HTN Now Awards 2023: EPR programme of the year

Next up, we come to our finalists in the category of EPR programme of the year.

Royal Free London NHS Foundation Trust

Overview. In October 2021, The Royal Free Hospital successfully completed the migration of over 1.4 million records and 820 thousand appointments onto their new Electronic Patient Record (EPR).

Why? The Royal Free Hospital had their own legacy instance of Cerner Millennium EPR, which necessitated developing and supporting two separate instances of Cerner, having no single source of truth and very fragmented workflows across all sites. With many clinicians largely working from paper medical records, the labour grew in intensity and caused delays in treatment. Changing to a single, shared EPR across all RFL sites, accessible from any location and device, can free up crucial clinical time which can be directed back into patient care.

What happened? The new EPR has resulted in 44 fully digitised standardised care pathways to reduce unwarranted clinical variation – delivering faster, better, and safer care. Overall improved patient safety due to fewer adverse drug events because of the closed loop clinical decision support in Electronic Prescribing and Medicines Administration. Bedside Medical Device Integrations (BMDI) have created early warning clinical alarms for deteriorating patients as well as achieving wider clinical community across two trusts, driving change and transformation.

Looking ahead. They are currently in discussion with several other Trusts who have expressed a desire to join the RFL-WHTHT shared domain. They will also be deploying new modules for patient flow, speech recognition and mobile working.

Somerset County Council and The Access Group

Overview. Somerset County Council has deployed an electronic patient record called Rio to improve public health and to offer further support to Public Health Nursing services. Working collaboratively with The Access Group, the providers of Rio EPR, the council was able to refine the system to suit the specific needs of the Public Health Nursing Service within the local authority.

Why? Implementing the EPR will enable clinicians to use real time data to meet the needs of the local population whilst the National Events Management Systems (NEMS) will automate many systems such as appointment booking, ensuring children do not fall through the cracks due to manual processes. This will ultimately reduce health inequalities for more children across the region.

What happened? Somerset Council assembled a digital workforce of clinical leads, project managers, configuration teams, trainers, testers, architects, and safety teams to manage the process. The local authority also worked closely with NHS trusts and the CCG, conducting a monthly steering group session as well as governance meetings to make sure the system was set up safely and securely. Now, the EPR is integrated with the NHS Spine, providing timely information about children born in the county and moving into the county from another area.

Looking ahead. Somerset Council has begun configurations in developing the system to suit the needs of Public Health Nursing and the population they service. They are expecting to see major reductions in Did Not Attend (DNA) rates as the system matures, so the children of Somerset can be as well supported as possible.

Leeds Teaching Hospitals

Overview. PPM+ (Patient Pathway Manager) is Leeds Teaching Hospitals’ (LTHT) electronic health record, built on the latest web technology and benefitting from a programme of continuous development to deliver an agile, multi-functional EHR.

Why? PPM+ has evolved to meet a growing range of clinical needs over the last 20 years. It supports everyday nursing, medical documentation, and clinical processes for two of the region’s largest NHS trusts – Leeds Teaching Hospitals and Mid Yorkshire Hospitals. The development of a web-based system, capable of capturing the structured information required for cancer services but also the unstructured narrative of a patient’s full needs, allows clinical colleagues to understand the full spectrum of care being received by a patient.

What happened? Over the past two years, the team has developed and launched a wide range of new features, working closely with clinical colleagues to support effective specification and adoption, and designed to support clinical priorities across a wide and varied context. LTHT has worked in partnership with Aire Logic for many years, providing consultancy and widening the scope to include Aire Logic’s forms4health digital forms engine – supporting the trust’s paperless strategy by digitising high volumes of medical forms.

Looking ahead. The development team is in the final stages of migrating PPM+ to the cloud, offering flexibility, scalability and resilience and delivering a huge benefit for a system which is relied on across the region.

Liverpool Heart and Chest NHS Foundation Trust

Overview. Liverpool Heart and Chest Hospital has been live with Altera Digital Health’s electronic patient record since 2013, and aims to reach HIMSS Stage 7 by the middle of 2023. The trust is one of the most digitally mature in Cheshire and Merseyside, has been rated ‘Outstanding’ by CQC for two consecutive years, and is a leading provider for patient experience, as per the National Inpatient Survey.

Why? The trust has an overall aim of being the leading cardiothoracic care provider in the country and becoming digitally mature was an intrinsic part of achieving this aim. Digital transformation enables a laser focus on patient safety and experience, managing inpatient beds, tracking patient flow in real time, assigning staff rosters, making referrals, and automatically uploading data from monitoring devices into Sunrise.

What happened? – The trust is now mostly paperless, with all clinical documentation, order communications and prescribing being done digitally through Sunrise. Everything a clinician needs is at their fingertips through a single tab function on the system. The organisation is now ranked in the top third in Europe for digital maturity. The deployment has reduced medication errors by 50 percent and improved patient safety by more than 50 percent, while also making major admin time savings.

Looking ahead. The trust recently conducted a gap analysis to understand how it can reach HIMSS Stage 7, which it is expecting to do by the middle of 2023.