Basildon and Thurrock University Hospitals NHS Foundation Trust has completed an electronic medical records (EMR) system to digitise its patient records.
The project saw the hospital scan 450,000 legacy patient records – equating to around 54 million pages – which were located in a dedicated off-site library. The trust now also scans its paper records after consultations with patients on a regular basis.
For now, doctors and nurses will continue to generate new information on paper and these will be sent to the scanning bureau to be added to the electronic records. But the plan is to begin digitising at source when the technology becomes mature enough.
Designed by the clinicians who use it, the system allows doctors, nurses and other healthcare professionals electronic access to their patients’ medical records. It also means important clinical documents can be located quickly using indexing to automatically recognise documents.
The project began in 2010 when the trust awarded the contract to Kodak Alaris, and the hospital has scanned the final batch of records from its paper medical records library onto its 34TB database.
The project cost £7m but it is estimated it will save £1m per year in reduced operating costs and £1.6m a year in improved efficiencies across the trust.
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EMR programme manager Phil Burke said the library was “pretty much bursting at the seams” and the hospital had the choice of finding a bigger premises or start scanning the records.
After deciding to digitise, it took four years to transfer all of its patients’ medical records from a warehouse the size of a small aircraft hangar into a computer that is not much bigger than the size of a fridge freezer.
However, in 2010 the trust found the market was not very mature, and it had to work with its suppliers to develop the system it has today.
The EMR system includes Mobius medical records software from Fortrus, Laserfiche’s electronic document management system, Adobe LiveCycle Workflow and eForms technology, while the records were scanned using both Kodak production scanners and ibml ImageTrac-Lite equipment.
The trust also relied a lot on in-house skills, using its substantial IT development team to manage and provide the interfaces between the systems, as well as creating a single user-friendly portal of entry.
Retired consultant and colorectal surgeon Ian Linehan, who was clinical lead on the project, said it has been an ongoing and evolving project.
“It’s not something you can just buy off the shelf and hope you can get it working – you have to grow up with it, develop it and change the processes around it,” he said.
Paperless or paper-lite?
Burke said digitising paper records is the biggest transformation project the NHS will go through.
“It’s a massive challenge,” he said. “And we need to make sure there’s clinical engagement all the way through and clinicians are involved in the procurement.”
Linehan pointed out that Basildon and Thurrock have never claimed to be paperless, but only paper-lite.
“At most NHS hospitals the IT infrastructure has grown up to support what’s going on in existing buildings and projects,” he said. “If you were starting afresh you could put a lot of infrastructure in and potentially be paperless, but thinking about the layout of wards and things like that, the ability to paperless is not yet there.”
Linehan went on to say it was only in the past 12 months the hospital got hold of suitable tablet devices to use.
“What we’ve done is taken the decision early on to use paper during appointment/hospital stays and scan it on completion of an episode,” he said. “Everything in the past is now digital and everything in the present is digital, and future developments will start taking paper out as technology improves.”