Picture this scenario: The Clatterbridge Cancer Centre, a dedicated cancer treatment network based in Wirrel, Merseyside, is one of the largest cancer centers in the U.K. It serves patients throughout the counties of Merseyside and Cheshire. Currently, medical records for the center's patients exist on paper, at one central facility. When clinicians treat patients, they lug a suitcase full of relevant documents on their travels. Currently, the facility has racks for at least 100 such suitcases.
Fortunately, these paper records have so far not been a major impediment to the high standard of treatment this center offers. But the facility's head of information management and technology (IM&T) Tom Poulter is ready for change. "The main benefit we see coming out of digitization is accessibility," he said. "We want information to be easier to access and share by our clinicians for the benefit of our patients."
To meet this goal, Poulter and his organization, the Clatterbridge Cancer Centre NHS Foundation Trust, have just introduced the first phase of an electronic medical record (EMR) solution from Kainos, a document management company based in Belfast, Northern Ireland. Poulter is proud to say that three of its senior (consultant) oncologists have been working with 100% digital patient records for new patients since the end of November.
[ Vendor-neutral archive technology shows promise in providing the groundwork for a national EHR. Read more at Could X-rays Be New Route To U.K. EHRs? ]
That move, however, is just the beginning, encompassing only 400 records. To get to the finish line and scrap its racks of suitcases, the centre must scan a backlog of 20,000 active patient medical note files. Considering budget and other limited resources, that will likely take at least 18 months -- but Poulter remains committed to the project.
He's not alone. Dr. Richard Griffiths, a consultant medical oncologist and lead clinician at the centre, is equally motivated by the benefits of EMRs. "The fact that I can readily access case notes if I'm not in the clinic is a big improvement in managing patient flow and dealing with issues as they arise," he said.
The scanning work isn't being done as a one-off. In line with a general push for a more integrated information flow in the NHS, Clatterbridge has also implemented a major upgrade of its 11-year-old electronic health record (EHR) platform, IMS Maxims.
The aim: to better link the EMR and the EHR to improve data flow and information sharing throughout the system. "Our EHR provides a wide range of information about our patients," said Poulter. "But like most such systems, it doesn't deal very well with all the paper in our system, which is still the primary record-keeping media about patients. But if the EHR can link with the EMR, we'll soon have what for doctors will seem like one unified system but which is actually three or four systems linked together."
To start that process, Poulter said, 750,000 paper documents were scanned and uploaded into the EHR earlier this year to get the EMR project up and running. Both the IM&T team and the clinicians feel that the new system will help them be more efficient at their job: treating and curing cancer patients. "Currently I spend about 60% of time with patients," said Dr. Griffiths, "and around 40% on admin and documents. The aim is to get this ratio to 80:20, or even 90:10."
That won't happen overnight. Poulter is able to digitize processes only a few clinicians at a time, and the general thrust of his plan is evolution, not revolution. His strategy is to create internal evangelists to promote the benefits of the solution and pass on best practices to other clinicians. The next key goal on the horizon: Enabling electronic information exchange with partner service providers such as GPs and referring hospitals.
Clatterbridge hasn't unpacked the suitcases yet -- but that day is coming.
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