The Royal Free London NHS Foundation Trust has digitised patient records as a stage in its modernisation programme.
According to trust director of information management and technology Will Smart (pictured), it hopes to move into “higher-end analytics” using the new trove of electronic content.
The Royal Free has used technology from OpenText Content Suite to carry out the digitisation of paper case notes and centralise new patient data as and when it is recorded.
The deployment went live on 12 November 2014 across all clinical services at the main Royal Free site in Hampstead. The trust plans to extend the implementation to its two other sites, Barnet Hospital and Chase Farm Hospital, near Enfield in north London.
The Royal Free was founded in 1828 and was the first hospital in England to provide medical care for free. The trust employs 10,000 staff, has an annual budget of £950m and has 1.6 million “patient events” to record every year. It is the specialist centre for Ebola care in the UK.
OpenText has provided a central repository for the trust to store, manage and make available 913,000 patient records, amounting to 10 million pages
“We are reducing paper storage costs, it is secure and we are freeing up space for patient care," says Smart. “Paper is very expensive to run and organise. We have been employing several people whose only job is to go up and downstairs looking for case notes.
“Paper case notes can only be in one place at a time. There are benefits around patient care, at the point of care.”
At present, health workers at the Royal Free use dual screens, showing the Cerner electronic patient record system and the new digitised case notes. There are plans to move to iPads for clinical staff.
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“There is always that anxiety that IT will get in the way of the consultation between clinician and patient,” says Smart. “We are in the early stages of a journey. Doctors don't yet have the same ease of use as they have with paper.”
So far, about 330,000 case notes have been scanned, he says, which is about one-third of a two-year job to be done.
Smart says the trust chose OpenText for two reasons. “It is not all about the medical records. There is a danger of having fragmented document management systems. We wanted a platform for staff records, too," he says.
“Secondly, from an analytics perspective we wanted the future possibility of doing semantic analysis on the content, which could help with medical research.
“OpenText gave us the platform we wanted. There are lots of UK government instances of OpenText and US health reference customers as well.”
As the project has progressed, says Smart, clinicians have been asking for data over and above that which had been captured previously in paper case notes such as some correspondence and test results. “We are continuing to add content,” he says.
OpenText Content Suite will be integrated with the trust’s Cerner electronic patient records system. “We are making the access as flexible as possible. You can get at the content through Cerner and directly," says Smart.
“We are on a journey. Patients tend not to have single conditions, so that’s why took a big bang approach back in November .”
Smart adds that the business case for the project indicates return on investment within seven years. “But we are also improving the experience of patients and using our clinician resources more efficiently because of this system," he says.
“Our partnership with OpenText means that we have been able to draw on their extensive experience of similar deployments globally, including in some of the world’s largest health systems, and access resources to ensure we maximise the value from OpenText."