Maximising digital transformation benefits via an integrated end-to-end solution for accessing patient files

Results

Along with time and space savings and decreased risk of loss or inadvertent disclosure the trust can drive more value from patient data through integrated case management, better decision-making and efficient digital workflows. Patients will also eventually benefit from remote access to records.

Enabling a trust-wide EPR system with potential for future patient access

Strategic reset during Covid-19

Building digital services around patients

With a busy hospital campus, outpatient clinics and various outreach services, the Foundation Trust provides care for more than 250,000 local residents. That means efficiently handling over 265,000 clinical appointments and 83,000 accident and emergency attendances annually.

Over the last five years, the Trust had been building digital capabilities, placing people at the healthcare system’s centre so they receive the right care at the right time. Those efforts further improved quality and patient safety, while stabilising the Trust’s financial position and achieving cost reduction targets. As with many NHS organisations, the strategy gathered pace as the pandemic took hold and priorities shifted to keeping staff and patients safe from COVID-19 through measures such as enabling remote working.

Online access to care plans and records

With the additional pressures on top of all the usual challenges of locating and pulling patient records from overflowing archives, the Trust began looking at scanning options. As COVID-19 cases eased during the first national lockdown those requirements were swept into a wider transformation programme to create a community-wide integrated electronic patient record (EPR) system. The immediate challenge was to digitise and provide access to 184,000 paper files, with an eye on the future for patients to securely view their own care plans and medical records online.

The search was on to find a complete end-to-end solution, delivering efficient file collection, indexing, imaging and destruction with an intuitive electronic document management system (EDMS) and a fully secure audit trail throughout.

Creating 184,000 digital records with potential for future patient access, remotely and from home

Full end-to-end digital solution

Maximising innovation and expertise

Intuitive user experience

Following a public tender, the Trust chose Iron Mountain® based on a successful solution demonstration, intuitive user experience and the organisation’s expertise in information governance.

As part of the service specialists collect boxes from site. Every document is carefully indexed and put through a high-complexity scanning preparation process. The files are given individual barcodes for tracking. After scanning, the paper originals can be securely destroyed with a full audit trail when authorised by the Trust.

Viewable instantly on any device

Once scanned the records and associated metadata are uploaded to the EDMS and presented in a format familiar to clinical end-users. Information is easy to find with customisable navigation and search options.

The EDMS is designed in HTML5 from the ground up and works with any device, including tablets and handhelds. Patients’ medical records are made available on the system in advance of appointments and delivered safely and securely into the EDMS via secure file transfer. The records are accessible via the Trusts’ host EPR in true context launch ensuring the minimal number of clicks.

Clinicians always see the patient’s most recent notes every time they log in

Transforming clinician and patient experience

Integrated case management driven by digital workflows

Iron Mountain’s ingestion process provides electronic handshakes as content flows between the delivery systems, ensuring strict compliance with latest data privacy and industry regulations as detailed in HL7. Once a patient record has been digitised it resides securely in the EDMS and is governed by strict access rights and accessibility rules. The system maintains a complete audit of every action taken at document, patient and system level. Users have access to various features and viewing functions, including the ability to annotate, bookmark and redact information. They can also search the patient record with OCR (Optical Character Recognition) or via SmartIndexing™, a technology which allows users to filter for key documents at the single click of a button.

The complete end-to-end tracking and ingestion process is managed and audited as part of a closed-loop approach. Implementation is supported by a team of ex-NHS professionals who complete the entire processmapping, business change and transformational work required to ensure complete adoption of the technology, services and processes.

Creating more patient-facing clinical time

Now, archiving space can be reclaimed for better uses. Moreover, by expediting the move to digital e-record delivery the Trust is able to accelerate the potential to analyse records and improve treatments and outcomes. Administrators and support are released from having to retrieve, circulate and track paper files. In the past, this process was often repeated multiple times for the same patient file. And there was always a chance that documents could be mislaid, lost or left exposed on a desk. Those risks have been completely eradicated.

Clinicians are pleased to get time back to spend with patients rather than hunting for information. Medical teams can quickly pinpoint key information. It’s also easier to see associated symptoms and conditions, aiding decision-making throughout the patient journey; from consultation and testing to diagnosis and treatment.