Aidan Kehoe, CEO at The Royal Liverpool & Broadgreen University Hospital NHS Trust, reveals the ways in which digitisation is transforming patient care and patient records' management at the hospital.
With a population of c.1.2 million people, and one of the most complex health systems outside London, the North Mersey region is putting itself firmly in the driving seat with regards to the Government-driven NHS Roadmap to digitisation.
Following the Secretary of State's response to a review of NHS technology by US clinician Bob Wachter, the Royal Liverpool was nominated as one of the country's 12 global exemplar trusts. This meant the Trust received considerable financial backing to deliver pioneering approaches to digital services and to lead others in the NHS with its expertise.
At the Royal Liverpool, we recognised the significant role that digital technology could play in transforming the way care is delivered in our region and the positive impact it could have on overall care quality and the patient experience.
One of our biggest challenges was managing the high volume of patients that we receive and being able to ensure that they get their treatment quickly. In addition to that, we need to be able to move them on to another environment as fast as possible so that the next wave of patients can also be treated.
We currently have to manage over 1,000 requests for medical records per day and ensure that the correct files are available for clinicians when patients arrive for appointments. Physically moving, managing and storing such a huge amount of paper documents and files is a time consuming and costly process for the Trust, and also a potentially insecure one. There is always the chance of patient notes being lost or misplaced and therefore people having to wait longer than we would like, before clinicians are able to see them.
The Trust's impending move to a new purpose-built hospital was another driving factor in the move to go digital as soon as possible. As the new hospital is totally designed around a paperless environment, it was a matter of priority to get our records in an electronic format ready for import into the Trust's Electronic Document Management System (EDMS). The main objectives being to create efficiencies in document management whilst saving space on document storage and allowing more time for us to focus on and boost front line patient care. Digital records will, most importantly, help us to improve patient flow with our clinicians having information at their fingertips.
Steps towards digitisation
Our requirements were to find a document scanning solution to digitise and index over 100 million pages of active medical records and to have them in an electronic format ready for import into the Trust's EDMS. The project needed to incorporate both scanning and archiving 'live' files and ongoing/day forward notes.
To this end, we embarked on a procurement process to find a professional partner who could assist in this digital transformation. It was important for us to find an experienced provider who had the correct governance process to deal with our medical records, ideally in close proximity to the location of the hospital.
Following an intensive vetting process, the five-year contract was awarded to Restore Scan. It was really important for the hospital to work with a good organisation that knows exactly what it is doing and can collaborate effectively on such a crucial project as this. Restore has years of experience of working with healthcare organisations which means it is a specialist in medical scanning, archiving, indexing and retrieval.
The company is responsible for the management of the full end-to-end process; from file preparation and scanning to the confidential and secure destruction of data. No record is missed as the state-of-the art scanners are able to process any size and shape of document from mixed materials.
Collaboration between Restore and the staff at the Royal has been great - output and productivity is exceeding our expectations. In fact, such is the efficiency that on 'go-live' in Mid-October 2016 the project was exceeding the required volumes by over 50,000 images per day. Impressively, by the end of 2016 it had delivered over 10 million scanned images.
As we often hear, NHS data can be targeted by fraudsters who try to use it for illegal activities and financial gain, and so it was particularly important to us that Restore Scan had already met the standards of IG Toolkit compliance and ISO27001. As part of the NHS, it is imperative to protect patient confidentiality, employee and supplier data with robust controls and we are confident that, by only using experienced and accredited contractors, we have achieved this.
The digitisation project is on target to improve many services for patients and staff. It has already yielded many tangible results such as: instant records access - creating more patient facing time for clinicians, a decrease in patient record administration time, more secure and resilient records and of course a big reduction in space needed for record storage. We are well on our way to being ready for the move to the paper-free environment in the new hospital building in 2018.
In summary, our digitisation programme is as much about people as it is technology. It is an ideal opportunity to improve patient care, both in the short and long term. If we capitalise on the real benefits digital technologies bring, then we should see transformational change for patients, doctors, nurses, social workers and the people of Merseyside.