Dr Johan EP Waktare

Consultant Cardiologist and Chief Clinical Information Officer

Liverpool Heart and Chest Hospital

• LHCH have formal reference site agreements with

• Hyland

• Allscripts

• Dr Waktare on Hyland Physician Advisory Board (no commercial interest)

Disclosure

• LHCH Journey

• Strategy, Vision, & Core Values

• Timeline

• What has been delivered

• Benefits

• Lessons learned

• Key messages

Goals

• Paperless is a by-product of an “IT Enabled Healthcare” plan, not a goal

• Bold and clear vision is key

• Find industry partners not suppliers – don’t be a customer, because the product you want to buy doesn’t exist. It needs to be developed

• Similarly, always go for best of breed but a key part of that is strong strategic alliances with a small suite of high quality suppliers

• This is transformational organisational change

Key Messages

• Specialist tertiary care center

• Coronary heart disease / PCI

• Cardiac Electrophysiology

• Cardiac devices (PPM/ICD/CRT)

• Respiratory inc. CF

• Cardiac surgery

• Thoracic surgery

• Upper GI surgery

• Aortic surgery

• Highest overall patient satisfaction (CQC inpatient survey) for 7 of last 8 years

• HSJ Hospital of Year 2012

• Patient and Family Experience Vision is a core value for us

Liverpool Heart and Chest Hospital

Amongst largest centres in UK

• Clinical decision support

• Data availability

• Closed loop systems

• Quality assurance

• Patient experience

• Process efficiency

• … but we didn’t always have such a clear understanding…

How Can EPR Improve Patient Care?

• Personal involvement began in 2010 • NPfIT & Lorenzo were still “default position”

• “Basket case” would be over-stating it, but overall we were in a sorry state

• Visioning – The art of the possible • Visits to UK & US sites

• Comprehensive requirements document

• Selected partner = Allscripts, with Hyland as EDMS supplier - Sept 2011

• Project commencement April 2012

LHCH EPR Program

EPR Project Scope

• Allscripts Sunrise Clinical Manager • Clinical documentation & nursing workflows

• Electronic prescribing and medicines administration

• Order entry / results reporting

• Allscripts Patient Flow

• Other features (SHM, Patient portal, Clinician Portal) *

• Hyland OnBase EDMS (integrated sub-project)

• Use as ECM (Enterprise Content

Management), not just EDMS

• Carestream PACS (parallel integrated project)

• Interface and integrate existing systems • Silverlink (iCS) PAS

• LSS (LHCH Scheduling System)*

• Radiance ABG from ITU*

* Outstanding work still to be delivered

• Paperless care = no

• Arguably closest UK approximation to it = yes

• Key enablers in place = yes

• HIMSS 6 candidate status

• Joint highest CDMI

Our Present Status

“EPR” System

PACS EDMS

EPR Vision – Underlying databases

PAS

Perfusion Database

Incident Reporting

RIS

Stock Mgt

Cardiac PACS

Pt Flow

• Paperless is true but a “side issue”

• The agenda is to create • better

• Safer

• Higher quality

• More efficient

• ….IT Enabled Heathcare

To deliver this, a clinically driven programme is required

Look not just at infrastructure delivery, but more importantly adoption and even more importantly outcome benefit

Conclusions