Case study: Papworth Hospital’s first steps to electronic patient records

The Cambridgeshire hospital has installed an e-referrals application as part of its journey towards electronic patient records

Papworth Hospital in Cambridgeshire has installed an e-referrals application as part of its journey towards an electronic patient records (EPR) system.

The hospital already had a document management system which started life as a pilot five years ago, but the addition of the electronic referrals process allows the hospital to keep a closer eye on patients while reducing paper and sharing patient details more easily between hospital staff.

The largest cardiothoracic centre in the country installed its referral workflow using CCube Solution, which provides a workflow and e-forms.

“It’s a stepping stone towards a full-blown electronic patient records system,” says David Wilcox, Papworth’s Hospital’s business change and information management and technology project manager. “We’re supposed to be going on with that next year, and really this is partly to get our people up to speed using electronic systems.”

Digitising patient records

Speaking to Computer Weekly, Wilcox explains that most of the referrals received by the tertiary trust come from district general hospitals.

“We get a lot of paperwork,” he says. “And because of the number of things that have to happen – not just clinical, but administrative too – an elaborate paper chase was developed over the years, with documents photocopied, faxed and put in the post to various locations.”

With the electronic referrals system, the documents still reach the hospital in paper form, but are immediately scanned into the CCube Solutions electronic document management software

“From that point on, all people involved in the care of the patient can see the referral electronically,” says Wilcox.

Consultants treating a patient can log into a web application through the hospital’s intranet and see the document on a computer screen. They can attach notes to tell a secretary what needs to happen and whether a follow-up appointment needs to be booked for them. 

On the administration side, the patient can be checked and put on the admin system, which feeds into other electronic systems.

“The document management system is also the portal to access other hospital applications, which means consultants don’t have to change systems. A single sign-on gives staff access to the various databases they need,” he says.

Additionally, the business support group can use the e-referrals system to ensure the hospital is meeting the NHS standards that all referred patients should get treatment within 18 weeks.

“As a tertiary trust, patients may have come from another district hospital, so that 18-week period has already been eaten into,” says Wilcox. “We need to identify how much time we have available to us. It’s about tracking this information as soon as possible.”

Preparing to go paperless

The trust is also building a £165m state-of-the-art hospital on the Cambridge Biomedical Campus, which plans to have no paper records on-site. The combination of electronic document management and e-referrals for all new patients trains hospital staff in a new paperless way of working in preparation for a move to the modern premises.

We no longer have issues about reading peoples’ scribbles on bits of paper

David Wilcox, Papworth’s Hospital

The e-referrals application went live in the cardiology department in September 2014, and there are plans to roll out incrementally throughout the hospital. To date, 850 staff have been trained and registered to use the system, including around 120 consultants.

When it was first implemented, Wilcox says there was a little opposition from some clinicians. But one of the reasons it rolled out the new software so quickly was to keep in line with its service improvement programme. The software streamlines processes so there is no time lost in treating patients. When clinicians realised this, they warmed to the system.

“It’s now quite well received and we no longer have issues about reading peoples’ scribbles on bits of paper,” says Wilcox. “We know exactly where in the path these documents are, and we know exactly who’s looking at them with a full audit trail.”

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It was amazing how quickly the EHR vendor industry sprang up. Basically, as soon as the federal government said it would provide subsidies, that made EHR "free" to the hospitals.

It's great to see that vaporware turning into something real. I expect it will turn into better service - charts will be available when people need them, without anyone looking things up in a file cabinet. Will it reduce costs? That one has a question mark at the end, I'm afraid.
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