Transitioning EPMA applications in a large multisite teaching hospital

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.