Opinion – Navigating the Deployment Dilemma: Mental Health EPR – Getting it Right First Time or Landing and Expanding?

Getting it Right First Time – The GIRFT Method

Alan Brown, the Managing Director at Apira, presented the “Getting it Right First Time” (GIRFT) method. According to him, the GIRFT approach involves:

1. Catering to Specialist Requirements: Building a Mental Health EPR that comprehensively addresses all specialist requirements is crucial for user acceptance right from the outset. The emphasis here is on creating a system that resonates with the unique needs of mental health professionals.

2. Mitigating Unsafe Workarounds: Alan highlights the potential risk of implementing unsafe workarounds if the system fails to meet specific needs initially. This stresses the importance of a robust and tailored EPR to ensure safe and effective clinical practices.

3. Data Migration for Safety and Continuity: Migrating and archiving data is deemed essential not only for user acceptance but also for ensuring safety, efficiency, and service continuity. The seamless transfer of data from existing systems to the new EPR and/or an archive is pivotal for maintaining a consistent and reliable patient record.

4. Legal Duty of Care: Alan emphasises the legal duty of care, asserting that a comprehensive and fully functioning system must be in place from Day 1. This highlights the ethical and legal responsibility healthcare organisations bear in providing a reliable and secure patient information infrastructure.

Understanding Both Perspectives

To comprehensively understand the rationale behind each approach, it’s essential to delve into the reasoning provided by both sides.

The Land and Expand approach holds merit for several reasons. Firstly, clinicians, known for their experiential nature, thrive on real-world experiences. Immediate deployment provides them with firsthand evidence, fostering user acceptance as they engage with the system directly. Secondly, clinical practice is inherently dynamic, necessitating a constant refinement approach.

The Land and Expand model aligns seamlessly with this dynamic nature, allowing for ongoing adjustments based on the evolving clinical needs of healthcare professionals.

Moreover, the Land and Expand approach is perceived as more cost-effective, with lower project costs compared to the meticulous planning involved in the GIRFT method. This agility is particularly beneficial in managing timelines and external costs.

Lastly, the immediate deployment characteristic of Land and Expand ensures that the benefits of the Electronic Patient Records system are realised sooner, avoiding unnecessary delays, and allowing organisations to swiftly reap the rewards of their investment.

Alternatively, the “Get it Right First Time” (GIRFT) method is underpinned by several key principles. Foremost, it places a strong emphasis on quality over speed, prioritising the need for a robust and reliable EPR system in the complex landscape of mental health.

This commitment to quality aligns with the overarching goal of ensuring that the system meets the highest standards from its inception. Additionally, the GIRFT method involves a greater financial commitment upfront for the full project, strategically aligned with external funding sources.

Moreover, the method actively aims to minimise the risk of losing key team members in later phases, safeguarding continuity, and stability within the project team for a seamless and successful implementation.