HTN Now Awards 2023/24: Solution Supporting Digital NHS Trusts

Here are our finalists for the category of Solution Supporting Digital NHS Trusts.

Elsevier

Overview: The North West London ICS expands the deployment of Elsevier’s Care Planning to support wider adoption of evidence-based practice.

Why? To help drive towards ICS-wide consistency of acute hospital care and ensure that evidence-based practice is widely adopted amongst the nursing workforce.

What happened? Elsevier is pleased to announce the expansion of its Clinical Decisions Support solution, Care Planning, across the North West London Integrated Care System (ICS), serving a population of 2.1 million people across eight boroughs. This is an extension of the initial partnership with Imperial College Healthcare NHS Trust, which integrated Elsevier’s Care Planning across the nursing team in 2020, to reinforce evidence-based practice at the point of care. Following successful implementation, the deployment of Care Planning across the ICS will help to reduce variation in patient care, further improving the nursing team’s operational efficiency. A total of 319 evidence-based, patient-centred care plans, will be made available to thousands of nurses, across the four acute trusts in the ICS. The content has been pre-built and will be delivered via a structured, normalised database, to ensure predictable and timely integration with the organisation’s Electronic Patient Record.

Looking ahead. Work will continue in North West London to make further improvements, as well as to provide learnings for other ICSs looking to undertake similar work.

OX.DH

Overview. OX.DH’s virtual consultation solution – OX.Waiting Room (OX.wr) –  enables video/online consultations for group and one-to-one sessions. It is device and browser agnostic, with no separate app is required, and as a Microsoft Teams plug-in, OX.wr is secure by design and default.

Why? The COVID-19 pandemic demonstrated the need for remote consultations, when in-person appointments were simply not feasible. Post-pandemic, both clinicians and patients continue to realise the benefit of virtual consultations and often feel more comfortable with a more personal, visual interaction.

What happened? OX.DH’s OX.wr solution uses Multi-Factor-Authentication to keep data safe, and pre- and post-appointment information and reminders enable effective communication with patients. Automatically triggered surveys help analysts assess the overall virtual consultation experience. One client, Barnsley Hospital NHS Foundation Trust, had embarked on its digital transformation journey by early 2023, rolling out a new EPR scanning electronic patient notes and implementing electronic prescribing. Richard Billam (deputy director of ICT at Barnsley) quickly realised OX.wr would meet their video consultation needs. Within an hour of initial demo, he had the solution up and running, with preconfigured settings, on the Barnsley Teams account on the NHS national tenant. Barnsley’s speech and language therapy team then trialled OX.wr’s video consultation platform during spring and summer 2023. A full roll-out is now planned for 2024, aiming to bring the trust’s appointments online as far as possible. The whole appointment process operates in real-time, with notifications to inform users (for example, if someone is running late). At the end of the call, the clinician simply updates the EPR and moves on. Time savings accrue because there is no need to log into multiple systems.

Looking ahead. Individual virtual appointments are just the start. Group consultations are also supported, providing a secure environment for clinicians and patients – ideal for supporting mental health sessions. Documents can be attached, sent and reviewed, to support triage and information sharing.

Alertive Ltd

Overview: Alertive says that it has positively impacted healthcare communication, addressing long-standing challenges and significantly impacting the industry. Its secure digital platform ensures timely information transfer, reducing response times in NHS Trusts and streamlining pathology result access. 

Why? To address challenges and reduce stress for staff.

What happened? The company’s secure digital system facilitates the seamless transfer of key information among healthcare staff, ensuring that the right information reaches the right person at the right time, every time. The platform, comprising highly configurable native mobile and web applications and a proprietary workflow engine, allows for a tailored solution that caters to each customer’s unique needs. Statistical data from Hull University Teaching Hospitals NHS Trust reveals that, on average, the time from delivering an alert to a response time to 2 minutes, compared to bleep response times of 9.35 minutes. Furthermore, 69.4 percent of alerts receive responses within 30 seconds of delivery, with 82 percent garnering responses in under 60 seconds. This is a substantial improvement compared to legacy communication solutions, with an average reduction of eight minutes. Another tangible impact of Alertive is the reduced time required to access critical pathology results. Norfolk and Norwich University NHS Foundation Trust reported a 98 percent reduction in the time needed to obtain these vital results. Statistics from The Christie on patient outcomes highlight a 77 percent reduction in clinical incidents due to communication delays when comparing Datix reports from the bleep system vs. Alertive.

Looking ahead. Alertive will continue its work to resolve challenges within the NHS.

inicio health

Overview: This project set out to elevate the standard of care delivery within the NHS, and set a new benchmark for digital excellence in healthcare, with initial focus on neonatal units.

Why? Manual, paper-based charting puts pressure on clinical teams to record bilirubin levels and takes time to complete, as results require manual searches, often from multiple sources across clinical systems. This process carries human-error risk and results in paper charts being used alongside a patient’s digital record.

What happened? This clinical need led inicio health to co-design and develop the hyperbilirubinemia mPage, incorporating key features required by the team, ensuring compliance with NICE guidance, and integrating directly into the digital patient record to form part of the clinical history. The MPage uses code to create a dynamic, digital, real-time clinical chart which surfaces key patient data such as lab tests, point of care testing, and therapeutic interventions, allowing a clinician to interact with the results and make timely, informed decisions about care. Deploying the hyperbilirubinemia mPage is intended to reduce clinical risk, improve patient safety, and based on NHS market research, with a hospital performing around 4,000 births per annum, this innovation could save approximately 1,000 clinical hours per year. This project was a true collaboration between MKUH and inicio health. incinio health followed an agile methodology and established regular meeting cadence and engagement with the hospital clinical staff across three main themes: product development, pathway mapping, and clinical adoption. The MPage itself requires very little training to use, seamlessly plugging in to the patient record as a clickable window.

Looking ahead. Benefits are still being realised, and work will continue to deliver further benefits, as well as to expand these where possible.

The Dudley Group NHS Foundation Trust

Overview: Dudley Group NHS Foundation Trust has developed a bespoke maternity patient record, building on the trust’s existing Sunrise EPR. As a result of the implementation, Dudley’s labour and inpatient maternity units are now entirely digital, supporting the trust’s aim to become a digital first organisation.

Why? Prior to implementation, clinical teams spent a considerable amount of time completing unnecessarily admin-heavy processes.

What happened? Recognising the limitations of paper records, the trust decided to extend Altera Digital Health’s Sunrise EPR to the maternity department. A robust staff engagement and training programme was developed to make sure the go live went smoothly, and so staff felt empowered to make suggestions for how the system could improve as they grew comfortable using it. Using Sunrise, staff can identify people at risk of deterioration by completing and recording observations electronically, automatically calculating the MEOWS score. This has enabled staff to recognise warning signs more quickly with embedded guidance a decision support prompts, making it possible to intervene and escalate appropriately, improving patient outcomes. Sunrise has been designed so that multiple people can review records simultaneously. This has meant that doctors and midwives have been able to document clinical records at the same time and in the same room as the mother, reducing the time taken to complete the task. As a result of these efficiencies women are having their c-sections at the scheduled time, avoiding long waits and improving patient flow. The time taken to complete postnatal documentation has decreased by 78 percent, from three hours to 40 minutes. The process, which was previously carried out in the handover office, and is now completed in real time at the bedside, and notes are immediately available in Sunrise.

Looking ahead. The trust is looking forward to continuing its digital journey and increasing the functionality of its EPR. Having already gone live with emergency department and nursing documentation, Dudley is now looking to go live in the paediatrics and outpatient departments, continuing to develop as an advanced digital trust.

Cornwall and the Isles of Scilly ICS & Strata Health UK

Overview: The unified electronic referral platform has streamlined processes across diverse sectors, handling 52,875+ referrals since July. With 2,000+ users and notable time efficiency gains, it signifies a leap toward accessible, high-quality care and improved system-wide patient flow.

Why? The previous system, while functional, had its limitations prompting the need for a more adaptable and streamlined solution. While it served its purpose, it became evident that to meet the evolving demands of our healthcare system and provide an even better user experience, a transformative change was necessary.

What happened? The journey began with an agile development using existing infrastructure—Microsoft SharePoint and Microsoft Forms. The collaborative effort between system partners across the Cornwall and the Isles of Scilly ICS and Strata Health resulted in a unified electronic referral platform spanning primary, secondary, community, social services, and the third sector. It provides comprehensive visibility, enabling stakeholders to track referrals and monitor the patient journey efficiently. Recognising that innovation is an ongoing journey, this project is structured into multi-phased approaches. Phase one involved replacement and enhancements, with a continuous focus on refining workflows and functionality based on user feedback. The successful deployment of the unified eReferral solution across 250+ referring locations and three Integrated Transfer of Care (ITOC) Hubs has been “remarkable”. On its first operational day, the system received 462 referrals, showcasing its immediate uptake and relevance. From July – November, 52,875 referrals have been processed, with 1,0575 referrals on average per month. A decrease of 38.95 percent in response time was seen in the first four months.

Looking ahead. As the platform implements more integrated workflows, its influence and impact are expected to grow significantly, enhancing its reach across various sectors and organisations. Future phases are aimed at leveraging AI-powered reporting for critical performance metrics, expanding functionalities to transform service delivery, automating complex referral streams, and integrating with various service systems for seamless data flow.