HTN Now: system-wide access to patient records

At our two-day HTN Now event, focusing on electronic patient records, digital strategy, transformation and change, we were joined by Vijay Magon, CEO of CCube Solutions. Vijay led a session discussing how digital medical records are in daily use, can improve patient care, and save money.

He began the session by sharing information about CCube Solutions. They have been operating in the NHS for over 20 years, specifically in the secondary health sector, where they help trusts and health boards up and down the country deliver and realise the benefits of their digital transformation strategies.

Vijay shared why there is a need to digitise patient records. “I think everybody understands what the problems are, and essentially any process that still relies on paper will be handicapped, and that’s what we want to get away from.”

Among the many problems with paper patient records, Vijay said, is the limitations on sharing and how this has been further compounded in the last two years because of the COVID-19 pandemic, “the cost of doing nothing also grows over time”, Vijay explained.

Next, the session covered solutions and how NHS trusts are embracing technology to manage their day-to-day problems. The solution is based on capturing documents, managing documents over their lifecycle, and delivering digital documents at the point need-  with three key steps involved. “The first one is captured content, so we need to be able to manage and capture any kind of records, and content… there is quite a wide spectrum of information that exists in various formats. They need to be captured and securely managed in the compound document repository, which then deals with delivery at the point of need – the electronic document and records management solution.”

Other solutions included management, with Vijay explaining that the EDRM technology is not new and that it’s all about how it is applied to deliver digital content – delivery which refers to acceptance, adoption and use of the system.

How to transform a multi-volume patient record into something electronic was next on the agenda. “For us, it’s important to recognise that a physical record has got a structure, indirect of tabs that stick out representing content for the different specialities and department within the organisation.”

He continued: “Its important to make sure that the structure you see in the physical medical patient record can be carried forward to the electronic records.” Vijay explained that the advantage of electronic patient records means that there is no need to sort and reorganise, and that is compliant with current guidelines.

“Interfacing interoperability is a key deliverable for any digital system. Having digitised the record is equally important to make sure that the delivery of the records is carried out and implemented in such a way to make it easier for the user to flick through and compare pages – simpler than flicking through a paper record.”

To help this, CCube Solutions have a number of development sites on APIs which include mobile integration on a smartphone app. Vijay explains: “A clinician on the move can quickly look at pertinent information about a patient before they go and see the patient… showing the latest recovery letter, a result, or other demographic data on a small device is absolutely acceptable and becoming more commonplace.”

When managing outpatient flow, Vijay outlined three key areas which include use of available data, healthcare providers, and patient engagement. How can technology help to improve engagement with patients and deal with the growing NHS backlog.

The last area to explore was experience: “Across all the sites using the EDRM system, we have estimated, roughly half a billion documents for about 32 million patients, containing about 52 billion pages in total. The adoption is high, on average 16-17,000 users login and use the digital patient record every day.

“Using digital patient records is not new, and actually it’s been going on for a number of years now and a lot of the sites are realising the benefits and are documenting those benefits as well.”

From a trust and organisational standpoint, the financial rewards are quantifiable, measurable and are also now documented, with Vijay explaining the savings per year for a trust. “The first trust, with an initial investment of about £1.2 million, started showing savings around £900k, and move up to currently £1.4 million per year after the first two years, and that was over ten years ago… these technologies can save money,” said Vijay.

In terms of patient engagement, Vijay said that it is still early days. “The whole idea here is to make sure the patient is actually involved in the delivery of the care and we believe that by doing that we can manage our patient flows. It’s making sure there is two-way communication using a convenient device like a smartphone between a patient and care team.”

Other patient engagement benefits included elements such as allowing the patient access to selected documents within minutes, outpatient clinic management, minimise on-site waiting and much more. Vijay estimated that it costs “around £1 in postage and labour to send a letter, with approximately 1 million out patient letters being sent per year, per hospital.

“The message is that nobody is going to solve all problems in one day. The idea is to start the journey and typically the starting point for a number of sites tends to be to solve the current problems which tend to be legacy, and make sure the systems embrace the whole patient record.”

At this point, Vijay moved onto questions and answers.

You can watch the full webinar here: