Ophthalmology EPR Business Case, Procurement & Deployment


Ophthalmology is both a technological and diagnostic focussed department within any NHS trust. Clinical staff rely heavily on state-of-the-art devices to diagnose patients.

To avoid labour-intensive processes these devices need to be networked. In 2019, it was clear that London North West University Healthcare NHS Trust (LNWH) was the only ophthalmology department in England without an EPR system. Simultaneously, legacy software was limiting the equipment the team could use and staff found working with paper records both frustrating and time-consuming.

Evelyn Mensah
Consultant Eye Surgeon & Clinical Lead for Ophthalmology

New System Drivers

There’s no doubt that without Apira, the business case and procurement of a new EPR would never have happened. They enabled the voice of ophthalmology and the clinicians’ voices to be heard and for the challenges we faced to be clarified, prioritised and resolved.

Evelyn Mensah

  • No existing Electronic Patient Record (EPR) system in the Ophthalmology Department
  • Legacy software in the department was limiting device and diagnostic capability
  • State-of-the-art photographic equipment was not being used to its full potential
  • Funding available due to the department’s pilot role in Eyeswise (a virtual clinic established for glaucoma treatment)
  • Clinical staff did not have the capacity or expertise to create a business case for EPR
  • Cost efficiencies needed to be considered
  • Desire to digitise diagnostic services across the Trust
  • Inefficiencies and inaccuracies around paper-based data entry due to non-networked equipment needed to be addressed
  • Demand on department – ophthalmology is the busiest outpatient department across the NHS. Cataract surgery is the most common procedure performed within the NHS
Review & Specification
Based on a recommendation, LNWH commissioned Apira to create its business case for an ophthalmology EPR system and to help facilitate the networking of all the department’s equipment. Apira worked swiftly with the ophthalmology team at the Trust to identify the existing challenges and to articulate a business case for the EPR. This included a review of existing EPR systems already in use in other ophthalmology departments across the NHS.
The Outline Business Case was finalised and signed off in December 2020. Due to the coronavirus pandemic, it was clear that digitising the system was paramount for the Trust and the decision to secure an EPR was expediated by the challenges of the pandemic. The procurement process was also expedited and a single tender waiver was agreed as the route to procure an EPR.
The Solution
MediSIGHT was selected as the ophthalmology EPR solution by the Trust. Delivered by Medisoft, mediSIGHT is an award-winning system that supports every aspect of ophthalmic assessment and treatment. The solution supports wider use of previously under-utilised ophthalmological equipment and offers integration with the Trust’s overall EPR solution.
Supported Deployment
Apira helped managed a fast deployment within just six months from the finalisation of the business case. This process included the deployment of the EPR, upgrading all the departments devices, training for staff and networking previously unused medical devices.
The Future
  • Apira is helping the Trust to fully digitalises letters and communications to patients via the EPR system
  • Apira continues to support the Trust during the deployment of other pathways for the department’s other ophthalmology services
  • Moved from a 100% paper-based department to fully digital within six months
  • Go-live for the system was delivered on time and within budget during a global pandemic
  • Patient safety improved by the reduction of errors in manual data transfer
  • Immediate positive feedback from clinicians using the EPR system
  • Reduction in labour-intensive and inefficient data-entry methods
  • Helped stabilise environment and infrastructure during the challenges of Covid-19
  • Full training provided to more than 50 members of staff using the system
  • System enables the Trust to now compare itself to other units around the country

Before we had an EPR system we had to manually input thousands of pieces of information on cataract treatments for patients. It was painstakingly frustrating but now everything is instant and automatic. This is highly beneficial to both staff and patients.

Evelyn Mensah