By making records fully available to those staff with access rights on a 24/7 basis the project has delivered direct benefits to clinical staff and patients. For example, colleagues can search the full history of a patient record prior to meeting them, this is especially useful for the many patients who return to services after a break in active care. This activity is much simpler and faster using a digitised format rather than paper.
Moreover, and in accordance with the full business case LYPFT expect a number of efficiency related benefits to be realised in the coming weeks. This includes the costs of owning and managing paper as more of the active records are scanned. This is achieved through reducing spend on courier services moving records around Leeds, reducing spend on consumables i.e. paper, folders, labels etc, freeing up of space in offices across the various LYPFT records stores for alternate uses; and freeing up of staff time used in the maintenance of paper records for alternate duties.
“Digitalisation of the complete patient record seems like an obvious thing to do but it not that common to see it in mental health services. The objective was clear, but it needed an integrated approach from multiple suppliers and a talented team in the Trust to achieve. Apira understood what we wanted and supported us from business case to deployment. Creating a team that trusted and believed in each other made all the difference. Many thanks to all of those involved.”
Bill Fawcett Chief Information Officer from Leeds & York Partnership NHS Foundation Trust
Challenges Overcome:
The project faced a range of formidable challenges. These included the need to establish a Digital Records Team from the ground up, requiring Apira to shoulder responsibilities in system configuration, testing, engagement, demos, and training until staff were recruited and trained. Additionally, the small size of the Medical Records Team led to the need for a more active operational role for Apira throughout the deployment.
Uncertainty regarding the extent of active paper volumes within the organisation presented logistical hurdles during the transition to digital records. Complex conversations around the scanning solution emerged due to stringent throughput requirements of LYPFT, Apira and the external suppliers worked proactively together to overcome these challenges.
The project encountered changes in the overall timeline, while waiting for an upgrade from the Trusts EPR solution. This was a key upgrade which enabled HL7 messages to fire to the EDMs for a Real-time integrated solution. Despite this, an initial go live was achieved in March 2023 with a context launch implemented, which was found to be acceptable for users.
Furthermore, integration challenges surfaced between the Electronic Patient Record (EPR) and the EDM but despite these challenges, the project successfully overcame these obstacles, through teamwork and determination, delivering valuable improvements in the healthcare records management.
”The key clinical objective for this project was to provide access to as much of the patient record as possible instantly. Mental health conditions can last decades with many volumes of notes, containing vast quantities of information. We were keen that this information is readily accessible and searchable. We also wanted a robust process to identify paper which is being generated, so that we can continue our efforts towards a paperless, or at least very paper light, organisation. We are very happy with the MediViewer product and the implementation that Apira has assisted with”
Dr Nick Venters
Chief Clinical Information Officer from Leeds and York Partnership NHS Foundation Trust
Key Deliverables and Achievements included:
- Successful Business Case and Procurement: The project began with the creation of a compelling Business Case, which displayed clear benefits and secured LYPFT approval. A rapid Procurement led by the LYPFT was also supported by Apira resulting in Mizaic being appointed to provide the software.
- End-to-End Involvement: Apira played a pivotal role throughout the project, from the Business Case creation to Procurement and then Deployment.
- Transformation and Efficiency of Record Management: The project transformed the way healthcare professionals interacted with historical records, creating a more user-friendly system, and streamlining access to the Health Record.
- Engagement and Training: The team ran engagement and training sessions prior to the onboarding of floorwalkers, ensuring a smooth transition.
- Process Redesign: Apira’s expertise was utilised to design and implement new policies and processes across multiple service areas and teams within LYPFT.
- On-Site Support: Apira provided critical on-site support, even stepping in to help box up files for scanning when resources were limited.
- Creation of Digital Records Team: Apira supported LYPFT to recruit and onboard a Digital Records Team to ensure the project and future digital projects deliver LYPFTs transformation journey.
- System Configuration: Supporting LYPFT to fill in gaps where necessary especially in the initial stages of Project Deployment, while we helped recruit and induct a new Digital Records Team. This included creating system taxonomy and conducting full end to end testing. This also included supporting LYPFT with a full end-end testing process to achieve full working solution.
- Technical Infrastructure – Supporting the development of system architecture and configuration, while working with Trust teams and external Suppliers to ensure a smooth transition of data.
- Supplier Management: Apira ensured third-party suppliers collaborated effectively to meet LYPFT’s minimum viable solution needs.
- Forward Scanning Process: A forward scanning process was designed for ongoing use in Business as Usual (BAU).
Critical Success Factors:
- Input from Clinical/Admin/Operational staff: Input from clinical, administrative, and operational members is essential for the success of healthcare projects. These stakeholders offer diverse perspectives and expertise that align projects with real-world healthcare needs. Clinicians and nursing staff, provide insights derived from direct patient care, enhancing patient safety and care quality. Involving them helps identify and address specific challenges related to patient records, clinical workflows, and data access. Collaboration among these stakeholders streamlines processes, identifies bottlenecks, and enhances project outcomes. Their involvement promotes a sense of ownership and engagement, improving the efficiency and effectiveness of healthcare services.
- Communication with Senior Team: Effective communication with the Senior Team plays a pivotal role in ensuring the success of healthcare projects. Regular interactions with clinical leaders and other executives and decision-makers was vital to preserve alignment with the organisation’s strategic vision. These touchpoints enable informed decision-making, optimal resource allocation, risk mitigation, and the delivery of a unified project message. The Senior Team acts as a conduit for engaging stakeholders, fostering accountability, and adapting to changing circumstances in a dynamic healthcare environment. By maintaining consistent communication with senior leaders, the EDM projects remain closely aligned with organisational objectives and better positioned to deliver lasting, impactful results.
- Strategy for Reducing Paper Volumes: A strategic approach to reducing paper volumes before the scanning process is both prudent and advantageous. This method ensures that the transition from physical records to digital archives is as efficient and cost-effective as possible. By proactively implementing measures to decrease the volume of paper documents, such as implementing digital capture at the source or instituting streamlined documentation processes, the NHS Trust can not only save time and resources but also enhance data accessibility and security. This strategy enables a seamless transition, minimises potential bottlenecks, and paves the way for a more efficient, digital-centric healthcare Records Management system.
- Defining Roles and Responsibilities: Defining roles and responsibilities at the outset of a project is a critical practice that fosters project success. This early clarity ensures that every team member, within the Trust, the project team, and external suppliers, understands their specific functions and accountabilities. It minimises ambiguity, mitigates conflicts, and enhances overall project efficiency. By aligning expectations and responsibilities, potential issues can be proactively addressed, teamwork is promoted, and project objectives are achieved more seamlessly. This practice is fundamental in maintaining a cohesive, collaborative environment and ensuring that all project stakeholders work together harmoniously toward a common goal.
The LYPFT EDM project highlights the remarkable transformation achieved through collaboration, innovation, and dedicated efforts in healthcare records management. It serves as a testament to the positive impact that a well-executed digital transformation project can have on a healthcare organisation.
Paul McIver, Digital Records Manager from Leeds & York Partnership NHS Foundation Trust, expressed his gratitude for the project, saying, “The roll-out of MediViewer as our new EDM system signifies an important digital transformational change for the Trust, moving away from the restrictions and pain points that existed with paper health records.” Paul further praised Apira’s project management and expertise, describing their service as professional and collaborative. Apira’s commitment to building strong relationships with all stakeholders including LYPFT colleagues to tackle challenges and deliver results was highly appreciated.
To find out more about EPR and other services offered by Apira, please contact Rory Dennis, Director of Growth rory.dennis@apira.co.uk