In June 2023, we reported on the appointment of Alistair Eaton as CEO of CCube Solutions. Three months later, we’re catching up with Alistair to get his views on the role of electronic document management software (EDMS) in an increasingly digital NHS, and how changes in technology will influence how such services are delivered.

How have your first few months at CCube been and what have you learned about EDMS in UK healthcare?

It’s been a busy time, not only getting to grips with the EDMS market and the dynamics of the CCube business, but also meeting most of the 27 NHS trusts and Health Boards that use CCube’s products.  The most striking thing I have learned by far is how significant the cash-releasing benefits can be from a good EDMS implementation.

I have been lucky enough to work for some of the UKs most successful healthcare software companies and I’ve been responsible for products like Rio, Adastra and Docman. All of these solutions delivered significant operational, financial and clinical benefits, but I don’t think I have ever seen a return on investment quite so obvious as that delivered by an EDMS. 

Each situation is different, but the majority of the savings are usually in two main areas: the cost of paper records storage and the cost of people employed to manage a paper-based medical records process. There are also additional savings to be made in transport costs, consumables and sometimes the replacement of existing digital record stores. 

What advancements in technology do you think will have the biggest impact on electronic document management in the NHS?

Firstly, without doubt, cloud technology. EDMS stores and organises huge volumes of digital artifacts – you could argue that that is exactly what public cloud was created to do. 

But it is critical that an ‘EDMS-as-a-Service’ platform, designed to support frontline clinical care, is reliable and secure, and just as importantly, fast. That can only be achieved if applications are well architected for cloud and maximise the use of the technologies available. Whilst at Docman, I oversaw the launch of Docman10, an exciting IT programme that involved the migration of half the GP practices in England to a SaaS solution on public cloud. It also required the migration of over one billion documents from thousands of on-prem systems. At the time, that service may well have been the biggest cloud service in use by the NHS and its security, reliability and performance was taken extremely seriously.

As we migrate NHS trusts to our CCube Cloud service, it has the potential (in terms of numbers of users and documents) to be as big as the Docman cloud. That’s why we have invested heavily in the development of our EDMS services so that we can confidently meet those key objectives of reliability, security and performance.

What’s the potential for AI and automation for EDMS?

I’m excited to discover how AI services can be applied to EDMS. CCube has always looked for ways to reduce the manual activities associated with document management processes, employing various techniques to automate document classification. AI, when used effectively, can drive significant operational efficiencies and labour saving; but in the past, AI development projects could be lengthy, often involving the complex and iterative development of machine learning algorithms. The recent acceleration in the development of AI and the availability of cloud -based AI services, could enable us to take great strides forward in automation, hopefully delivering a greater return on investment than ever before.

Coming back to right now, how does EDMS align to the priorities of health and care today?

There was an article in the Times recently, reporting that the NHS spent £1 billion on the storage of paper-based medical records over the past five years. This figure is supported by the evidence we have from many of our customers who can demonstrate savings in excess of £1m per annum.  In some cases, the savings in the first year following implementation can even exceed the overall initial investment in the EDMS and scanning projects.

These, however, are just the cash releasing benefits. In addition to that, there are significant operational benefits such as reduced appointment cancellations and the clinical benefits associated with having the complete medical history instantly available, at the point of care. Trusts should even consider the positive impact on retained medical records staff who can move on to other roles for them in the organisation.

How do you think the role of EDMS will change in the future as NHS trusts implement or update their EPRs as part of the Frontline Digitisation programme?

The short answer is, the importance of electronic document management won’t really change much as new EPRs are implemented. An EPR alone will not eradicate the use of paper records and it certainly won’t enable providers to effectively digitise the existing paper records. Ultimately, every year that a healthcare provider continues to run paper-based medical records processes, more money is wasted. Had some of these organisations implemented an EDMS 10 years ago, the savings to date would go a long way in supporting the elective recovery plan, or even that EPR project.