Chelsea and Westminster plans post EPR

Chelsea and Westminster Hospital NHS Foundation Trust plans to replace much of its LastWord electronic patient record functionality and go out to tender for a portal early next year.

The trust implemented LastWord from IDX Systems Corporation before the national programme for IT in the NHS was launched.

IDX was the system selected to be rolled out across London as part of the NPfIT, but was later dropped in favour of Cerner Millennium.

Chelsea and Westminster IT manager Bill Gordon told eHealth Insider that despite being old, the IDX EPR “exceeds other products in the market place”, a view he said is backed up by staff who have worked at other sites.

However, the plan is to replace much of the LastWord functionality, such as the patient administration system, e-prescribing and order communications, over the next three years.

“Our risk is that the system is 13 years old. We can’’t run it forever so we do have to replace that functionality,” he explained.

“As we go forward we will be looking to take a best of breed approach, building on the integration engines and data warehouse and the legacy EPR.”

Final decisions have not yet been made regarding what part of the EPR will go out to tender first, but it is likely to be the PAS.

A slick and uniform front end for the new systems will be provided by a portal with a tender due to go out early next year.

Key to the trust’s EPR strategy is the introduction of an electronic document management system.

The trust has chosen the supplier and is now finalising contracts. The decision on how the system would be designed was based on 300 interviews with “all kinds of staff” – including six chaplains – over one month.

Gordon said the deal would see about 60m pages scanned into the digital record as patients are due to attend the hospital.

The trust is also looking for a customer relationship management system.

“It’s all about allowing the patients to have the best experience they can have, allow access to book and change appointments and going forward, being able to manage their medical record,” Gordon explained.

The trust’s IT team has been working on a number of mobile applications.

“Some apps are purely for us, some are sellable and the ones yet to work on are the ones for patients,” he said.

The apps for patients will be developed to extend the look and feel of the hospital’s check-in kiosks, into patients’ homes.

The first app to be made available is a directory of services app for GPs. Another one soon to be released is a maternity app, which other trusts have shown an interest in using.

Gordon said the trust is looking at both deploying more mobile devices and implementing a ‘bring your own device’ strategy. However, he said there is no point giving staff more mobile devices until they have systems that can be used on them.

“We have to provide people with enough applications to make it worth their while,” he added. “We need to enable the workforce to be mobile.”

The trust has already deployed more than 300 tablets used for e-prescribing on the wards.

Gordon said Chelsea and Westminster’s IT budget is the second largest capital budget after buildings, but like other areas they are expected to make savings.

This year the target was 10%, but Gordon said this was done through efficiencies rather than staff cuts. Staff numbers have remained consistent at around 60 for the last few years.

Part of the trust’s IM&T strategy, passed last year, is to look towards collaborating with other trusts on IT.

Gordon said this will mean sharing resources for “nuts and bolts” sort of stuff, rather than complex clinical applications and he is in talks with a number of other trusts about how this would work in practice.