Implementing an Electronic Patient Record for RDaSH
Rotherham Doncaster and South Humber NHS Foundation Trust (RDaSH) covers a wide geographical area, providing a range of services including community health services, children’s services and adult in patient and mental health services to support patients with complex medical conditions.
The Trust had been using two different clinical systems which was identified as a clinical risk. As a key element of the process to implement whole person care, RDaSH wanted to implement an EPR that would enable clinicians in clinic and community settings to access consistent, reliable and up to date information about patients, with the ability to share appropriate clinical information with GPs. In addition, RDaSH recognised the benefits of implementing Electronic Prescribing and Medicines Administration (EPMA) as an extension to the EPR.
The Trust appointed Channel 3 Consulting to support them in developing a business case for EPR and EPMA, procuring the best solution and implementing the new technology and associated work practices.
We approached the task as a business change project from the outset, with appropriate preparation, engagement and training support throughout. We created a project team incorporating experts in technology, clinical engagement, governance and system implementation. Integration of Trust resources to create an integrated Project Team was key from the start.
Channel 3 was responsible for developing the Outline Business Case (OBC). Drawing on best practice, the OBC assessed five options, resulting in an EPR+ model being adopted which would:
- Enhance the quality of care provision
- Improve agile/mobile working
- Support more integrated care by sharing data across internal and external boundaries
- Better access to accurate activity data to support the Trust and its commissioners
- Improve productivity
- Allow and enable the efficient and effective integration of a specialist clinical application, where the alternative functionality of the EPR application does not fully satisfy Trust requirements in the future.
Following a robust procurement process, RDaSH selected TPP’s SystmOne to provide the EPR solution. SystmOne was already being used in Community Health Services across the Trust and by a majority of GPs in the geographies serviced by the Trust.
Our SystmOne specialists worked with RDaSH and TPP to configure the EPR, creating templates that would support care plans aligned to the way the Trust works. We ensured that the Trust’s Clinical Systems Team was fully involved to ensure efficient and effective transfer of knowledge during the development and as a key part of the handover to Business As Usual (BAU). Operations In addition, through effective consultation across the organisation, new and more efficient processes were introduced to improve quality, consistency and productivity.
Consultation was embedded throughout the project:
- Four Local Implementation Groups (LIGs) involving administration teams and senior nursing staff, were crucial in helping the team understand exactly what the system needed to do and how it should be implemented, which increased confidence that what was being delivered would work across the wider team.
- Design Authority – chaired by the Chief Pharmacist and involving senior clinicians, plus senior representatives from corporate functions.
- Steering Group – cross functional senior management group, jointly chaired by the Director of Health Informatics and the Chief Operating Officer as project sponsors to reinforce the objective of a Business Change project.
- Executive Programme Board – monthly reviews as a key element of the Trust Transformation Programme, chaired by the Chief Executive.
This comprehensive approach to team engagement ensured EPR implementation was a clinically-focused business change project, not an IT project. It was appropriately designed to support the Trust and ensure processes and systems were developed in response to clinical requirements and ultimately patient needs.
Ten different workstreams were set up to manage the implementation of the EPR, including training and data migration. This was phased through four implementations of increasing size across four Care Groups to provide a manageable approach with limited and acceptable impact on the delivery of care. This approach also enabled the project to benefit from learning and improvement at each phase.
Channel 3 developed a detailed plan to ensure timely delivery of the activities, training and deliverables which was reviewed weekly by the Programme and Project Managers.
This was a complex business change programme, delivered successfully by working in close partnership with RDaSH through an integrated, single core project team, as well as full engagement with broader clinical and administrative staff throughout. The EPR project went live on schedule in all In Patient and Community Mental Health settings, with EPMA built into the programme to maximise the benefits of digitising patient records.
Implementation was phased to follow the Mental Health Implementations in each Care Group, smallest through to largest, with consequential improvements through post implementation learnings along the way.
RDaSH clinical and medical staff now have a single, complete view of the patient’s record, enabling a whole person care approach to be adopted. Where local GPs use SystmOne, they can also access appropriate parts of the community and/or mental patient record, including critical prescribing information, with the appropriate information governance in place.
By implementing standardised processes, RDaSH has been able to make more time for care. Configuration of the EPR is consistent and manual processes and work arounds have been eliminated, especially in Mental Health Services.
“Channel 3 Consulting helped us understand the scale of the task facing us in switching to a single Electronic Patient Record and plan accordingly. As a result, we’ve been able to successfully engage with our teams and ensure those delivering care to patients have access to the information they need in a format that is easy to use, reliable and secure. Channel 3’s expertise in EPR procurement and implementation ensured the smooth-running of this project which is already delivering the outcomes we intended.”
RICHARD BANKS, DIRECTOR, HEALTH INFORMATICS, ROTHERHAM DONCASTER AND SOUTH HUMBER TRUST
- More time for care through more efficient and consistent ways of working
- Faster clinical decision making
- Improved service user outcome and experience
- Reduced elapsed time between request for tests and/or referrals
- Reduced Adverse Drug Events (ADEs) and Adverse Care Events (ACEs)
- Better co-ordination of care between care providers
- Improved access to business information/intelligence