Tags: NHS

Without full integration into trust EPR systems eReferrals fall short

NHS goals for a paperless healthcare system are well intentioned, but too often there remain gaps in trusts’ electronic capabilities, causing efficiency leaks and hampering overall process transformation.

One of the starkest examples currently is around electronic referrals (eReferrals), an NHS initiative established to streamline the transition of patients from primary into specialist secondary care – from the traditional situation of manual correspondence over the space of several weeks. Managing referrals electronically ought to speed up that process, while giving healthcare professionals continuous and speedy access to all associated notes.

Yet there remains a digital disconnect. Referrals may be coming into trusts electronically now, but too often these are being printed out for circulation with patient records, or re-input manually into clinical or patient record systems. This not only creates extra work for those involved; it also generates new scope for risk if errors are made or printouts go astray – the very eventualities eReferrals were designed to avoid.

Bridging the digital divide

The problem is that there is no inherent way for trusts to connect incoming electronic referrals to their existing clinical or patient record systems, to streamline the onward workflow or accelerate clinical pathways.

Ultimately, the NHS e-Referral Service (e-RS) really only provides a user interface through which hospitals retrieve electronic referrals. What happens after that is down to each trust to figure out. There are third-party tools out there which ‘screen scrape’ the information from incoming referrals and use robotic process automation (RPA) technology to interpret and capture it, but until now there has been nothing that works natively with the NHS e-RS to capture content and metadata directly into hospital systems.

That’s a need we’re meeting with our new SynApps eReferrals Gateway solution. This provides direct, real-time integration and information capture directly into trust’s preferred systems – whether an EPR or other existing clinical system (for instance one holding medical imaging records). And these could be based on Alfresco, Documentum or some other electronic content management platform – the brand or format of system doesn’t matter.

A solution developed with trusts for trusts

We deal with NHS trusts all the time, and it’s through these close connections – in particular our partnership with Sandwell and West Birmingham Hospitals NHS Trust – that we developed our eReferrals Gateway solution. It allows e-Referrals content to be stored and accessed digitally alongside electronic patient records.

Without this capability, the digital benefits of eReferrals stop at the hospital threshold. And, once the content is transferred onto paper, it carries the same risks of the notes going astray, or not being readily accessible, as have traditionally been the case with written or faxed referrals.

The idea of extending the impact of eReferrals end to end across a trust is to give clinicians seamless, immediate and concurrent access to everything they need – on demand – as part of a broader workflow. This will ensure that trusts process referrals reliably and effectively, and are paid promptly and accurately for their work.

Now that we’re actively marketing the SynApps eReferrals Gateway, we’re seeing demand soar. A major London trust is the latest to implement the solution, and broader interest is intense. The need to clear referral backlogs following the pandemic adds to the impetus to streamline their handling across trusts, and we’re keen to help in any way we can.

SynApps Announces the General Availability of its New eReferrals Gateway Solution, Developed in Partnership with Sandwell and West Birmingham Hospitals NHS Trust

The native NHS e-Referral Service (e-RS) integration, which is already generating significant interest among UK trusts, will allow secondary care providers to digitally disseminate referrals to clinicians with patient records

Hatfield,  UK – September 15th,  2021 – SynApps Solutions, the enterprise content management specialist with a leading presence in UK healthcare, has formally launched its new e-Referrals Gateway solution for NHS Acute hospitals.

Developed in partnership with Sandwell and West Birmingham Hospitals NHS Trust, the solution allows e-Referrals content to be stored and accessed digitally alongside electronic patient records – addressing the inefficient practice of e-Referrals being printed out and circulated manually within hospitals. Crucially, secondary care providers can connect this to their existing patient administration or clinical systems, whatever the underlying repository – whether Alfresco, Documentum, etc.

The SynApps e-Referrals Gateway, which was tested in a successful proof-of-concept project at Sandwell and West Birmingham Hospitals NHS Trust and is set to be rolled out to other UK trusts, bridges a gap in NHS Digital’s electronic referrals initiative. Usually, when e-Referrals come in to Acute hospitals via the NHS e-Referral Service (e-RS), the content is printed out before being passed to the relevant consultant.

“The NHS e-RS is really just a user interface through which hospitals retrieve electronic referrals,” explains Jason Scholes, CTO and co-founder of SynApps. “Unless this is integrated with everyday hospital systems, the digital benefits stop at the hospital threshold. And, once the content is transferred onto paper, it carries the same risks of the notes going astray, or not being readily accessible, as have traditionally been the case with written or faxed referrals.”

SynApps’ e-Referrals Gateway provides the means for e-Referrals content to be captured and stored alongside electronic patient records, or other existing clinical systems (for instance those holding medical imaging records). The idea is to give clinicians seamless and concurrent access to everything they need, on demand, as part of a broader workflow. Unlike other solutions in the market, it doesn’t ‘screen scape’ the referral notes, but captures them natively using the NHS’s native e-RS application interface (API). This enables richer information to be captured, and supports rapid search.

To optimise the solution, SynApps partnered with Sandwell and West Birmingham Hospitals NHS Trust, a valued customer and digital trailblazer. “It was important that we got this right – and what better partner than Sandwell – a visionary Trust and a very knowledgeable customer of ours,” Jason comments.

Sandwell, which has eliminated paper from its sites in recent years and embraced electronic patient records, seized the opportunity to automatically upload referrals to its EPR system, so that consultants can triage them directly and move them to clinics.

Word of the latest SynApps/Sandwell collaboration has already reached neighbouring hospitals, generating a lot of interest, and a major London hospital is among the latest to implement the solution.

Says Liam Kennedy, Deputy Chief Operating Officer at Sandwell and West Birmingham Hospitals NHS Trust, which is co-marketing the e-Referrals Gateway, “We are very ambitious in our vision and are now in the top quartile among NHS Trusts for advanced digital operations. With SynApps’ support we’re storming ahead, and we’re keen to help light the way for others who want to learn more about what we’ve done.”

“We’re excited about the potential of the e-Referrals Gateway,” Jason at SynApps adds. “Existing NHS e-Referrals handling is at odds with Trusts’ paperless strategies. It is also critical that Acute Trusts are able to handle referrals reliably and effectively, with good traceability – so that they get paid for their work and cover their fixed costs. With this new solution, devised with proactive input from Sandwell and West Birmingham Hospitals NHS Trust, we’re bridging that gap.”

SynApps Transforms West London NHS Trust’s Document & Patient Records Management

Modern, easy-to-integrate Alfresco system allows NHS Trust to improve search, reporting and more

Hatfield, UK – October 14th, 2019 – SynApps Solutions, the enterprise content management specialist, has overhauled the document and patient records management of West London NHS Trust, improving user access to content, the ability to search and reporting.

SynApps works with a number of organisations in the UK health sector and became involved with West London NHS Trust when it became clear that the Trust’s legacy system for its document and patient records management was not fit for purpose.

Users were unable to search text in the Trust’s millions of documents and individual patient records, making it cumbersome and time-consuming to find documents. Trying to generate basic reporting metrics was clunky and slow at best, and often impossible.

“Access to documents and patient records is critical to the smooth-running of the Trust and our previous system was expensive, slow and starting to cause major issues for us,” said Graham Birrell, central records and EDMS manager, West London NHS Trust. “It was clear we needed to change and we started to look at the options available.”

The Trust had to decide whether to upgrade its existing system or replace it, and it was becoming increasingly clear that a replacement would offer the most potential for providing the more modern and improved experience users needed. It was important to be able to integrate the new system with Rio, the Trust’s patient administration system, as well as increasing accuracy and productivity, and improving overall service delivery.

For enterprise-level content management, Alfresco stood out as the obvious option for the Trust. Not only did it have a modern feel to it, and come with some great APIs, when Alfresco introduced the Trust to its strategic integration partner, SynApps Solutions to implement the new system, the Trust was immediately assured it had made the right decision.

SynApps swiftly demonstrated that Alfresco offered a lot more functionality than before, such as the ability to preview content, drag and drop documents, easily upload files and display folder contents. The whole experience of using the system was much easier, faster and clearer, while it is has also integrated with other systems easily and transformed reporting.

“I have been in the NHS for over 20 years and I can’t sing the praises of SynApps highly enough,” continued Graham Birrell. “They’re extremely responsive, even out of hours – which tends to be when we contact them – even though this isn’t in their contract. They put enormous effort into the preparations and the transition to the new Alfresco system, smoothing the way and doing exactly what they promised.”

West London NHS Trust, formerly West London Mental Health NHS Trust, is one of the most diverse providers of mental and physical healthcare in the UK, providing integrated services across 30 sites. SynApps has a strong track record in working with such health organisations, a result of its ability to understand the specific needs and challenges they are facing, according to spokesperson, job title, SynApps.

“Our work with West London NHS Trust is a further example of the success we have had within the UK health sector. It’s a market we have a deep understanding of, and we know how important document and patient records management can be and the impact they have on service delivery.”

SynApps helps accelerate roll-out of NHS mobile lung checks

8 Trusts are already in discussions to deploy its Veolity solution, which enables radiologists to review or validate ‘lung MOT’ scan results at speed

  • NHS England aims to check the lung health of 600,000 individuals over the next 4 years, via CT scanners in mobile trucks in supermarket or workplace car parks, to get ahead of cancer
  • SynApps Solutions is the UK distributor of Veolity, from MeVis Medical Solutions AG, whose medical image processing software integrates with existing NHS PACS or VNA patient record systems

Hatfield, UK – June 11th, 2019 – SynApps Solutions, the enterprise content management specialist with a large customer base in UK healthcare, has reported soaring demand for a new software solution – Veolity – which helps radiologists review or validate lung CT scans at speed, as the NHS rolls out mobile lung health checks.

SynApps is already in talks with 8 NHS Trusts about the product from strategic partner, German medical software specialist MeVis Medical Solutions AG, as part of an NHS England scheme to take travelling lung clinics to supermarket car parks and other high-footfall public locations. The NHS has allocated around £70 million to fund 10 projects, which initially will target regions with high rates of lung cancer.

The initiative, designed to improve cancer survival rates, will create increased workloads for radiologists who will need to interpret and validate high volumes of new lung scan results within an acceptable timeframe – in addition to their existing pipelines. Veolity targets this scenario by providing an optimised reading workflow. Further, Veolity helps to identify, segment and calculate the proportions and make-up of pulmonary nodules in individuals’ scans. Radiology teams can use the software to perform an automated first review of patient scans including current-prior comparisons. After the initial reading, CAD findings alert the radiologist to regions of interest that may have been initially overlooked.

“A radiologist performing 10 lung studies per day could gain back two hours of their time, by using the software”, according to Jason Scholes, CTO and co-founder of SynApps. “With the shortage of trained radiologists, having access to tools that can help process workloads more swiftly, while maintaining high accuracy of analysis, is vital,” he notes.

SynApps, the UK distributor of Veolity, is ideally placed to implement the solution for NHS Trusts, many of which already source their patient record systems from the company. SynApps can provide full integration with hospitals’ existing picture archiving and communication system (PACS) or vendor-neutral archive (VNA) systems, along with appropriate advice and training.

SynApps, in partnership with MeVis, is experiencing high levels of interest from across the NHS. Manchester University NHS Foundation Trust is one of the first in England to pilot the Veolity solution. “We hope to be involved in many trials like these,” Jason says.

Since being appointed a distributor for Veolity last year, SynApps has attended joint events with MeVis, to promote the solution to the UK healthcare market. “The reception has been fantastic – very positive indeed,” Jason says. “While a good proportion of the interest is coming from Trusts tasked with delivering the NHS lung clinics, we’re also getting requests to cope with incidental health checks/referrals from GPs. Veolity is a necessary tool for larger hospitals, and in time we expect to see this kind of automation aid become a mainstream part of their digital strategies.”

Lung cancer is the most common cancer worldwide and causes the most cancer deaths each year, so early diagnosis and prevention strategies are increasingly important. Low-dose computed tomography (CT) is recognised as an effective form of medical prevention among groups at higher risk of developing lung cancer.

The new checks mean large volumes of medical imaging data must be acquired and read – in a standardised and efficient way, ensuring high diagnostic precision – when radiologists are an increasingly scarce resource. Veolity fills that gap, and makes more effective use of radiologists’ time, by combining images of solid pulmonary nodules and findings from prior studies to efficiently create clear reports. These inform next actions, including further analysis. The software improves workflow and enhances quality in lung diagnostics, especially in high-throughput environments, such as routine lung checks.

About MeVis Medical Solutions
MeVis Medical Solutions specialises in developing software applications that combine innovative medical image processing and workflow support, bringing the precision of scientific studies to everyday work environment in hospitals and medical offices.

More at https://www.mevis.de/en/

SynApps Dubbed ‘2019 EMEA Partner of the Year’ by Open Source ECM Leader Alfresco

Earlier this month, SynApps Solutions was delighted to learn we’d been honoured as EMEA Partner of the Year for 2019 by our key Enterprise Content Manager (ECM) partner Alfresco. Chris Brice reflects on the depth of our relationship – and where it’s going next

Wow – what can we say but THANK YOU.

We’ve been working together for nine years, shifting about seven years into a major joint focus on helping NHS customers, which I’ll say more about in a second. What I can say right now is the things that made Alfresco originally so attractive to us – that it’s a major player in the ECM arena and an open Open Source platform, meaning that ISVs like us can build specific solutions with our customers on it, remains as true now as it was back then: Alfresco is a superb digital transformation platform with truly global reach.

And like I said, it’s in the NHS that we’re seeing the most benefits together of those facts. We share very important customers: Leeds Teaching Hospital, Northampton General Hospital and Sandwell and West Birmingham NHS Trust.

At Leeds we are helping its very dynamic CIO deliver on his ambitious plan to totally digitise the Trust – a task which will improve the working lives of all 20,000 employees. It’s a similar story with Northampton, which has 6,000 team members, and which has a plan to similarly digitally transform, based on implementing the Alfresco workflow solution as it allows them to provide immediate benefits by automating manual processes, making people’s lives easier, and making sure that they minimise the number of risks taken in, in any process. Interestingly, Northampton is working on its Referral To Treatment (RTT) workflow right now, as RTT pathways is a very important tracking solution that tracks every single individual through the entire 18-week cycle through their referral. Finally, over at Sandwell, the Alfresco digital platform is supporting another great workflow improvement, but we’re about to start work on an e-RS triage system there as well.

If you’re not familiar with that latter term, it’s an E-Referral system provided by NHS Digital where referral has to go through a portal. Working with Alfresco tech again, what we can do to help there is capture the content from the portal – be it fax, email, or scanned-in entry – then we deliver it to the right team of clinicians within the organisation, automating the whole process.

That’s a lot of achievement, and it’s so nice that for its 2020 kick-off the company decided to single us out for our great support. But you know what? The best is yet to come, as it’s the future we are creating together that I think is really going to open the next chapter: our joint SCR (Shared Care Record) push, which is what our relationship will all be about in the next few months.

SCR is, of course, a new initiative, funded and sponsored by NHS England ultimately, that is all about joining up care across the community in regional areas, so that if you get referred to a hospital that isn’t your local one, when you walk in the door and they identify you properly, there’s no delay in your treatment.

SynApps and Alfresco are working together on this front – joining together its Open Source digital platform and our VNA (Vendor Neutral Archive) and our Cross-Enterprise Document Sharing (XDS) platform, to provide what we’re calling a ‘cradle to archive’ view of any person – be they a patient, a citizen, or somebody in social care or mental health, with a timeline view.

Our plans now are to do a significant marketing campaign to help Trusts working on their NHS England  Local Health and Care Record Exemplars’ (LHCRE  Exemplar work) – and we think it’s going to be a really big success over the next two years.

And we will make sure it is – as the benchmark our partners like Alfresco measures us by is its license model – and if we carry on making that work for them, I think we’ll become their key partner, not just in the UK, but the whole of Europe.

Chris Brice is Director of Sales & Marketing for SynApps Solutions

Tackling the referred pain of digital patient referrals

As NHS England mandates that faxed referrals are phased out, and trusts look to alleviate the grind of manually re-entering details between different IT systems, SynApps Solutions’ Chris Brice charts a practical, pain-free way to exploit NHS Digital’s e-RS referrals service more fully – which delivers for patients, trusts and NHS budgets

On the face of it, NHS trusts are already making progress with electronic patient referrals. Steadily, GPs and patients are defaulting to the NHS Digital’s e-Referrals portal which will soon be mandatory for primary care referrals, to guarantee payment for services. Yet, although this is widely understood – and despite an appreciation that referrals by fax, email or other manual means are not efficient or easy to trace – a large majority of patient referrals are still being handled using complex, time-consuming workarounds. Even where requests are channelled via the NHS e-Referral Service (e-RS).

This undermines the purpose of the NHS e-RS, which is designed not only to provide a single central digital platform for capturing and coordinating patient referrals, but also to streamline associated processes, speed up treatment, and provide reliable traceability of a patient’s progress and status.

So what is preventing total take-up of the broader digital experience – where referrals pass quickly to the right person, and targets of faster patient diagnoses and treatment are met?

The issue is two-fold.

First, NHS Digital hasn’t yet developed its own workflow-driven applications to make it easy to pass referrals through the system automatically and track and report on progress.

Second, the diversity of IT systems used by GPs and hospitals has proved a barrier to integration. As a result, primary care providers have resorted to faxing and emailing referrals. For their part, hospitals have printed and scanned those requests, manually re-entering and tallying these with patient records held elsewhere on their systems. Rather than accelerating case flow-through or alleviating administrative workloads, this has often created more work and delay. It is not unusual for a trust to be manually re-entering details of 15,000 referrals per month. Some major trusts accept up to 50,000 patient referrals daily.

Joining the dots

For the NHS e-Referrals programme to have its intended impact, digital processes need to be joined up end to end. Then they can start to exploit intelligent automated workflow. That includes prompt diversions of cases to more appropriate specialists or services (inside or beyond the immediate hospital); and complete traceability and reporting – with rules-driven alerts, to ensure that no case enters an administrative cul-de-sac or slips through the cracks, and that critical performance targets are not missed.

All Acute trusts are aware that the current piecemeal situation cannot continue. As of 2020, faxed referrals will no longer be accepted, and NHS services already face the prospect that they will not be paid for referrals accepted through any channel besides the e-RS portal. So trusts and their primary care practitioners might as well ensure that the e-RS leads to perceptible benefits for staff and patients.

Fortunately, approved NHS Digital development partners SynApps Solutions and Alfresco have already put in the groundwork to deliver end-to-end electronic referrals solutions. These offer trusts all of the integration; rules-based workflow; process automation; monitoring, prompting and reporting required to fully harness the benefits of digitising patient referrals.

From electronically capturing patient requirements and connecting these to patient records; to accelerating the triage process and clinicians’ acceptance/refusal/redirection of referrals; to vigilantly monitoring, prompting and reporting on referral-to-treatment progress, our combined, modular solutions are designed to extract maximum early benefits from NHS Digital’s e-Referrals initiative for everyone concerned.

The expected benefits are substantial – including efficiency gains of 60-70 per cent compared with manually processing, checking and following up on referrals and progress to treatment.

And that’s aside from the benefits to patient safety, as cases are proactively tracked and escalated thanks to automated rules in the system. Robust compliance and performance measures, meanwhile, will help ensure that trusts are paid in full and within acceptable timeframes for the cases they have accepted.

None of this needs to be an upheaval or costly exercise for trusts, either. Our solutions can be run in the cloud as well as on premise, and there are significant grants available for trusts ready to make the full transition now. Funding is applicable especially where organisations come together on joint projects, in line with NHS England’s Sustainability and Transformation Plan. Each trust can go at its own pace too, or prioritise how it tackles its respective migration to a fully digital referrals scenario. That’s because the SynApps Solutions/Alfresco solution suite is modular, offering trusts the flexibility to concentrate on just the capabilities they seek right now.