EDM Deployment at
London North West University Healthcare NHS Trust

“Patients who have multiple conditions can have a disproportionate experience with delays due to availability of paper notes as they can have multiple appointments across different departments. ”

Mr Nicholas Ferran, Digital Services CCIO at LNWH

INTRODUCTION

In early 2020 London North West University Healthcare NHS Trust (LNWH) launched an ambitious project, MedRecsOnline. Its aim to digitise the entire active caseload of records, over 150k paper records spread across three sites, and make them available at any time via a secure web-based application.

In March 2020, when the Coronavirus hit the NHS, the project was at risk of being derailed before it even began. However, despite the pandemic lockdowns, the project hit its deployment timeline.

 

Thanks to the tremendous efforts of trust staff, software supplier IMMJ, professional scanning services Restore Ltd, and the project management of Apira, the EDM solution “MediViewer” was deployed and over 160,000 scanned records are now accessible via any trust device with an online connection.

Currently, any new paper content generated is digitised within 48 hours, enabling the trust to bridge the gap in the run up to the new Electronic Patient Record system implementation, by making records digitally available.

THE CASE FOR MEDRECSONLINE

Paper records present the NHS with a huge operational burden. They drain staff resources as well using up valuable space in hospitals. They can also spread germs and pose a constant risk of a clinical incident, should they go missing.

The use of paper of records limited the trust due to:

  • Paper records are slow to navigate, especially as they rely on (often poor) staff adherence to filing and organisation
  • Dozens of porters are required to move them around the hospitals, or worse shuttle them between sites;
  • Paper records can go missing or fall into the wrong hands
  • The wrong data can be transferred because patient records can be stretched across multiple folders
  • Paper degrades and can get damaged in any number of ways in a hospital environment

There is also one other important risk associated with paper medical content. As physical objects made of absorbent material being handed around, sometimes by very sick people, they represent a non-trivial infection control risk.  In the light of the COVID-19 pandemic this risk became even more tangible.

APIRA’S ROLE IN MEDRECSONLINE

Apira deployed experience and expertise to enable the successful deployment of MedRecsOnline at LNWH. Acting in an overall project management role as well as the conduit between the trust and the software and scanning suppliers, IMMJ Systems and Restore.

Throughout the creation of the business case by Apira, appropriate trust staff were consulted. A full project and engagement plan was also developed for the system implementation, all validated by senior trust staff.

Mr Nick Ferran and Dr Frank Geoghegan led the clinical input to the programme.  Apira ensured the solution was configured and rigorously tested before use in Mr Ferran’s orthopaedic services as an early adopter.

Following success of the business case, LNWH engaged Apira to manage the deployment which was done via a formal Programme Board.  As part of this process Apira liaised with technology vendors and trust staff on key aspects of the project.  Through the period of COVID-19 lockdowns regular video calls were held with workstreams.

Apira ensured that the project team included patient forums as part of the engagement plan, to gain validation and feedback on their ideas relating to virtual consultations.  For example, a Patient Experience Group was used to present and agree the project goals.

The project team also created leaflets outlining changes in consulting to patients as the solution went live, explaining new ways of working and advice in how the processing of patient data and records would be changing.

Since the beginning of COVID the Medical Records team have been working on this project in partnership with Apira, IMMJ and Restore.  The partnership has been successful and enabled the trust to achieve their Digital Strategic Goals. The knowledge and experience Apira brought to the project has supported both myself and the team to achieve our objective within a safe environment”

Mary Cahill, Associate Director of Digital Services at LNWH

Kiranjoth Dosajh, Team Leader, Medical Records Library at LNWH and Mary Cahill, Associate Director of Digital Services at LNWH in the now digitised library at Northwick Park Hospital.

THE IMPACT ON THE DELIVERY OF CARE

Medical records underpin every clinical decision.  Replacing paper with a digital solution enabled rapid access to essential information from anywhere, reducing risk of lost content, and search tools enabled rapid location of key information in complex histories.  This also facilitated widespread remote care: clinicians can now consult with patients even if either is housebound, for example during isolation or lockdowns. This provided an important tool to enable care to continue being delivered despite the pressures of the pandemic. The lack of physical files also removed an important nosocomial infection vector, improving the ability of the trust to control the spread of infections across  the hospital.

BENEFITS OF MEDRECSONLINE

  • The creation of space. At St Mark’s Hospital the trust freed up 133m2 (worth £4.5k pcm) and at Ealing some £309m2 has been freed up amounting to £10.3k pcm, currently over £177k pa in total. 
  • Freeing up staff. The expected freeing up of medical records staffing will start in the second half of the FY22/23 and is expected to be significant. Staff will be re-trained into other positions across the trust.
  • Patient benefits. Multiple clinicians can access a digital patient record at the same time across the entire estate with secure remote access.  For patients this can help alleviate any delay to their care and any cancellation or re-booking of appointments.

THE FUTURE

At an event in September 2021 in Leeds, Apira presented the work on this project and current progress to an audience of NHS trusts and suppliers.   

From this event and as a result of the success at LNWH, Hillingdon Hospital commissioned Apira to assist them in developing a business case and implementing an EDM system throughout the hospital.    

Apira will also now be using the project plan and lessons learned to deploy EDM software at Leeds and York Partnership NHS Trust.  

“Implementation of MediViewer in has eliminated the circumstance where a patient presented to the trust’s hospitals for clinical care and become aware that their paper file had not been locatable for the episode.   ”

Dr Frank Geoghegan, Diagnostic Pathology Consultant, Clinical Lead at LNWH