There’s often an assumption that adopting a better patient record will result in better patient outcomes. This is far from guaranteed, but a new Electronic Patient Record (EPR) can provide the ideal catalyst for change.
Channel 3 is frequently commissioned to support NHS organisations in procuring and implementing a new EPR.
This is often predicated by the ‘end of life’ of a particular product, the perception that an existing system no longer works optimally or that there are ‘better’ systems on the market. We anticipate seeing more of this as the NHS Long Term Plan has put such emphasis on interoperability and specific core functionality, such as effective discharge summaries – something which not all the legacy systems support well.
The supposition is that by adopting the ‘better’ system, there will subsequently be better patient outcomes, but this doesn’t happen automatically. In fact, the opposite is often true. There are well documented cases of hospitals that have sought to ‘upgrade’, only to find their systems grind to a halt as their old processes fail to keep pace with their new technology, or too much focus is put on the system change rather than in embedding new, streamlined processes.
Changing processes to improve patient interaction
The biggest driver in better patient outcomes usually comes from directly changing the interaction with the patient.
Upgrading software doesn’t in itself change that, but it provides an opportunity to review processes and identify improvements. On numerous occasions we’ve seen this lead to changes in the clinical pathways that benefit both clinicians and their patients.
So how do you ensure your EPR programme delivers the improvements you seek?
Understand the issues
Engage with your teams to identify how the patient record needs to integrate with the rest of the processes in the health economy network:
- How much data is really needed?
- Who uses it?
- When, where and what is it used for?
- How does it need to be shared?
When challenging whether existing forms and templates used within the system to capture data are fit for purpose, we almost always find a way of simplifying and shortening the data entry process which results in less patient and clinician time being wasted.
Secure buy-in
Inform and explain the benefits to clinicians and administrative teams and be prepared to challenge hard- won cultural norms. Consider how to embed this change in future generations of clinical and administrative teams.
Support adoption
Process and technology change need to be considered, planned for and built into a new way of working, supported by the new systems and training.
Using the same system artefacts (discharge letters, referrals etc.) to support a common process saves time and money. Maintenance is easier, too, if there is only one template or form to change per task, or one system to update. In some cases, specifics will be required for different specialisms, but this should be the exception rather than the norm.
Simplifying data collection and developing a core set of forms and templates also makes it easier to link with other parts of the health system, including primary, community and hospice care, where there is a willingness to adopt similar processes. This reduces the need for patients to repeat information and helps deliver a more joined-up service.
These benefits can all be enabled through EPR implementation, but it is understanding and improving the systems, processes and behaviours feeding the EPR that will make the biggest difference to patient experience and clinical outcomes.
