient record (EPR) system, offering a significant opportunity to enhance data on equity. Whether this potential is realised depends on how these systems are configured, specifically which fields are activated, which categories appear in menus, and how patient-facing features are enabled. The NHS in England procures EPR systems trust by trust, leading to localised configuration decisions and variations in the data recorded. Scotland, Wales, and Northern Ireland operate separate health services and have adopted different approaches, though configuration challenges arise wherever commercial EPRs are deployed. The configuration of an EPR system determines which patients the system can describe and which services they can access. These decisions are crucial for monitoring and ensuring equity, defined as the absence of avoidable differences in access and health outcomes among groups based on characteristics such as ethnicity, socioeconomic deprivation, gender identity, sexual orientation, disability, and language.