1Lancashire Teaching Hospitals NHS Trust

EPR Implementation –LTHTR

Heather Binkle

EPR Project Manager11 December 2003

Lancashire Teaching Hospitals NHS Trust

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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 A&E patients 3,568 births

5,400 staff

Lancashire Teaching Hospitals NHS Trust

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Current IM&T Position

X-rayfilms

Email

Radiology

PAS

A&E system

Theatreman

Other systems

In-houseclinical

developments

PaperCasenotes

Intranet

Lancashire Teaching Hospitals NHS Trust

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email

Specialist Clinical systems

Internet/Intranet

EPR

Pathology

Future IM&T within clinical areas

Lancashire Teaching Hospitals NHS Trust

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The Solution

Misys CPR

Lancashire Teaching Hospitals NHS Trust

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EPR – 3 year implementation

Nov 2002 April 2004 March 2005 March 2006

Phase 1

Phase 2

Phase 3

Lancashire Teaching Hospitals NHS Trust

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

Nov 2002 April 2004End phase 1

Sept 2004

Phase 1

CasenotesCasenotesPreparatory workPreparatory work

Lancashire Teaching Hospitals NHS Trust

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Phase 2

Nov 2002 April 2004 March 2005 March 2006

Phase 2

Phase 2 – Electronic requesting of tests and services throughout Trust, documentation of Nursing Care, Clinician screens, GP access

CasenotesCasenotes

Lancashire Teaching Hospitals NHS Trust

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Phase 3

Nov 2002 April 2004 March 2005 March 2006

Phase 3

Phase 3 – Electronic Drug Prescribing, Clinical Pathways

Lancashire Teaching Hospitals NHS Trust

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Issue – Infrastructure readiness

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

12 month implementation project:

Lancashire Teaching Hospitals NHS Trust

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Lessons Learned

Experience is a hard teacher because she gives the test first, the lesson afterwards.

Vernon Sanders Law

Lancashire Teaching Hospitals NHS Trust

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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

Lancashire Teaching Hospitals NHS Trust

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Don’t 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”

Lancashire Teaching Hospitals NHS Trust

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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

Lancashire Teaching Hospitals NHS Trust

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Technology versus Change Management

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

Lancashire Teaching Hospitals NHS Trust

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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

Lancashire Teaching Hospitals NHS Trust

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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

Lancashire Teaching Hospitals NHS Trust

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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

Lancashire Teaching Hospitals NHS Trust

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