The document discusses the strategies taken by Aintree Hospital in the UK to transition to a paperless system. It details how: 1) Aintree resolved legacy paper records by scanning over 195 million pages and completing the entire archive conversion. 2) They implemented systems to stop generating new paper such as electronic prescribing and results management to eliminate paper forms. 3) These electronic systems provide benefits like improved clinical efficiency, safety from all records being accessible remotely, and cost savings from reducing logistical burdens of paper.

1. New technologies:
driving efficiencies
Catherine Beardshaw
Chief Executive
17 October 2012

2. The path to greater efficiency –
the paperless hospital
• NHS organisations are drowning in paper
– Incredibly inefficient/expensive
– Logistical nightmare
– Disorganised – difficult to access information
– Barrier to change – archaic processes
• Aintree’s two prong strategy
– Resolve the legacy paper
– Stop generating the paper

3. The path to greater efficiency –
support for clinicians
• IT as a clinical tool
• Data for clinicians
• Safer care for patients
• First time, right every time

4. The Paperless Hospital

6. The paper trail
• 195 million pages on 10 miles of shelving
• 686,000 patients (381,000 active)
• Finding/transporting/tracking 1200 requests per day
• Missing notes inevitable, especially out of hours
• Six figure sums spent on external storage and
retrieval
• Paper is our biggest data loss vector

7. Resolving the legacy paper issue
• Records scanned by Capita – and whole archive completed by end of next
month
• All doctors have adapted to EDMS with clinical change support and attitudes
moving from universal dislike, to tolerance and now some plaudits
• Some errors (mostly clerical) but less than on paper in past and records
available 24/7
• Gains on staffing (mostly redeployed), and on estate amounting to £2M
revenue and £20M capital for a £1.5 M outlay
• Gains of 24/7 availability and fewer missing records, external access a
bonus
• Revolutionised our approach to clinical records
• Opens up the expectation of importing data from any other system
• Allows the organisation to be more nimble
• Provides a better experience for patients

10. Find the MEWS Chart
1
2
3
4

11. Stop generating paper
Results Management
• Results move with the patient e.g. from AED to MAU to ward
to ITU to ward
• On discharge from hospital – checks for outstanding
unacknowledged results and can prevent discharge until
they are dealt with
Net effects
• No paper results– no filing/scanning needed = COST SAVING
• Consultants aware of delays = CLINICAL EFFICIENCY
• No patient goes home without someone checking the
results = SAFETY

12. Support for Clinicians

13. Electronic Patient Records
• E-assessments – triggers tests, calculates scores
• E-orders/results – no result can be lost or missed
• Integration – other systems/organisations
• Remote access – Trauma/OOH support
• Reporting – true Business Intelligence
• Reduced costs – logistics of paper is expensive
• Transparency – clear view of what is happening
• Flexibility – can treat patients quicker

14. Ward-based Eboards – real-time bed state
• Safety information - falls, alerts, nutrition
• Patient information - EDD, location,
Consultant
• Results availability - alerts results are
available

15. ePMA
(electronic prescribing and medicines administration)
• Safer system
• Greater transparency
• Improves compliance with medication policies
• Allows data analysis and improves patient care

16. These records can be
just as available for:
• Clinicians in other
hospitals
• Clinicians working from
home
• Full access to all systems
from home decreases the
risk of losing highly
confidential data

17. A modern clinical desk at Aintree
PAS/Letters/results dictation control PACS (Xrays) EDMS (archived records)
Blood label
printer

18. The paperless office and support for clinicians
Benefits
• Financial
• Greater flexibility
• Better experience for the patient
• More informed care delivery
• Real-time reporting/management
Issues
• Totally dependent upon the IT systems, outages are major
incidents
• Changing the culture
• Change management is critical