DIGITAL TRANSFORMATION
engaged throughout the planning process to help develop solutions to potential problems, a process welcomed by both Claire Ranson and Dr Vasani. The phased roll-out saw wards shift to the new system, with help always on hand during the switchover period. Between 8am – 11pm there was support from the digital programme team available for staff to seek help with any questions or concerns they may have had. Dr Vasani asserted: “The digital programme team were on each ward, each week, as the system rolled out, helping staff to navigate it effectively. The wards also benefitted from peer support, with clinical ‘super-users’ offering words of wisdom and advice on how to best use the system. “The technical aspect is about 25% and the rest is just workflows, continued Dr Vasani. “The roll-out programme began in March 2018 and was completed by October 2018.”
The support provided during these months was intense, something that all agree was necessary. “I definitely think we needed that period,” Ranson observed. Once completed, Ranson said that all nurses and doctors were comfortably embracing the new way of working as demanded: “It tackled some of the existing frustrations nurses had with the paper-based system.” Software is only as good as the hardware
it runs on, with the Trust relying on aged infrastructure and a poor wi-fi connection, both issues have been recognised and rectified as part of their digital transformation programme. “There has been a massive infrastructure investment,” Dr Vasani noted. “The Trust is also responding to clinicians’ concerns by rolling out single-sign on devices as standard. Within a few seconds, you’re logged into systems. It’s a small thing that has made a huge difference.”
Anecdotal feedback has been positive, with nurses and doctors clear about the impact the system is having at a patient and ward-level. The next stage is to undertake a comprehensive benefits realisation programme to quantify the impact that TrakCare is having on the Trust’s performance on key indicators.
Connecting the dots
“North Tees and Hartlepool NHS Foundation Trust is one of the UK’s leading adopters of TrakCare, with a board that fully embraces the potential for technology to transform healthcare,” Dr Vasani said. To him, the transformation journey within the hospital is one of evolution: “Everybody has bought into the idea that we need to digitise a lot of processes, reduce our reliance on paper and improve clinical care.” In the near-term, the EPMA system will be rolled out to day case areas of the Trust. It’s the start of a more ambitious programme to embed the system completely within the Trust – something demanded by medical professionals.
In a future phase, the EPMA system could be used in ITUs, where the real-time information exchange and prescribing information could help to improve care for some of the sickest patients being treated at the hospital.
“In the medium to long-term, clinicians want to have everything available within TrakCare, where it is quickly accessible,” Dr Vasani added. “We’re in the middle of a process that’s connecting the dots of care. The adoption of the EPMA is the first stage in a shift toward more intelligent prescribing.” Dr Vasani is keen to embrace the potential for order sets and, in the future, more intelligent prescribing with a higher level of decision support. All will be completely digital, with the Trust hoping to go paper-free by 2024. It’s helping the Trust realise significant efficiencies, including reduced software license costs and a significant reduction in expenditure on paper. Replacing the existing Kardex paper- medicine system with TrakCare has helped the Trust save more than £2000 per quarter. Across the hospital, system savings could increase exponentially. In total, the Trust hopes to save up to £8 million in efficiencies and improved productivity by adopting the system as the Trust’s EPR.
The next stage for the EPMA is a planned move to incorporate complex medications and ‘injectables’. The Trust is currently investigating the approach necessary to safely and successfully manage this integration. In a future phase, the EPMA system could be
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used in ITUs, where the real-time information exchange and prescribing information could help to improve care for some of the sickest patients being treated at the hospital. According to Dr Vasani, the system is changing the way North Tees and Hartlepool NHS Foundation Trust delivers services – as well as behaviours. When asked what advice he would give to other Trusts considering making a similar shift toward a comprehensive digital system, he said: “Focus on the outcomes, not the technology. The best system is the one which you engage with and improve for the benefit of the user. “You need constant dialogue and engagement from all three aspects: the vendor, the project team and crucially the clinical users – doctors, nurses and pharmacists.
“No system will be perfect from day one, but in time the system can be shaped and formed to deliver the outcomes Trusts need, and deliver the improvements in care that patients expect.” In partnership with InterSystems, he believes the Trust is doing just that – joining the dots, developing a connected healthcare system that inspires and empowers clinicians, and enabling them to deliver on the promises of a digital future.
CSJ AUGUST 2019
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