Interview, News

Interview Series: Constantin Jabarin and James Hodgin, Allscripts

In our latest interview, we speak to Dr Constantin Jabarin, chief clinical information officer, EMEA and James Hodgin, solution director, EMEA from Allscripts, the company behind the Sunrise Acute Care electronic patient record and the dbMotion information sharing platform.

We talk about how the solutions have been supporting The Dudley Group NHS Foundation Trust and Gloucestershire Hospitals NHS Foundation Trust during the coronavirus crisis, discuss what’s coming up in the next 12 months, and get some top relaxation tips and careers advice.

Constantin started as a paediatrician before moving into emergency medicine. As well as his role at Allscripts, he also works part time as a doctor. James has a background in pharmacy and is responsible for the solution portfolio, working with healthcare organisations to enhance their systems.

How have you responded during the COVID-19 crisis?

James: Our priority has been to support our clients in managing their patients’ care during the COVID crisis. In the early stages of the outbreak, we held a COVID workshop to allow our clients to come together as a group to highlight things they were doing, so other trusts could benefit from their work.

Trusts were able to configure Sunrise to support the treatment of COVID-19 patients and to display their statuses on tracking boards. They did an amazing amount of work in a short time, and it is a testament to the flexibility of our solution that they were able to do that.

We also accelerated the rollout of deployments planned for later in the year, because there was an immediate need for access to clinical data across acute and primary care settings.

We also offered a series of enhancements to our solution portfolio. It was clear that analytic capabilities were key to organisations understanding the impact of COVID and helping plan responses, map out resource and report on statistics. As such, we created a series of reporting tools based on current platforms that were offered to our Sunrise and dbMotion clients.

Could you take me through how you supported The Dudley Group NHS Foundation Trust during this time?

Constantin: The Dudley Group is using Sunrise Acute Care and deploying the dbMotion information sharing platform. At the start of the year, it was running a proof of concept trial of dbMotion, but as patients with COVID-19 started to be admitted, its plans were accelerated.

To support the medical teams, medicines information was added from GP records. The trust has also been adding further feeds to include information from laboratory, imaging and document systems, giving clinicians access from Sunrise, without logging into many disparate systems.

This will be invaluable as the NHS returns to something like “business as usual.” As a fellow clinician, I can really see the value in this kind of information.

Could you take me through your project with Gloucestershire Hospitals NHS Foundation Trust?

James: Gloucestershire Hospitals is deploying Sunrise Acute Care as a clinical wrap around its patient administration system. The trust wanted to move fast, and we have been able to support that with our UK blueprint, which is “out-of-the-box” content to support faster deployment and adoption.

Four months after starting the project last year, we were able to go live with the first phase, and by February 2020 the trust had rolled out nursing documentation across both Gloucester Royal Hospital and Cheltenham General Hospital.

The next go-live was planned for March, when the trust was due to go live with e-observations functionality. This included automatic calculation of NEWS2, the national early warning score that is designed to pick up patients at risk of deterioration.

The trust “held its nerve” to go ahead to help manage patients during the pandemic. It also added icons to its patient tracking board to identify patients with COVID-19, and it gave GPs access to Sunrise.

Overall, what have the past few months been like for you, personally?

Constantin: I increased my work in the ED and from a clinical perspective, the period has been very challenging. The physical demands of working in PPE has meant that tasks like observing patients, examining patients, even talking with them… everything has had to change.

This means technology solutions have had to recognise the increased clinical pressure that staff are working under; and suppliers have had to do the same. For example, Allscripts has reorganised its processes so people can work remotely.

That’s why it was great to see trusts go ahead with major deployments despite the pressures of being bang in the middle of the COVID period. That was a great achievement.

What’s coming up over the next 12 months for Allscripts?

James: A key focus for us is the remodelling of our Sunrise EPR solution, which includes a transition to a cloud native, web-based and mobile-first platform. As part of this journey, Allscripts signed a five-year cloud partnership deal with Microsoft recently, extending our current relationship and looking to leverage joint opportunities for smarter, more scalable solutions. We have UK clients using Sunrise environments in Azure today, and we are excited to see the possibilities of how that future innovation will carry forwards.

Closer to home, we have several first-of-type deployments coming up. One will be at The Dudley Group, who will be deploying our Allscripts Care Director solution. Care Director is a web-based, cloud-hosted care pathway tool that enables organisations to create a shareable care plan and link in patients with automated monitoring and communications tools.

The Dudley Group is part of an emerging integrated care system, and it will use Care Director to coordinate patient support across multiple services. That’s going to be an important focus for the NHS as it looks to reset after the pandemic.

We will also be supporting Salford Royal NHS Foundation Trust, our global digital exemplar client, to reach stage 6 on the HIMSS EMRAM maturity model. That’s significant for us, because the trust will be the first of our UK clients to reach this level of digital maturity, and all the evidence is that reaching the upper stages of the HIMSS EMRAM model has a significant impact on efficiency and patient safety.

Plus, we are continuing our rollout of Sunrise across key clients in the UK.

What was your go-to entertainment during lockdown?

James: I’ve been a bit of a Netflix junkie. I’ve caught up on a lot of box-set episodes – although I’ve also been trying to get out as much as possible, within the rules, to remain sane!

Constantin: When I’m working clinically, I stay in the hospital carpark in our 1975 VW Camper van called Bertie. That’s a great release. I also use knitting to relax. Some people shake their heads when I say that, but I’m proud of the craft, including undertaking complex knitting projects.

What impact has COVID-19 had on health tech? 

James: Our managing director, EMEA, Richard Strong was asked this by the HTN recently, when you ran a feature on whether NHS IT has had its “online banking moment.”

He suggested that it’s had its “telephone banking moment” – it has adopted a lot of remote working and digital clinic solutions, but it hasn’t adopted technology that will fundamentally change the way it does things and create new, digital pathways.

I think that’s right, but we are hearing from our customers that clinicians have been very appreciative of the support that IT has been able to give them over the past few months and that Trust Exec boards are suddenly much more interested in healthcare technology.

So, there is a real appetite to build on what has been done, and that’s great for Allscripts. Sunrise can get trusts to HIMSS 5 out of the box, while dbMotion and Care Director can set up ICSs for the new world of population health management.

Plus, we’re committed to open standards and open systems; so if the NHS really wants to tackle interoperability and start doing creative things with data, Allscripts is the perfect partner.

What’s the best piece of career advice you’ve ever received?

James: The best piece of advice I was given was to know your own strengths and focus on those. Everyone has different skills and excels in different ways. You’ll add the most value and feel the most fulfilled when you’re doing what you’re good at.

Constantin: The advice given to young clinicians is to complete what you are doing and then move into the next thing. It’s good advice; as long as you don’t follow it to the point where you lose sight of the bigger picture, and what you actually want to be doing.