North East Change Management Network- Changing from paper based health records to a digital version - ECDM


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Sarah Perkins Associate Director of Operations & Performance, Project lead for the introduction of Electronic Clinical Document Management. The project involved the re- provision of the paper based medical records into a scanned( digital ) format for County Durham & Darlington NHS Foundation Trust. The Trust provides health care to a population 550,000 across County Durham and Darlington on multiple sites and employs 8000 staff. The Trust had approx. 900,000 paper files containing on average 230 pages of clinical information, the files were used in all medical settings, i.e. out-patient appointments, planned surgery and emergency admissions. The project involved reorganising the current files, deciding how they would be scanned, installing software to view the records, training staff to use the software and agreeing the new processes in a paper light environment

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  • North East Change Management Network- Changing from paper based health records to a digital version - ECDM

    1. 1. Changing from paper based health records to a digital version - ECDM Sarah Perkins Associate Director of Operations and Performance
    2. 2. What will the presentation include What is Electronic Clinical Document Management (ECDM) What were the options considered for an ECDM solution What are the benefits Clinician engagement – how do we involve 8,000 staff How will ECDM change working practices Project Management arrangements What have I learnt
    3. 3. What is ECDM? Electronic version of current paper health record – approx 900,000 in existence Paper record is scanned when required, and destroyed (within agreed timescale) Electronic record made available using a software application Contents of the record is indexed to aid presentation and retrieval Opportunities to introduce electronic forms and closer interaction with other electronic systems
    4. 4. The Previous Situation 1
    5. 5. The Previous Situation 3
    6. 6. The Previous Situation 2
    7. 7. Clinical Benefits of ECDM Notes can be accessed 24x7 securely from any Trust location leading to timely diagnostics and treatment Notes available across Acute and Community teams supporting integrated pathways (and potentially other providers in the future) Notes available instantaneously: Removes the current paper-trail of requesting, finding and transporting notes No cancelled clinics due to notes not being available Multiple people can access a set of notes simultaneously Provides flexibility in where we provide care from
    8. 8. Clinical Benefits of ECDM Opportunity to use electronic forms to aid clinical recording Removal of the clinical risk caused by loose filing
    9. 9. Further Benefits Reduced costs for: Medical Records staff Storing paper records Transporting records Stationary (paper folders etc) Staff efficiency savings in terms of time locating records (e.g. Medical Secretaries)
    10. 10. How were clinicians engaged At the start of the procurement process 3 clinicians on ‘evaluation team’: Helped develop Trust requirements Assessed supplier demonstrations Visited other Trusts as supplier ‘reference sites’ Advised on contract contents and provided clinical assurance Trust events (January 30th and 31st 2012) Over 600 attendees 326 people provided feedback 151 stated a preferred supplier 98 people volunteered to be involved going forward On going road shows Clinical reference group – all decisions about devices/layout of software made by clinicans
    11. 11. How it change the way clinicians work? No trolley with piles of paper notes Notes are scanned ahead of clinics Clinician access record electronically Notes are written onto history sheet, which is subsequently scanned and incorporated into main electronic record Supplier has to make record available to contractual response times (e.g. 3 hours for emergency), initially returning the paper record if required.
    12. 12. What was the impacts on our staff? Health Records staff had the option of transferring to the supplier, or being re-deployed within the Trust in some cases Transferring staff will had full TUPE rights Staff had to undergo a significant transformation by working with electronic health records as opposed to paper – mandatory for all consultants
    13. 13. Management risks that were identified Forming a suitably skilled team in time for the project Trusts acceptance of ECDM and the willingness/ability to change The Trusts ability to manage any other significant transformations taking place during the ECDM project timescale The model and scale proposed has not been successfully implemented in another Trust The project remaining consistent to the planned objectives and scope, in order to realise the benefits envisaged. Maintaining the clinical engagement for the project
    14. 14. Project Management Project planned to be 13 month implementation Stage 1 January 2013 TNT started to work with current Medical Records service 4 months from contract signature Stage 2 August 201 3is services going live Pilot department go-live Trust-wide over 4 month period including pilot Project team Staff to plan and support the changes to working processes in order to maximise the benefits Human resource and communications staff to support the transformation IM&T staff for integration to Trust systems and device roll-out
    15. 15. What have I learnt Private companies were not as ‘expert’ as they thought they were Project management was crucial Communication skills, how to connect with 8,000 staff
    16. 16. Any Questions?