New technologies: driving efficiencies

Catherine Beardshaw Chief Executive 17 October 2012

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

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

The Paperless Hospital

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

• 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

Resolving the legacy paper issue

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Find the MEWS Chart

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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

Stop generating paper

Support for Clinicians

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

Ward-based Eboards – real-time bed state

• Safety information - falls, alerts, nutrition • Patient information - EDD, location,

Consultant • Results availability - alerts results are

available

ePMA (electronic prescribing and medicines administration)

• Safer system • Greater transparency • Improves compliance with medication policies • Allows data analysis and improves patient care

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

PAS/Letters/results dictation control PACS (Xrays) EDMS (archived records)

Blood label printer

A modern clinical desk at Aintree

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

The paperless office and support for clinicians