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Case study: Hospital trust moves to digital patient records

St Helens & Knowsley Teaching Hospitals NHS Trust claims it is the first trust in the UK to move to a purely digital records system.

Francis Andrews, director of critical clinical care at the Merseyside trust, said the move to an electronic system was made to cope with vast numbers of people and too much information.

Under the old system patients would arrive for appointments and no paper notes would be available. They were stuck in transit, or at another hospital site or in a doctor's office and sometimes they had to have their appointments rearranged as their notes were not available. "This is one of the most exciting projects I have been involved in for 20 years," he added

The new system offers more security as it is only the trust's doctors and nurses who have individual log-ins and passwords. "Now we know exactly who's logging in and reviewing notes. So if someone unauthorised is doing so we would know, unlike when we had a paper-based system," said Andrews.

Screens display patient names, appointment times, last doctor's letters, and a range of links into the electronic document management software (EDMS) so that a clinician can access the patients' medical history.

The hospital used C Cube Solutions, integrating EDMS with Kodak document scanners in its theatres, wards and outpatient clinics.

E-records

Digitising health records meant the trust can save £1.4m per annum. The system cost about £1.2m and has already paid for itself, and by 2014 the hospital will close its paper library, said Andrews.

Previously the hospital was moving 7,000 records every week for nearly 350,000 outpatient visits annually.

"So far we have already cleared half the records library. We are already using two fewer vans to ferry files around. We had temporary staff of 62, which went down to 52. Previously there was a whole raft of people whose job it was to walk around and deliver notes," said Andrews.

All 27 hospital departments across the trust are now using the system, which was rolled out over a period of 22 months.

The EDMS runs on four clustered HP servers with more than 14Tbytes of patient data stored on two HP storage area networks, backed up to tape and optical disc to ensure robust disaster recovery.

The trust intends to remove all paper entirely by developing the EDMS through adding direct data entry capabilities to turn it into a fully-fledged electronic patient record system. The first pilot will start before Christmas 2010.

Access to the system will also be extended to GPs and other primary care professionals via a voice and data network which interconnects 340 sites in Merseyside. A consultation process is underway with the project team anticipating this to be available in 2011.


Return on investment on EDMS

  • Patient risk is reduced because all medical history is available at the point of care.
  • Admissions from the A&E department have reduced as clinicians now have instant access to scanned notes.
  • Appointments can be made at short notice and patients can see several specialists in one visit because case files are accessible.
  • Multidisciplinary team meetings are easier and can be done over the phone or via a PC rather than everyone having to physically meet to share one file.
  • Fewer complaints are made. Historically, 40 complaints a year were received specifically about records from individuals sent home because doctors had not received files on time; now there are none.

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