NHS trusts are under pressure to modernise their digital estates while maintaining safe, efficient care. The challenge is clear: How can trusts maximise their existing investments and advance towards NHS priorities such as EPR innovation, interoperable systems, FHIR adoption and digital resilience?
We caught up with Paul Downie, CCIO at Gloucestershire Hospitals, to learn more about how the trust is progressing with interoperability, its Altera Sunrise™ EPR, and the impact it has on clinical workflows.
Journey to date
Gloucestershire Hospitals NHS Foundation Trust successfully implemented several components of Altera’s Sunrise Electronic Patient Record (EPR) in just six months, leveraging the solution’s flexibility and configurability to meet its unique clinical and operational needs.
The trust’s leaders opted to wrap the EPR system around the existing Patient Administration System (PAS), a strategic decision that enabled rapid deployment while minimising disruption to clinical services. This phased approach allowed the trust to quickly realise the benefits of the new EPR system, with significant improvements already evident in clinical decision-making, patient safety, and operational efficiency. As the trust continues to evolve and mature its EPR capabilities, further enhancements and integrations are planned, building on the solid foundation established to date.
Paul talked about the trust’s EPR journey to date, sharing that one of the biggest reasons for choosing the Altera Sunrise EPR was its interoperability. He said, “We were looking for interoperability, and for most things to be within the one system, if that was possible, to give us an EPR-first solution.”
The fact that Sunrise integrates with legacy applications and uses open standards and APIs to support information exchange between existing clinical systems, was a big factor in the decision-making process. A flexible solution helps maximise what can be possible to be surfaced to clinicians, preventing the need to jump between systems or manage multiple programmes at once. Paul went on to add, “We’re still on that journey, we’ve got a document management store which has a good proportion of our documents in there. The Laboratory Information Management solution (LIMs) is fully integrated into Altera; and we’re working on ancillary such as ECG ordering.”
The Altera solution is also helping to support improved patient flow across the organisation and more widely across the NHS Gloucestershire, Paul highlighted, noting the impact with visibility, coordination and access to data within Sunrise.
Paul discussed the next steps for increasing interoperability across the organisation and with the Altera Sunrise EPR: “We’re working on trying to architect our way out of the problems, and we’ve got the Altera solution that clearly does that, as well as an integration engine which supports it, but we’re just chipping away at those legacy systems, getting those in where we can.”
Subtle changes can often make all the difference, and having the flexibility to respond to those needs within the system is important. As Paul stated: “In our Shared Care Record a simple change allowed us to improve that interoperability, and it just shows how the user design of the system, and that flexibility around how integration actually works, makes a huge difference to clinical workflows.”
Measuring improvements
When asked how health and care organisations can measure progress and improvements with interoperability, Paul noted: “Interoperability can be measured through the number of handoffs a clinician has to do. We’re looking at presenting things to clinicians with as few clicks as possible, what metric you can assign to that I’m not sure, but ultimately the point of interoperability is that you don’t have to go searching for things.”
An important use case is medication, and Paul highlighted the opportunity: “By streamlining medication reconciliation, we can make the process more efficient and effective. This process should happen once at admission and once at discharge, covering the entire care continuum. By achieving this, we can unlock more time for our pharmacists to focus on high-value tasks, such as providing expert guidance and support to patients, ultimately enhancing patient care and safety.”
Looking ahead: The role of EPRs in driving innovation
Paul also considered the role of EPRs in fostering an organisation’s innovation ecosystem, outlining how there’s a fine balance between embracing the new functionality an EPR might offer and “managing expectations.” Close collaboration with Altera has helped with this, he said, “as they come in and listen to the problems from clinicians, then go away and come up with solutions to those.”
The result of interoperability is measurable efficiency: fewer manual workarounds, improved data quality and faster access to critical information at the point of care. Trusts avoid costly duplication and protect their current assets, while laying the foundations for future innovation such as AI-enabled decision support and advanced analytics.
