Tags: EPR

Time To Plug Every Paper-Created Care Pathway Gap

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SynApps’s Mark Winstone looks at how NHS CCIOs and CIOs can make a smart move to new ways of paperless working in a crucial part of hospital workflow – Care Pathways

“We are a long way to getting to our paperless targets – but we are still working to remove paper out of our medical records work.”

The quote is from David Walliker, CIO at the Liverpool Women’s NHS Foundation Trust – and I am sure his is a reality many NHS teams can relate to.

In fact, even as we are moving to a paperless NHS by 2020, many hospitals are still shuffling a lot of paper around. This is happening even though a fair number have adopted leading-edge EPR (electronic patient record) suites that are making a lot of their processes fully digital.

Why is that a problem? There is one serious problem with paper still filling up the hospital –and another that’s absolutely critical. Actually, they are inter-related, as we’ll see.

The first one is simple efficiency. When you start a Care Pathway, such as when a patient comes into A&E, if your staff are having to transcribe details onto paper or on and off terminals, that’s simply time wasted – and time they should be using to help the patient directly.

Don’t let Never Events happen because of the paper chase

The second critical issue is that a complicated, disjointed system that’s paper here and digital there means there are gaps – gaps into which patients can fall. And, tragically, they do, resulting in what NHS England classes as the unforgivable Never Events – “serious incidents that are wholly preventable as guidance or safety recommendations that provide strong systemic protective barriers are available at a national level and should have been implemented by all healthcare providers”.

We know of at least one Never Event caused by such a disjointed process: a Trust that has paper at a crucial part of its emergency admissions – and some paper got lost, and a patient ended up with double the dose they should have received.

Minimising the chance of Never Events is one of the principal drivers of the whole move to paperless. But not everyone has an EPR: not all Trusts have turned on all the modules; not all systems have been joined up.

That means there are gaps, often at crucial steps in a Care Pathway, that don’t have any support for a better, more digital way of inputting data and keeping it safely in a central repository. That’s now possible, however, via some great new technology that’s being brought on to the marketplace by our key Enterprise Content Management (ECM) partner Alfresco in the shape of something called Activiti, a functionally rich Business Process Management (BPM) solution.

What Trusts can do is automate some parts of their care Pathways with Activiti, which is a simple but powerful way to build easy to use e-forms that can plug these gaps – and help stop these Never Events ever happening.

‘Significant efficiency gains’

One Trust that’s already finding out just how useful paperless support for Care Pathways is, is Liverpool Women’s NHS Foundation Trust. Let’s find out a bit more about just how.

One of only two hospitals in the UK dedicated to the care and treatment of women and their families, Liverpool Women’s is also the largest women’s hospital of its kind in Europe. And as part of its commitment to a paperless NHS, the Trust recently made the move to an EPR it thinks will completely transform the delivery of its patient-facing services, enabling better, more informed patient care at the point of care while streamlining working practices between clinical teams. The project will generate significant efficiency gains alongside major operational cost savings for the organisation.

A great way to make sure you don’t miss your RTT target

But interestingly, says CIO David Walliker, management soon realised as the EPR project progressed that the non-clinical workforce could similarly benefit from an enterprise content management solution. “It was time to initiate a more efficient paper-less ‘next generation’ working approach that was better aligned with how business users need to operate today,” he says. “Implementing Alfresco will improve staff access to documents and, in due course, support remote access to our resources by mobile workers and remote workforce personnel.

In specific terms, that’s going to include advances like automated electronic document management processing, task management and powerful workflows that he thinks will maximise workforce performance and internal collaboration capabilities, he predicts.

So what’s his view on Activiti? Very positive. “It’s been very quick to develop and get up and running,” he has recently stated. “We’re replacing our paper forms with e-forms this way, starting with emergency staff.” Team members are very enthused by how easy this way of working is, he says, especially how connection with that back-end EPR means many fields in a Care Pathway can be automatically populated by the system itself.

Efficiency is also helping patients, as better record taking and information inputting has started to cut down the need for pregnant mums to come in, he adds.

So there seems to be real basis for optimism here: Activiti does seem to be a way to build more digital NHS workflows. And it’s worth bearing in mind that when you start a Care Pathway of any kind, the clock starts ticking for your RTT (Referral to Treatment) waiting times – another reason to ensure a streamlined, safe way of Care Pathway building.

We really think there’s value in this approach, and I encourage any NHS IT team to explore how it might help.

Mark

Mark is joint Chief Executive and head of all Sales activities at SynApps Solutions

You can see a short video about how Liverpool Women’s NHS Foundation Trust is benefiting from Activiti on YouTube here, while a fuller case study can be found online at our partner Alfresco’s site here.

Plus, if you’re interested in finding out more about e-forms and an automated approach to get to paperless Care Pathways, you may want to go to one of these upcoming roadshows. In them, you can hear more about the Activiti technology and about Trust experiences.

The events are supported by NHS England, and are being run in London on June 22 and Liverpool on June 23: please go here for full details, including how to secure your free place if you are a qualified NHS professional.

Hope to see you there!

SynApps Announces June Healthcare Event Series

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May 23rd, 2016 – SynApps has today announced dates for  its June Healthcare event series.

Working in collaboration with partners Alfresco and Kainos Evolve, the healthcare seminars bring together clinical teams to develop digital maturity and improve patient care and offer an opportunity to discuss how optimising the flow of information and processes within healthcare organisations is vital to achieving this aim.

Supported by NHS England, the events will be led by national programme leads plus CIOs from two of the UK’s most digitally mature Trusts, who wil share learning from successful projects.

Aimed at CIOs, IT Leads, Operations Directors and Commissioners, these free to attend sessions run from 1.30pm to 6pm and will be followed by a Q&A panel, drinks and canapés.

 

London, June 22 – King’s College, Waterloo Campus, London SE1 9NH 

Richard Jefferson, Head of Programme Commissioning at NHS England, will be joined by David Taylor, Programme Lead at Virtual Worlds and Medical Media at Imperial College Healthcare NHS Trust.

Register

Liverpool, June 23 – Maritime Museum, Liverpool L3 4AQ

David Walliker, CIO at Liverpool Women’s NHS Foundation Trust will be leading this session, highlighting the strategies and solutions that have helped Liverpool Women’s achieve the highest level of digital maturity for both its readiness and infrastructure.

Register

SynApps Wins Extensive And Positive Coverage Around Work Helping Hospital Trusts Realise EPR Ambitions Via VNA

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SynApps Solutions and its key technology partner Alfresco have just launched a unique new Open Source VNA (Vendor Neutral Archive) medical data system for the UK health market, based on Alfresco’s technology.

The system was the subject of extensive reporting by UK tech and HIT (health IT) titles, such as The Enquirer, Digital Health News (formerly E-Health Insider) and 24n.Biz.
According to Digital Health News (formerly E-Health Insider), in a widely-viewed news piece which generated 18 comments, Peter Coates, NHS England’s Open Source programme manager, was quoted as follows: “‘I think this is a key piece of the jigsaw puzzle of a whole open digital ecosystem that we’re all going to need to enable data portability and integration.’”

According to 24n.Biz, in an interview with pioneering user of the VNA approach, Rachel Dunscombe, CIO of Bolton NHS Foundation Trust, “Open Source becomes all the more important when in the context of a VNA [as] archiving technology can become interoperable, allowing the incorporation of different types of data from all over a hospital.”

http://www.digitalhealth.net/news/ehi/9970/open-source-vna-fits-digital-%E2%80%98jigsaw%E2%80%99

http://24n.biz/news/open-source-vnas-are-the-future-of-the-nhs-.html

http://www.theinquirer.net/inquirer/news/2401818/nhs-rolls-out-vendor-neutral-archive-initiative-to-open-source-records

SynApps coverage in leading IT titles Computer Weekly and ComputerWorld UK: Helping Hospital Trusts realise their EPR ambitions via VNA

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Two of the biggest UK trade press IT titles are covering one of our most recent wins for our VNA solution – we encourage you to check out the coverage!

The stories report on how London’s Kingston Hospital NHS Foundation Trust is to use a new content management system to secure access to patient information and clinical images, thanks to a new ten year partnership with SynApps Solutions.

Kingston is using the VNA (Vendor Neutral Archive), a standards-based way of extending PACS (Picture Archiving and Communications System) services to incorporate DICOM and other format content, to make the sharing of medical data easier for clinicians as well as making patient records available across any combination of service providers.

The system also incorporates XDS Repository/Registry cross-document sharing capability, which Kingston Hospital plans to use to create electronic patient records easily accessed by doctors.

Please visit these websites to read more:

http://www.computerweekly.com/news/2240238242/Kingston-Hospital-NHS-Trust-moves-off-BT-with-new-picture-archiving

http://www.computerworlduk.com/news/public-sector/3594054/london-kingston-hospital-nhs-trust-deploys-integrated-imaging-system/

Buying an EPR System Won’t Save the NHS

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By Tony Backhouse, Business Development Manager – Healthcare Division, SynApps Solutions

Last time we spoke, I started explaining why SynApps has expanded the functionality of our pioneering VNA (Vendor Neutral Archive), our system to help hospitals better handle their digital information (see ‘Saving the NHS – Let’s Start with Local Health IT’).

I also put that work in the context of recent NHS thinking on the central place of localised, useful health IT systems and how those local systems can be built from the ground up. This time, I want to put a bit more context around what we’ve done with VNA.

A term that I need to wheel out again to get us started is the EPR – the Electronic Patient Record. I hesitate a bit as the term has so much legacy, not all of it good, in the NHS (thinking about the National Programme for IT, of course – which failed to deliver a national EPR, despite all our best efforts.  The thing is, the concept of Electronic Patient Records is still a really good idea. It would be fantastic to centrally store, but easily access, your patient history and data wherever you needed it.

That’s especially true as we start to use more and more digital information and images in the NHS. Think about radiology images, MRI scans, output from an echocardiogram – they really all should be available in a true EPR. Plus there are lots of reasons clinicians might want to take pictures of you too, to record a specific injury on the night you were brought into A&E, or the progress of a bedsore.  Those images could be virtually and securely attached to all those images in your digital, e-patient folder.

So back to the true EPR. This is where it gets a bit complicated, as information in EPR Systems have structured, electronic file data that’s not that hard to store and work with (and there are some systems out there described as ‘EPRs’ which are okay at what they do). What about all the unstructured data, though? That’s the Images we have talked about, the GP notes, the letter or email he or she sent to your specialist two years ago – there’s a lot of information we’d like to collate and keep with you on that patient journey you’re making through the NHS, across your lifetime.

The reality is that a proper EPR is going to have to be able to manage huge amounts of both structured and unstructured, document and paper-based content. Most experts agree the ratio between unstructured (GP letter etc. digital image or sound file) data and structured is in the order or 80:20 – that’s to say, 80% is unstructured.

How does this connect back with what we have been doing at SynApps Solutions? Well, what we had with our great VNA archive was a brilliant way of helping you handle part of that 80% – the images from you PACS, RIS and Ophthalmology systems as well as those poorly filed Medical Photography files. But we needed to give you more. And that’s what the Clinical Content Store (CCS) offers – a way to deal with the rest of the 80%, the unstructured ‘eight tenths of the iceberg’ of that patient content you want to be able to work with as well as the inactive part of the 20% that is either Read Only or locked in departmental systems.

To do that, you’d really like to be to offer both a VNA and a proper clinical archive, an intelligent repository that will offer a way to access all the data you need, importantly, in tandem with your EPR System. You can work with that data in your team, by the way – but it will also allow it to be worked on by other organisations, giving the social care team, as well as other hospitals and primary care or mental health institutions that act as stations on that (lifelong) patient journey, access.

Best of, well, multiple worlds?

The great news is that the CCS pulls all this together. One, it helps you manage all your Read Only data. Two, it gives you a repository to start working with all your unstructured information, too.

But what is really exciting is that it goes beyond what an EPR currently does and links together all that great new content in a patient centric view for sharing both in and out of your hospital.

Just one extra data point to get you excited about CCS; one hospital that we work with is telling us that by using our system is going to save them at least one million pounds a year in not having to directly work with such legacy systems any more.

Maybe now you can see why I and the rest of the SynApps healthcare team are so excited about the Clinical Content Store and what we know it can do for Trusts.

Which is, building out of the EPR – but in a new way of working with all your patient data, in a way that doesn’t force you to compromise.

Now that is exciting!

We are currently offering a free consultative study to scope out the potential of CCS to meet your need, but be aware it is time-limited – so start talking to us today!

Please – take advantage of the seminar [https://www.synapps-solutions.com/events/addressing-the-twin-challenges-of-retiring-applications-while-increasing-access-to-patient-information] on Thursday 29th January at 12.30pm at the London Chamber of Commerce, EC4R 1AR, and find out more about the Clinical Content Store and how it can help you meet your EPR challenge.

SynApps Launches The Clinical Content Store – An Image-Enabled, Information-Rich Electronic Patient Record

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UK healthcare providers can finally move beyond the traditional EPR, combining the best of new and old in one central, secure and easily searchable repository

 Maidenhead, UK – December 15, 2014 – SynApps Solutions, the Enterprise Content Management (ECM) solutions leader, has launched the Clinical Content Store (CCS), a next-generation data management system for digital patient record keeping.

The Store can hold all of a hospital’s medical images, including medical photography, as well as a wide range of other vital patient information too often locked away in niche departmental systems or in a read-only legacy system formats, as well as all the unstructured data that a true EPR (electronic patient record) demands.

The Store will also improve the sharing of information across the whole care pathway in or out of the hospital, a task made more challenging by the large number of hospital IT or PACS systems in the NHS that are too complex and expensive to maintain and which serve to place limits on viewing and sharing information.

The Store also comes on-stream at a time when former National Programme for IT (NPfIT) radiology and PACS outsourcing contracts finally wind down, forcing Chief Clinical Information Officers to find new image storage solutions in a context of financial constraint. A proven response to these challenges is the consolidation of PACS silos into one Vendor Neutral Archive (VNA), which is at the heart of the new SynApps product, but the Clinical Content Store is also a powerful data repository for all clinical and patient data, both structured and unstructured.

“We’re excited about Clinical Content Store as early customers in the NHS tell us it’s a fantastic place to start building powerful consolidated data repositories for all clinical and patient data,” commented Tony Backhouse, Business Development Manager – Healthcare Division for the company.

“These NHS customers also tell us they’re seeing a 70% reduction in the costs of keeping all their data in multiple systems when they’ve started using the CCS, with one institution already estimating is going to save at least £1m per annum by not having to directly work with legacy systems anymore,” added Backhouse.

Please – take advantage of the seminar [https://www.synapps-solutions.com/events/addressing-the-twin-challenges-of-retiring-applications-while-increasing-access-to-patient-information] onThursday 29th January at 12.30pm at the London Chamber of Commerce, EC4R 1AR, and find out more about the Clinical Content Store and how it can help you meet your EPR challenge.

About SynApps

SynApps is an independent services and solutions company specialising in Enterprise Content Management (ECM) technologies. Founded in 2003 by former Documentum services professionals, SynApps provides consultancy, implementation and support services for EMC Documentum and Alfresco, and has authored a suite of content integration solutions, ConXApps, that allow businesses to quickly maximise their investment in ECM technologies.

Organisations across healthcare, government and commercial markets rely on SynApps solutions and services to capture and share knowledge more dynamically and efficiently.

Find out more at synapps-solutions.com, or follow us on Twitter @Synappssol