sustainabletimes
15
document management
Patients can
be prioritised
according to
their needs,
with two work
streams created
simultaneously –
an administrative
pathway and a
clinical pathway...
Digital from
the start
Papworth Hospital, the largest
cardiothoracic centre in the country,
is implementing an electronic
medical records system (eMR)
to improve how patient referral
paperwork and medical notes are
indexed, routed and shared among
clinicians and clerical staff.
The eMR system is a necessity as a
state-of-the-art £165 million hospital
that Papworth Hospital is building on
the Cambridge Biomedical Campus will
not have a paper records library on-site.
However, it also delivers significant
time- and cost-savings and removes the
inefficiencies of paper handling, storage
and distribution. Current and future
benefits include:
n
Fast access to patient records
24/7. Historically there was a day’s
delay as paper records had to be recalled
from storage. In an emergency, a
courier would have to be sent to collect
paperwork, which was expensive;
n
Support for multi-disciplinary
team working by allowing secure remote
access so that clinicians can view records
from their offices or homes;
n
Significantly reduced operational
costs. Paper notes storage and logistics
were costing the Trust around £100,000
per annum, not including staff costs.
Papworth Hospital estimates that in the
last year eMR has saved the Trust 53km
of paper from a total output of 1600 km;
n
Compliance with targets. The
system will help Papworth to meet the
Government target to treat patients
within 18 weeks – and know where
people are on this timeline – thereby
avoiding financial penalties imposed
when targets are missed;
n
Improved clinical services and
efficiency. Papworth provides services to
10 outreach clinics around East Anglia,
including sleep apnoea care. Currently,
notes have to be ferried to and from
The implementation of an electronic medical records system at
Papworth Hospital has been named Public Sector Project of the Year
at the 2014 Document Manager Awards
these centres by courier. In the future,
eMR will remove these transport and
handling costs by allowing clinicians and
nurses to access notes digitally;
n
Increased productivity. A project
is underway looking at all the factors
that could cause a person to stay longer
in hospital, but by cutting the time to
process patients, the eMR system could
reduce the surgical length of stay.
The eMR system is based on CCube
Solutions’ EDRM software, supplemented
with an eReferrals application, an
eClinical letter and workflow approval
system, plus integration with a third
party digital dictation solution.
It also gives portal access to other
hospital applications like the PAS and
Pathology solution, which means
consultants don’t have to change
systems; a single sign-on gives staff
access to all the databases they need.
To date, 850 staff have been trained
and registered to use eMR including
around 120 consultants.
eReferrals
The eReferral application went live on
September 8, 2014 in the Cardiology
department and is being rolled out
incrementally throughout the hospital. All
referral letters are scanned into the eMR
system as soon as they arrive so that
staff can see where a patient is in the
booking and treatment process. Patients
can be prioritised according to their
needs, with two work streams created
simultaneously – an administrative
pathway and a clinical pathway – both
operating independently of each other.
The health records team can view
a referral on their computer, register
a patient if required, check the
demographic information and input
patient data into the PAS. The Business
Support team can check clock start
dates and 18-week pathway status.
The eMR system is also used by
clinicians to document recommended
treatment, which clinic should be
involved and whether to add a patient to
a waiting list or route them to another
colleague. Secretaries will have visibility
of the process so that appointments can
be arranged.
eClinical letter and workflow approval
The eClinical letter and workflow
approval system enables secretaries
and clinicians to draft letters after a
consultation and route them around
colleagues for review and sign-off before
sending them on to GPs.
New patients
The hospital is in the process of
designing and implementing eForms to
help capture new patient information
without relying on paper.
Digital dictation
Further efficiencies have been achieved
by replacing the old analogue dictation
system with a digital solution integrated
with the eMR system. Integration
enables secretaries to listen and type
letters within the eMR system, which
speeds up the letter drafting process and
makes it easier for managers to organise
and distribute work to staff.
Commenting on Papworth Hospital’s
eMR system, Vijay Magon, managing
director of CCube Solutions, said:
“Papworth has addressed the beginning
of the patient’s journey within the
hospital. It hasn’t worked back like other
trusts and focused on scanning legacy
records. It is hoping that by greatly
reducing the amount of paper produced
at the outset, it won’t have to do back
scanning, given the cost and complexity
of doing so. This makes a lot of sense as
over 70% of new patient information is
generated electronically anyhow.”
