EPR Implementation

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EPR Implementation LTHTR
Heather Binkle EPR Project Manager 11 December
2003
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Trust Activity in 2003 2003

• 575,514 patient contacts
• 90,363 inpatients in 1,174 beds
• 89,684 new outpatients
• 229,112 follow-up outpatients
• 105,923 AE patients
• 3,568 births
• 5,400 staff

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Current IMT Position
Theatreman
AE system
Paper Casenotes
PAS
Other systems
Radiology
X-ray films
In-house clinical developments
Intranet
Email
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Future IMT within clinical areas
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The Solution
Misys CPR
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EPR 3 year implementation
Nov 2002
April 2004
March 2005
March 2006
Phase 1
Phase 2
Phase 3
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Phase 1

• 1st Phase Nov 5th 2002 to April 2004
• Replaces 2 PAS systems
• Replaces 2 Radiology systems
• Replaces 2 AE systems
• Replaces Theatre system
• New interfaces to pathology for better result
  reporting
• Introduce access to archived scanned casenotes

Preparatory work
Casenotes
Nov 2002
April 2004 End phase 1
Sept 2004
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Phase 2
Nov 2002
April 2004
March 2005
March 2006
Casenotes
Phase 2
Phase 2 Electronic requesting of tests and
services throughout Trust, documentation of
Nursing Care, Clinician screens, GP access
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Phase 3
Nov 2002
April 2004
March 2005
March 2006
Phase 3
Phase 3 Electronic Drug Prescribing, Clinical
Pathways
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Issue Infrastructure readiness
12 month implementation project

• Organisation wide network upgrade
• Wireless network on wards
• 400 mobile, wireless computers for use on wards
• Additional PCs
• Barcode readers, printers, security
• Resilient, centralised data storage
• Windows 2000 and MS Office 2000

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Lessons Learned

• Experience is a hard teacher because she gives
  the test first, the lesson afterwards.
• Vernon Sanders Law

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Organisation of Project

• Smaller project teams with appropriate leadership
  and corresponding analyst
• Discovering appropriate forums for advisory to
  project by different user groups
• Target groups differently

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Dont underestimate the work

• Appropriate resources are required
• Understanding the role of the on-site analyst
• A huge amount of configuration is required to
  make the system ours

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Data collection the key to success

• Getting the right people involved
• Begin standardising the processes well in advance
• Helping people to an early understanding of
  standardisation
• Understand how the data will be used

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Technology versus Change Management

• Putting a PC on every desk and at every nursing
  station does not make an EPR

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Talking the talk versus understanding what it
means

• That is what learning is. You suddenly understand
  something you've understood all your life, but in
  a new way.
• Doris Lessing

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Communication

• American system differences in language and
  health care system
• Complex organisation
• Large number of staff with different interests
• Team approach to getting the message out

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Scope of the project

• Stick to the scope in each of the phases
• Help the end-users understand that it is a phased
  process
• Beginning to plan for Phase 2 now

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• If computers get too powerful, we can organize
  them into a committee -- that will do them in.
• Bradley's Bromide