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Electronic Medical Records (EMRs) primarily center around electronically documenting patients' health information within a single healthcare organization or practice. They contain essential clinical data related to a patient's medical history, diagnoses, medications, treatment plans, lab results, and other pertinent information relevant to the specific encounter or episode of care. EMRs are designed to streamline documentation and workflow processes within individual healthcare...
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Transitioning EPMA applications in a large multisite teaching hospital.

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Area of Science:

  • Health Informatics
  • Clinical IT Systems
  • Digital Health Transformation

Background:

  • The National Health Service (NHS) aims to improve healthcare delivery through Electronic Prescribing and Medicines Administration (EPMA) and Electronic Patient Record (EPR) systems.
  • Implementing new clinical IT systems presents challenges, particularly in large acute trusts and during periods of high clinical pressure like the COVID-19 pandemic.

Purpose of the Study:

  • To describe the co-development and deployment of a novel EPMA application within University Hospitals of Leicester (UHL).
  • To demonstrate the successful implementation of a large-scale EPMA system meeting NHS interoperability standards.
  • To highlight strategies for managing clinical risk and ensuring sustainability during IT system deployment.

Main Methods:

  • A 'big-bang' whole site-based approach was used for transitioning 1844 acute adult inpatient beds to the new EPMA system.
  • A frontline-driven, agile management strategy was employed, with early clinical team engagement for product configuration.
  • Clinical risk was managed through risk logs, clinical prototyping, and disaster recovery plans.

Main Results:

  • A complex new EPMA system was deployed in a large acute NHS trust with limited resources and minimal disruption to clinical services.
  • The deployment was achieved through an iterative, well-governed approach involving IT, clinical staff, and a responsive vendor.
  • Sustained transition support for clinical staff was minimized due to advanced product configuration.

Conclusions:

  • It is feasible to deploy new clinical IT systems, such as EPMA, at scale without interrupting services, even with a modest deployment team.
  • A clinically led governance structure is crucial for managing risks, ensuring project sustainability, and facilitating learning for future developments.
  • Co-developed EPMA and EPR systems are key enablers for improved healthcare delivery within NHS trusts.