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Lessons learned from EPR implementations in the UK 1

Editor’s Note: In October, nearly 50 healthcare leaders gathered for the first Allscripts Client Experience (ACE) User Group in the UK. Clients shared their experiences with electronic patient record (EPR) systems and discussed getting ready for the eras of population health management and precision medicine. This is the first in a two-part blog series that shares some highlights from the day-long event in Birmingham.

Our clients are doing great work and, given the opportunity to connect with peers, they are eager to share insights and tips for success. Continuing that spirit of collaboration, we share some of their lessons learned from EPR implementations.

For example, Wrightington, Wigan and Leigh (WWL) NHS Foundation Trust went live with Sunrise across all three of its major hospitals in June 2016. WWL chief clinical information officer Dr Martin Farrier, outlined five lessons he had learned from this experience:

  1. Trusts do not go from analogue to digital working. They go through a stage he described as “analogue digital” – in which there is still a lot of free text entry and scanned paper in use.
  2. “It is much easier to put a system in than it is to take one out” – and old systems holding letters and results are proving remarkably hard to dislodge at WWL.
  3. Implement a “minimum viable product” because “the simplest system is always the best system.”
  4. Although implementation projects focus on data entry and devices for doing it, “output is more important than input” when it comes to getting clinicians to use systems.
  5. Keep “politicians” on board, particularly when “good data” reveals problems that were masked by “bad data.”

Setting out on the EPR journey 

One UK trust in the foothills of this journey is Bolton NHS Foundation Trust, an integrated acute and community trust that is preparing for the first of two big Sunrise go-lives next spring.

Phillipa Winter, the trust’s chief information officer, and Ken Bradshaw, Deputy CIO and EPR Programme Director, said the Trust has started with a focus on infrastructure. For example, it implemented a wi-fi network good enough to let patients stream Netflix and to enable staff to access records at the bedside.

It is also engaging with staff on the design of the new EPR, and it is thinking about how it will hook into systems across an increasingly integrated ‘north west Manchester.’

“I would say challenge yourselves on what you can do,” Winter told her audience. “We will be doing something really special, and Allscripts will be part of that.”

Go-live is just the start

One of the themes throughout ACE User-Group UK was that, for all the effort it takes, go-live is the start rather than the end of a journey.

Liverpool Heart and Chest Hospital NHS Foundation Trust deployed Sunrise in another “big-bang” back in June 2013. EPR clinical configuration analyst Carol Moss said that since then it had worked on an optimisation project with Allscripts.

“For us, Sunrise has worked well. Indeed, the trust is now “99% paperless,” Moss said. She explained how this has enabled it to streamline its processes while improving care for patients. For example, it has redesigned its cardiac rehabilitation forms and made them electronic, which has reduced the number of missed referrals from 50 to just two per month.

Look after your team

“Implementing an electronic patient record is not like any other implementation you have ever done,” Peter Lowe, IT programme director at The Dudley Group NHS Trust, told the ACE User Group-UK.

“Only people who have implemented an EPR get to wear the T-shirt.” Standing in front of a Been There, Done That T-shirt slide, he explained that when a trust implements an EPR, it does not just implement an IT system.

Instead, it must work with its supplier to tailor the system and define its business processes. Then it must build and test the system, as well as train staff. Each stage is exacting, and Lowe suggested building “a chronically optimistic and resilient team” – and to look after it.

“You need to spend 80% of your time looking after your staff and 20% looking after your project,” he said. “If you look after your team, the project will look after itself.”

To learn more from UK clients, check out our recent eMagazine about Digital Transformation in the UK.

1 Comments

Comments (1)

Gary Davies

When Trusts embark on the journey to deploy an EPR they take on complex problems which require hard work and creativity to resolve. Having led EPR teams at three of the sites in this article I know first-hand that they have learnt so many valuable lessons along the way, and it genuinely makes me incredibly happy to know they are working closely together to pass on those lessons. Ensuring where possible that mistakes are not repeated, and successes are, requires one Trust to share their knowledge and the other to be open to receiving it. Working collaboratively is no mean feat, and while reading this article was a nice reminder of the great teams I’ve worked with recently, what really made me smile was knowing they are working together to facilitate each other’s success.

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