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County Durham & Darlington NHS
Foundation Trust has introduced
a new electronic medical records
(EMR) system to enhance its
operational efficiency and improve
patient care.
The EMR system removes
the headache of managing the
preparation, distribution and
collection of paper-based notes and
enables clinical staff in different sites
to access electronic medical notes on
desktop PCs and mobile devices – a
major benefit as patients often require
multi-disciplinary medical care.
The total investment in the EMR
solution over a 10-year period is
predicted to be £33 million. During
this time, the Trust expects to
generate savings of £4.5 million
through reduced paper use.
The Trust, which manages six
community hospitals and two
acute hospitals 21 miles apart,
handles around 650,000 outpatient
attendances, plus 70,000 planned
and 70,000 emergency admissions
each year. As the Trust has
modernised its services, patients
move around more within its
system. For example, someone may
go to Durham for an outpatients
appointment and then to Bishop
Auckland for surgery.
Moving hard copy records around
with patients created significant
logistical difficulties for staff at
the Trust’s three record libraries
located at Durham and Shotley
Bridge Hospitals and a warehouse in
Darlington.
Sarah Perkins, County Durham &
Darlington NHS Foundation Trust’s
associate director of operations
and performance, said: “Whilst our
100 records staff have delivered a
very good service in terms of notes
availability, there was a constant
level of stress about moving them
about to get paperwork to the right
place at the right time and then filed
away correctly, such that at any one
time 25% of our library was out and
in use.”
The Trust started a pilot of Civica
WinDIP records management
software in August 2013 in the
dermatology and plastic surgery
units. The implementation team
included the Trust’s IT department,
plus 14 other staff including an
overall project manager and health
records expert, change management
specialists and training personnel.
It was rolled out to the rest of the
hospital by December 2013.
To date, 4,000 staff have been
trained to use the EMR system which
they can access directly via an icon
on their desktops or through an
iSOFT-based system that integrates
with it. The EMR solution displays
information in a time line and via
tabs so that staff can quickly see and
access associated records.
On-demand scanning
The scanning of the Trust’s existing
medical records was undertaken
by TNT Business Solutions using
high performance ibml ImageTrac
scanners and SoftTrac Capture Suite
software supplied by Kodak Alaris,
with Kofax software used to classify
document images.
Alex Morris, TNT Business
Solutions’ General Manager
Operations, said: “We took over the
Darlington library facility which was
converted into a scanning bureau.
Every patient has been given a
unique barcode so we know where
every single record is. Now records
are digitised, it will make it far easier
for everyone working in the Trust and,
of course, patients themselves will
be better served by immediate notes
availability.”
A core group of 80 staff were
allocated to the project by TNT
Business Solutions. At its peak, this
team grew to 200 people on-site,
processing 1 million scanned images
each day.
To avoid scanning notes
unnecessarily – typically notes are
destroyed if an adult has not been
to hospital for eight years – the Trust
has adopted a scan-on-demand
approach rather than digitising
everything. This means that
people coming in for outpatients
appointments have their paper
notes scanned in advance of clinic
and made available electronically
via WinDIP. Individuals arriving at
the Trust’s emergency department
receive their complete digitised notes
within three hours.
This approach removed the
need to scan 55% of the estimated
900,000 folders the Trust held in
its three libraries – each containing
an average of 229 pages – saving
time and money and reducing the
total amount of folders scanned
and stored in the purpose-built data
warehouse storage system to around
400,000.
County Durham & Darlington
has now closed its three libraries
and is using ImageTrac scanner
and software technology for all-
day forward scanning. Every day,
handwritten updates to the records of
people who have come in and seen a
clinician are collected and scanned
into the system within 48 hours.
Better patient care is on the cards as a new
electronic medical records system is rolled out
in Durham and the surrounding area
Durham goes digital
Before & After
The problem:
l
Paper medical records held in three record libraries
l
Record collection and distribution time-consuming and
stressful
l
Multi-disciplinary medical care requires multi-user,
multi-site access to records
The solution:
l
EMR system based on Civica WinDIP records
management software
l
On demand scanning of existing and new medical
records by TNT Business Solutions
The benefit:
l
Instant access to records via PC
l
Staff in different sites can access the same records at
the same time
l
£4.5 million saving from reduced paper use
Moran’s managed print service
charge, Waters-Duke regards it as
cost-free. “It’s so affordable that
we can deploy the solution to more
people than before, answering the call
from many of the staff who asked to
have a PDF solution on their desktop.
With Adobe being so expensive, what
we are looking at now is a win-win
solution,” he said.
