Dr Natalie Canham, Chief Clinical Information Officer, and Matt Connor, Chief Information Officer, both from Liverpool Women’s NHS Foundation Trust, raised the curtain on HTN Now November with a 9am session on the importance of clinical leadership within digital transformation.
The duo gave a wide-ranging presentation, covering where clinical engagement needs to take place, and when, the trust’s upgrade of its electronic health record (EHR), and an overview of Liverpool Women’s digital transformation roadmap so far, as well as what’s still to come.
Sharing their journey, the team explained that the specialist women’s health hospital delivers care for “over 8,500 deliveries in a normal year, a huge amount of gynaecological procedures, and we’re both community and acute inpatient services – maternity, gynaecology, genetics, fertility services.”
From a digital perspective, Matt added that the trust had previously implemented the MEDITECH Magic EHR, “many, many years ago”, but last year made the decision to upgrade to MEDITECH Expanse, a process of integration which is still underway and being aligned with Liverpool Women’s work towards improving its digital maturity.
To broach the importance of digital leadership within the transformation, Matt then introduced Natalie, who began her CCIO role on 1 April 2020, at the start of the COVID-19 pandemic.
“The NHS, as everyone here knows, is undergoing a massive digital transformation and there’s a lot of emphasis on transformation…within the Long Term Plan…[it’s] changing the way people work, and that can be really hard – people can be reluctant, they can be uncertain,” commented Natalie.
“We decided to be some of the first to adopt Expanse,” she added, but went on to highlight that bringing digital change in from the top doesn’t always work, “people don’t adopt it…people don’t enjoy it, explore it and use it in the best way. They just use it because they have to essentially.”
Digital engagement with health professionals and clinicians instead, she said, “is so important for a successful adoption of any technology within the clinical framework.”
One of the main issues, she stated, was clinician time and availability, with people often having to attend meetings in their own time, or face the backfilling cost of missed work. Resistance was mentioned as another barrier, with reluctance around previous failed attempts or replacements of other projects, as well as concerns over COVID-19 and staff illness impacting on time.
“So, where does clinical engagement need to take place? Frankly, everywhere,” Natalie commented, noting that Liverpool Women’s has a clinical advisory group for the Expanse EHR, of which she is Chair, with representatives from every division and clinical area. Regional meetings and focus meetings from specific areas were some of the other examples of how the trust gained greater insight.
“Digital engagement definitely needs to take place in the clinical areas…in the wards. Digital people need to know actually what doctors and nurses do on the wards in an ER, before they can design a system that works for them,” she said, adding that digital departments should be, “like an octopus with tentacles everywhere, rather than a little oyster sitting in its shell, waiting for people to come and poke it.”
On Expanse in particular, Natalie noted that the team had been heavily reliant on clinical engagement during development, with at least one clinician attached to every work-stream.
On clinical digital leadership, Natalie explained that, in addition to her role, Liverpool Women’s has appointed digital nurses and midwives, and additional allied digital health professionals, with the trust also in the process of appointing three associate CCIOs. She admitted that she also hopes that the “idea of clinical digital engagement” is “becoming more natural within trust and others [in the NHS].”
Matt then returned to the talk to share updates on the trusts digital roadmap, which stretched from 2020 through to the present, as well as to emphasise the importance of clinical leadership and provide a “flavour” of the work that has been undertaken so far.
The Digital Generations Strategy was the first aspect to be launched in September 2020 around the trust’s key themes, “giving a very clear identity around digital” he said, in addition to the fundamentals, such as processes and infrastructure.
Other notable pitstops on the digital roadmap Matt shared, from across the last year, included their work with the Cheshire and Merseyside Health and Care partnership on their population health management platform and the sharing of discharge correspondence into the shared care record.
Further highlights from the past 12 months were going live with K2, Liverpool Women’s dedicated digital maternity record, as well as the redevelopment of national data submissions, daily COVID-19 information reporting, hardware migrating to new data centres, patient records achieving a BS10008 standard, and the hiring of a second digital midwife.
On another aim, the reduction of paper, Matt added, “with Expanse, we’ll be able to capture more electronically, at the point of care.”
Looking ahead to the rest of 2021/22, Matt explained that there’s still more to come, including a Wi-Fi network replacement, a cloud data back-up project, and the replacement of the 2010 Office 365, as well as optimising the digital maternity record, improving data quality, back scanning, Robotic Process Automation (RPA), and opportunities around voice recognition.
To conclude, Matt summed up the main areas of focus, commenting on how, “the clinical piece that Natalie took us through earlier, we really want to foster that and transfer a real ownership of that within the divisions…we really want to empower them to consider all things digital.”
In addition, he also covered ideas around up-skilling and training, adding: “Up-skilling, training, having digital facilitators, really educating on the impact of digital or poor digital use, is a real key priority for us . When we talk about tools, we also talk about training…it’s not training to use a tool but training to use them in their [the clinicians’] context.”
Catch up on the full session below: