At our recent Digital Primary Care conference we were joined by Vijay Magon, Managing Director of CCube Solutions, for a session to discuss the case and options for managing the digitisation of Lloyd George records.
With over 20 years of experience in the industry and with 98 percent of their work taking place within the NHS, the supplier shared with us their extensive experience of helping NHS trusts and GP practices across the country alleviate paper and move towards digital ways of working.
“Any process that depends on paper will be handicapped”
“Access and use of digital records is not new”, opened Vijay, “however we’re able to bring our lessons learned from secondary care to primary care, in terms of digitisation, and support CCGs and practices with Lloyd George records.”
“Lloyd George records take up valuable premium space within GP practices; retrieving, accessing and moving them is time-consuming and costly; and there are data protection risks with the local holding of physical records. There are plenty of established rules and guidelines on digitising information,” Vijay said, “so any solution has to abide by and comply with the existing rules.”
After highlighting some of the challenges to overcome, Vijay covered the benefits of digitising Lloyd George records: “Along with freeing up space which can be repurposed, saving money on external storage and file retrieval, and enhancing security and access control, secure digitisation also ensures the ability to fully audit patient records and keeps them GDPR-compliant. In terms of clinical benefits, digitisation offers instant access to patient information for GPs, less time spent on report-writing, multi-user access to the same patient record, easier sharing of information within the NHS and the preservation of historical records once scanned.
“There are also benefits to the wider NHS: by removing the need to outsource management of the paper records, millions of pounds would be saved annually, and public health research would be benefit from the ability to perform better analytics.”
“So what’s the solution?”
Vijay began by outlining the two key components of the process, scanning services and records management services.
“We work with a number of scanning service providers. The key steps involved are collection of the records from practices, preparation of the records for scanning, [and] the actual scanning using industrial equipment. Quality assurance is a mandatory requirement in terms of ensuring the quality of the scanned record, and also compliance with the established legal requirements.”
Vijay highlighted another difficulty arising from the paper records: “They are often old and folded, squashed in limited storage space. Going through each file to prepare them by hand would be time-consuming and expensive, and would present a risk to data protection, so it’s important to work out a scanning method which doesn’t require prior reorganisation.”
“The physical structure of the Lloyd George case note must be carried forward into the electronic representation of the record”
The session then focused on the importance of keeping the digitised records user-friendly and accessible. “We’ve seen many systems where you can scan the entire Lloyd George record as one single PDF, which is fine,” Vijay said, “but when it comes to retrieval and navigation… it makes it very difficult for the user, because if you need to find a particular page within that record you’re going to have to flick through all of the other images. There are recognition technologies available… but that’s all additional work and additional cost.
“At the minimum, we recommend using barcoded sheets to indicate where the sections are… [they] can be inserted into the paper stack and dropped on the scanner to automate the entire process. This is important for when the digital record is then carried forward into the electronic repository. The scanned record, which will have sort of barcoded tabs… will actually create tabs in the electronic system.”
Presenting a flowchart to illustrate the journey that the paper Lloyd George records take on their way to becoming digitised, Vijay highlighted how the process provides GP practices with more autonomy: “Each practice will be able to manage their own account in terms of numbers of users who need access to the records… training is all online and typically takes around 15 minutes.”
There are additional practical benefits to digitising the records in this way, in terms of both expense and efficiency. “There is no cost, either to the practice or the scanning service provider, for uploading the information to the hosted Lloyd George platform,” Vijay pointed out. “When we get the data packet… we go through an additional verification process… to evaluate the patient information that has been sent to us. And also, to expand on that… the scanning service provider will key in the patient’s NHS number, and that’s it, really. We will then look at the patient’s NHS number in the data file and go and check it against the NHS file, and fetch back all the patient demographic data that we need in the Lloyd George platform to make it easier for the users to search for and access the information.”
“Some of the lessons learned include measurable, tangible benefits”
At present, CCube Solutions’ system has been in live use across St Helens and Knowsley for a number of years, where they are managing over 1.5 million records for 105 practices, digitally.
Having the system in live use has generated useful feedback for CCube Solutions. Vijay described how the necessity for sharing records was key to building upon their solution. “Currently, when patients join or move, or when records need to be shared with external agencies or even the patient themselves, the options are to print, email or export files. None of these options give you the audit traceability,” said Vijay. “Once you’ve printed a record or even emailed a record, you’ve lost control. You don’t know if it’s got to the recipient, when the recipient received it, when they looked at it.”
Two years ago, CCube Solutions launched a cloud-based sharing portal that can support any source or IT system. It provides users with more control; by sharing data through the portal, senders can set data expiry on files and provide recipients with the ability to download records to be held in a local repository. Recipients are notified of the record’s arrival with a secure encrypted link. The entire process is strictly audited.
Vijay rounded up by reiterating the benefits of digitising the Lloyd George records in this way – the immediate positive impact upon storage requirements, access to a resilient high-performing and secure infrastructure, a predictable cost and access to 24/7 service desk support, among others.
As for case studies and savings, Vijay finished off his presentation by sharing data from three of the sites that CCube Solutions work with; St Helens and Knowsley Teaching Hospitals, Aintree University Hospital and Milton Keynes Hospital.
Watch the full video below: