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November 12, 2010

NHS Trust claims first paperless patient records success

£1.4m annual savings on £1.2m investment

By Steve Evans

St Helens & Knowsley Teaching Hospitals NHS Trust has completed a switchover to electric patient health records as part of a project to become a truly paper-free organisation. It claims to be the first NHS Trust to completely eliminate the use of paper health records in clinical practice.

An initial investment of £1.2m is expected to lead to annual savings of around £1.4m through no longer having to pay for the upkeep of its document library and associated staff costs.

The Trust used electronic document management software (EDMS) from C Cube Solutions and installed a number of scanners from Kodak. Investment in the back-end infrastructure was minimal, the Trust said.

Neil Darvill, director of Informatics at the Trust, told CBR that going paperless is part of a long-term strategy to transform the way the Trust works. "We wanted to provide a higher quality of service to our patients and to ensure all data is available for every patient. We needed 100% accountability and that meant going digital."

Workers at the Trust now have instant access to patient records at any time of the day and from a variety of locations and the rollout has reduced the risk of lost records. This is particularly useful for night time emergencies when paper records may be sealed in a library somewhere.

In total over 40 million pages of records have been digitised and 27 hospital departments have now gone live with the platform.

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The system was implemented over a 22-month period and over 500 clinicians and 130 medical secretaries are now using the system. An update to the system, due around Christmas this year, is expected to provide access to local GPs as well. Direct entry on to the system is also going to be introduced at a later date, the Trust confirmed.

For the end-users the project has improved their ability to treat patients. Dr Francis Andrews, director of critical clinical care at Whiston Hospital, told CBR: "Many doctors thought it wasn’t going to work as many are not too good at embracing technology. Notes often took two or three days to be transferred around, which created delays. With the electronic records we instantly know all about a patient and their medical history, which means we can get the treatment right."

Both Darvill and Dr Andrews believe that involving the end-users in the design and development stages of the project helped towards a successful launch. "There was lots of clinician involvement," said Dr Andrews. "We requested that the system be faster and new servers were installed and we also asked for a thumbnail view of the records for easier view and got that as well."

The entire system is replicated at another data centre off-site, so in the event of the system at the hospital going down users will just have to log off and on again to switch over to the backup system.

This scheme is part of a wider modernisation project at the Trust, which has invested £338m in rebuilding its two hospital sites. It is not, however, connected to the £12bn NHS National Programme for IT (NPfIT), which had, "good intentions but has so far failed to deliver on its promises," Darvil said. "This is completely different to NPfIT," he told CBR. "We had a problem that needed solving now and didn’t want to wait. The NPfIT has not been managed well, engagement with external companies meant a lot of the technology in place wasn’t right; a lot of it was meant for interim use but is still in operation."

Darvill hopes the success of this rollout will spur interest from other NHS Trusts in moving to an electronic patient record system, with 30 other NHS Trusts expressing an interest in the system and visiting the site to see it in action.

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