We recently had the pleasure of speaking with members of Channel 3 Consulting about their EPR implementation journey, projects, challenges and thoughts on digital transformation at scale.
We were joined by Eleanor Rollason and Simone Collins, two of the lead partners at Channel 3 Consulting, who gave some thought-provoking insight into the world of EPR programmes and large scale system transformation.
What do Channel 3 Consulting do in the EPR world?
Eleanor: We are a specialist digital healthcare consultancy and provide support to organisations all the way through their EPR journey, from developing digital strategies in the first instance, which is really important in terms of setting the ambition the organisation wants to achieve. We then help to develop robust and compelling business cases, EPR programme delivery plans and support organisations to get ready to embrace the transformation opportunities from deploying a new EPR. It is vital to set the foundations for a comprehensive transformation programme which ensures benefits are realised, following a safe and successful implementation and go live. We can also provide assurance as well, for organisations that don’t necessarily want or need implementation support – we can help by giving guidance to keep them on track through a structured gateway review process. We are currently supporting a host of different clients at different stages of their EPR journey as part of the frontline digitisation programme.
Simone: It is never too early to set the foundations for success which is critical and something which is often rushed or overlooked, in my experience. Over the years, we have seen that often insufficient time is given to really focus on the transformation activities. The excitement around the solution itself and a desire to rush into implementation eclipses the foundation and preparatory work that needs to be done in the first place. The foundations for success phase centres on getting a good understanding of the baseline position – where the organisation is, what their vision is and what they want to achieve. If you’re wanting to transform services to realise benefits alongside the EPR, it is never too early to put the foundations in place to underpin this. It is vital that this happens before the technical team comes on board or else you may just get a technical deployment and miss the opportunity to transform. Most importantly, it’s about getting the Executives on board to understand what this change actually means to the organisation as a whole. To change is to disrupt, and so there will be and should be a significant impact on business operations and they need to manage that safely.
Can you take us through a couple of projects you have worked on?
Eleanor: We worked with both Derbyshire Healthcare and Cambridgeshire and Peterborough Foundation Trust who were doing a SystmOne deployment and thankfully we had done all the preparedness work with them before COVID then hit. At first we thought they were going to halt the EPR deployment because they couldn’t possibly run a programme of that scale through the pandemic, but because of the importance of having an electronic patient record in a COVID environment, and the fact that they were well prepared and confident in the implementation programme, both organisations were committed to keeping the show on the road. We just moved to a remote deployment model and we all learned and grew together as a single delivery team. As their strategic delivery partner we were committed to achieving a successful go-live, no matter how much effort that took. Many of the learnings we gained from shifting to a remote deployment have now stayed with us, so much so that we have fortuitously been able to support an EPR deployment in Bermuda, which went really well. The go-live was very energised and positive, there were the usual teething problems but it was safe, people were engaged and the hospital has not needed an extended period of stabilisation support, so they are onto the optimisation stage now.
Simone: Eleanor has used that word ‘safe’ there, which is really important. When we are working with clients it is important they feel safe and supported throughout their journey with us, which brings us on to assurance. Keeping them safe and ahead of the programme plan is really important to us and we work with boards to provide assurance and recommendations about how to manage the inevitable risk of a complex EPR programme through a structured gateway process.
Eleanor: It is important to remember that risks are perceived as good, as an assurance partner we tend to worry more about EPR deployments which have a very clean risk register and present themselves to be ‘on top of everything’ – because that is not normal in EPR programmes. It’s normal to have risks and it’s normal for organisations to feel concerned about mitigating those risks, but if those risks are not on the risk register that’s a concern for us – so we really encourage organisations to have a positive risk culture. If you are aware of it, you can do something about it; otherwise you are in danger of things catching you out and it not going well.
Factors for success
Eleanor: I think the most important things for a successful implementation are passion, energy and excitement. These are really critical because people typically don’t like change – whether they’re moving from paper or their trusted spreadsheets to a new technology, this can be quite a wrench even though, for most people, our whole lives are digital now.
We find that communication and engagement is often not given the significance it requires in a deployment; this is about hearts and minds, it’s about people, changing the way that they work must be seen as a really positive change. So, having passion, energy and enthusiasm goes a long way to get people bought in to adopting the change.
Even something as simple as naming an EPR programme, giving the project an identity and branding that people can recognise it – this is often underestimated but it is really important. Going back to our deployment in Bermuda, their comms team were brilliant and they had an established brand name called PEARL, which stands for Patient Electronic Administration Record Log. The branding was unmistakable from the posters to the paper shields that go over coffee cups, it was all really exciting and so important in terms of engaging peoples’ hearts and minds on the programme. This is a transformation programme that is going to improve their working lives, improve outcomes for patients and make things better – it’s not just an IT system that’s being brought in and people are expected to just ‘feed the beast.’
Simone: Exactly, and this is why the analogy of having a baby really applies in this instance because it is a celebration and the go-live should be seen as such. It is exhausting, as giving birth is exhausting, but it’s exciting because at the end of it, you get the lovely baby – the EPR which will transform lives. It really is about enthusing the organisation and making the go-live celebratory in that way, really helps with embedding and adoption – recognising that it’s not just about IT, it’s about the whole system welcoming this new step change together as one.
There have been instances where we have come in to support organisations where the workforce feel that the IT change programme is being ‘done to them’, that this new process is happening to us rather than there being anticipation and excitement about it happening. It’s a missed opportunity to maximise the impact from the EPR in this environment.
Thoughts and advice on digital transformation
Simone: The important thing to remember is that we don’t create the transformation, we support the organisation to transform; they will do that themselves and it’s about embracing digital holistically and truly changing ways of working. Bringing it back to the ‘us’ – everybody is in it together and it’s about looking at things in a completely different way, a better way that will be more successful.
In terms of what this looks like, it’s really about being able to support clinicians and everyone to work better without any hinderance. The technology shouldn’t be the main focus, it’s more about “I can do my job better, I can care for patients better because of this” – that is what transformation is. The technology is a footnote really because it just enables everybody to work in a better way.
Eleanor: For me, one of the important things about transformation is that it’s continuous; you need to continuously transform and do this before you start thinking about the EPR. It needs to be less about how the technology is going to come in and change things, and more about “what is it we want to achieve by transformed service? and then how do we get the technology to underpin in?”
As part of our core deployment methodology, we will undertake an ‘as is’ and a future state mapping and unless you have really considered what that future state ‘can be’ before you start the deployment, you can end up just digitising your existing paper or historical processes.
Key lessons and challenges
Eleanor: Setting the right foundations is vital, it is never too early to start transforming, you need to be ready and that means everyone being aware of what the changes are going to be and what the benefits are for them. It’s about transformation, not technical deployment and to transform you need to be prepared. In terms of capacity and capability, it’s about making sure organisations build the skills and capabilities internally across the team to provide resilience post go live. Many people will never have been involved in an EPR programme before and won’t have the experience and insight to know what makes a successful implementation. That is where a delivery partner such as Channel 3 can help in building the internal capability and resilience for business as usual and continuous improvement It takes a maverick leader to lead a programme of this scale and complexity, but a maverick leader that recognises the skills and competencies needed in a partner to do that successfully and safely.
Simone: The benefits are really important because they are what is sold to an organisation, but they also need to be able to set the mechanisms in place to support the management of this moving forward – which links with what Eleanor was saying about it not stopping at go-live, it continues. From a benefits perspective, that’s even more true because you are not going to achieve benefits at go-live, the real benefits occur further down the line. This is why you need to ensure that you are prepared in order to realise those benefits and the ways you are going to achieve them. Being honest about what it will take in order to deliver these results.
What are you most excited about going forward?
Eleanor: For me it’s optimisation, the NHS has spent millions on new technology and what we need to do now is make sure we continuously optimise it to realise the benefits for the workforce and patients.
We have just done some work with the system in Devon on this, with the implementation of a programme called digital asset optimisation, where we have assessed the investment the system has made in their digital assets, understood how well they are using them and what more they could do with them. We have helped to develop a three-year plan which helps to deliver operational and financial efficiencies through optimising the impact from digital. The pockets of digital innovation and proven pilots need joining up and integrating by embracing technology. By doing this we will really help to improve health and care services across Devon.
Simone: It really is about levelling up, we are now in a position where there are funds available to support those organisations to enhance their systems and implement an electronic patient record as a standard system – this is very exciting because it sets a foundation to really join up health and care. Joining up health and care with the use of data is going to be a massive game changer and a real opportunity which has to happen and will happen.
Thanks again to Eleanor and Simone for joining us. To learn more about Channel 3, please click here.
