HTN Now: Vijay Magon on building a patient centric record

Recently at HTN, we had the pleasure once again of speaking with Vijay Magon from CCube Solutions, who gave a thought-provoking presentation on EDRMS, talking us through the software and how this can benefit other systems.

Vijay provided a high-level overview of the three key functions of electronic document records management (EDRM): capture, manage and delivery – and how these add value to an electronic patient record (EPR) system.

He said: “The first key functional area is ‘capture’. Capturing any kind of information – not just paper – but electronic information that is created during the patient pathway. That information is created across a number of IT systems and by users using desktop applications, emails, electronic forms etc. All that information is currently being captured and saved within an electronic document and record management solution, which are designed to capture and hold vast volumes of unstructured content. This can be easily accessed through EDRM and through the interfaces with other systems as well.”

Building a Patient Centric Record

“There is a growing volume of patient information: results, reports, clinic letters, forms, email, Day Forward paper, as well as legacy records. Once retained, it’s then managed within the EDRM, in the underlying compliant depository, to deliver at the point of need. This pulls together both structured and unstructured information, keeping in mind that as much as 80 percent of the information on a patient is unstructured.”

“The system must understand the user’s role in delivering appropriate, pertinent information for the user”

“The third key functional component of EDRMS is delivery at the point of need. Keeping in mind that within an average hospital trust, there are many kinds of users who each have their own demand on the patient record. Nurses will look at certain sections of the care record, cardiologists will want to flick through a particular area, maternity will have their own section and so on.

“So, everybody has a different demand on the patient record, ie. the delivery is very important, you can’t have one system that offers the same presentation of patient information to all users. The system must understand the user’s role in delivering appropriate, pertinent information for the user – reducing the key clicks necessary to get to a particular document within the system. To deliver that, we capture a lot of metadata in the EDRM solution during the document capture part of the process which is also integrated with data held in other IT systems such as patient appointments, wards or theatre lists.

“We provide access for that data within EDRM to deliver what’s called role-based access. The system understands the user’s role and will deliver the appropriate information to the user, rather than presenting the same interface for all users. That is vital in EDRM, to ensure that time-pressed users can quickly access what they need. Another key part of what we deliver is interoperability – EDRMS must be able to link bi-directionally with other IT systems. For example, we make it easier for users using an EPR to see what’s going on in the EDRM world, without flicking between applications.

“Once the system is set up and given the investment necessary to reduce dependency on paper, the last thing you want to do when you need to share that information is to hit the print button. A lot of work has gone into the functionality – particularly since GDPR kicked in five years ago – to make sure that when there’s a need to send the patient information to an external agency, whether its medical, legal or somewhere else that you’re not going back to paper by printing patient records held in EDRM and also, you don’t want to have to email this information, nor do you want to copy it onto removable media like a USB.

“The moment you do that – email or removable media – you have lost track of it and you have created multiple copies.”

Infrastructure to support sharing

“We’ve launched a sharing platform to allow information to be shared securely. The recipient will receive an email with an encrypted link, they can click on that and it will take them to the hosted file sharing portal. They can inspect the record and (if authorised) can download it. After an expiry time (or after download), that content is removed from the sharing platform. So, you’re not going to be leaving multiple copies in places, but the key here is that the entire process is actually audited and verifiable.”

“A couple of other components can be added to streamline processes: such as electronic forms for capturing new information, making it easier. There is still a need for paper in some cases and of course workflow behind the scenes to streamline a number of operational processes. Interfacing is a key part of the deliverable. EDRMS is not a system that sits in a corner looking after your document, it is very much knitted into the IT infrastructure and linked with a range IT systems out there. It is part of the whole operation.”

Thanks again to Vijay for sharing his digital journey with us.