North Bristol NHS significantly reduces costs

North Bristol NHS  selected CCube Solutions’ EDMS to complement its Lorenzo EPR system as part of a Trust-wide paperlite strategy. The EDMS is an ‘invest to save’ initiative which uses a scan0n-demand model to digitise patient medical records. The system will pay for itself based on a reduction in operating costs with over £1.3 million saved within 4 years.

The introduction of EDMS is part of the Trust’s phased EPR strategy and will facilitate a more extensive move towards creating a paperlite environment which also involves developing its EPR to reduce the amount of paper created on a daily basis. The choice of CCube Solution’s EDMS will complement and augment a Lorenzo EPR solution which was implemented in November 2015.

Neil Darvill, North Bristol NHS Trust’s director of informatics, says, “The business case for the EDMS project is predicated on a scan-on-demand model where only the patient notes for people booked to attend clinic will be processed, not everything in the library. This saves a huge amount of money given the other records will be destroyed in line with our retention policies and procedures as and when they reach their expiry dates.”

Out of its total of 1.2 million folders, the Trust therefore estimates that it has 223,1o0 active patients who will need their records scanning. As each folder contains on average 150 sheets, this means 33,465,000 pages are likely to be scanned in total. The massive back scanning task will be outsourced to a scanning specialist.

Darvill explains, “Our analysis shows that 70% of active patients have follow up appointments after an initial consultation. Once their records are scanned, it means for any subsequent visits, their records are available on the system for clinical staff to see.”

In parallel, the Trust is working on a paperlite project to augment the investment in its EPR system. To date, PAS functionality has been successfully implemented within Lorenzo with this now expanding to include real-time data capture. The Trust will customize Lorenzo to its own requirements, tailoring the system to match its own clinical pathways and ways of working.

Darvill explains, “We simply can’t afford to keep generating paper at the pace we are given the number of patients we see – around 1,300 outpatient and 200 inpatient attendances each day. The paperlite project will look at how we capture clinical information immediately at the point of care rather than writing notes on paper and scanning them afterwards.”

Until the paperlite initiative has evolved, so-called ‘day forward’ scanning will be managed in-house. During this period of transition, the Trust has purchased production scanners from Kodak Alaris which process up to 150 pages per minute.