University Hospitals Birmingham reorganises case notes with EMC Documentum

UHB reduces paper work and organises patient data into one central location through EMC Documentum

The University Hospitals Birmingham (UHB) NHS Foundation Trust was overloaded with case notes and referrals in paper form, resulting in misplacements of documents and unnecessary retesting of patients due to lost results.

It decided to turn to EMC for a content management system (CMS), in particular to help with its referral system. The trust chose EMC Documentum 6.5 to improve efficiency through Clinical Portal.

The hospital has an estimated 700,000 patients a year, with 7,200 staff across 40 disciplines. In June 2010, UHB opened a new £545m site – the Queen Elizabeth Hospital.

UHB also runs the Selly Oak Hospital for adults, split over two sites. The trust specialises in cancer, trauma, burns and plastics, and claims to have the largest solid organ transplant programme in Europe.

The IT network supports an estimated 5,000 laptops, PCs and tablets. 

The trust has been an EMC customer for over 10 years. In 2008, it started using EMC Clariion CX340 and EMC Centera in order to secure its records, which include corporate files, emails and clinical records. The environment also runs on VMware ESX Server, VMware vCenter and VMware vMotion.

Realising that the trust needed paper appropriate sites and a solution to moving documents/records between hospital sites, Dean Grinham, IT programme delivery manager, at UHB said: “From an ICT perspective, I didn’t want to spend time fixing things – I can’t innovate, if I’m fixing.” 

Dean Grinham shared the trust’s case study to an audience at EMC’s Momentum in Vienna.

He explained: “We had a huge amount of paper records – case notes, memos, test results coming in, referrals. In Documentum, we provide different folders for filing referrals, management plans, electronic documents, and anything else the staff use on a daily basis. With Documentum, 4,000 documents are accessed a day.”

Using EMC Captiva, capture technology, along with VMware ESX Server, VMware vCenter and VMware vMotion, the information is virtualised.

When choosing a CMS, Grinham said he had come to the conclusion that he “didn’t need a solution that did everything for us, as it doesn’t exist. We just needed everything in a central location.”

Grinham said the trust initially looked into back-scanning all of the paper documents, but it was considered too pricey:  

“However, if we need to scan a document to go with case notes, such as a letter from another company, then that can now be added. That document is then readily available for all to see, providing they have the right permissions,” he said.

Challenges of the project

“We were moving from two old hospital sites to a new one. In the old sites, there were between 40-50 outpatient sites with case documents in paper form – that’s a huge amount of paperwork,” said Grinham.

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The question was, he added, how do we communicate that the patient has arrived and needs testing for instance? 

EMC’s Captiva captures patient information, with no more forms for them to fill out. 

“Sometimes patients would walk off with paperwork, or the clinical staff did not enter all of the information correctly into the system. Now with the paperwork gone, it is a clearer environment for all,” he said.

Digital pen technology for use with patients has also been implemented in addition to dictation technology too.

MyHealth and staff portal

Used mostly for patients with long-term illnesses, MyHealth enables patients to access their own medical records. The patient can upload their own documents too, to share with the consultant in the clinical portal view.

Some 350 patients use MyHealth currently. Grinham said UHB expects 2,000 patients to use the service within its first year. 

“With a bio and profile you can talk to others with the same conditions as you,” he explained.

Documentum is also used by the staff through a staff portal. This is used by employees as a dashboard, which covers key day-to-day tasks such as web usage, emails and electronic payslips.

“We have also developed our own talent and recruitment tracking with Documentum as the back-end solution,” added Grinham.

Benefits of the deployment

Grinham mentioned the main benefits of the deployment as being a single log-in to view all the information in one place and the solution is patient-focused.

It integrates with the new dictation system and with other clinical systems, such as PICS, which is the trust’s drug prescribing, order communications and observation system.

“The system basically means no more missing notes in clinics, reduction in manpower for paper medical records and informed decision making at point of care,” he said.

Grinham explained that referral letters from GPs are always there now: “It’s usually the record that’s missing. This means that tests do not need to be redone.”

Looking towards the future

Future plans at the trust include more integration to other systems and mobile and tablet access, as well as data consolidation to remove the need for personal databases. 

"It should all be accessible for all via Documentum and that’s where patients should store their records,” said Grinham.

More projects around HR portfolio, with electronic staff files, and more support for R&D is also on the table for future developments.

The trust will also look into using EMC’s Kazeon, which is an in-house eDiscovery system. A new version of Kazeon – 4.7 – was released at EMC Momentum yesterday.

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