Brighton Alert in outpatients

Brighton and Sussex University Hospitals NHS Trust is rolling out its Alert electronic patient record to 40 outpatient clinics over the summer.

The go-live introduces clinical documentation and e-prescribing to each clinic, with consultants adding patient notes directly into Alert. 

The first clinic went live on 18 June and a new specialty is being added at a rate of one a day through to August.

Judith Steen, Brighton’s EPR programme manager, said this first batch of outpatient services involves around 60 users across two hospital sites. 

Historical paper notes will still be supplied to the clinics while the EPR is built up.

Steen said clinicians will also soon be able to do ordering for radiology through the EPR. They can already see pathology results via a link to the Sunquest ICE order communications system.

A direct link to the Summary Care Record is also in the pipeline, with the ability to pull medication information directly into the EPR.

Alongside the outpatient clinics, the Alert e-prescribing module is going live in the trust’s infectious diseases department, with help from a successful bid to the Safer Hospitals Safer Wards: Technology Fund.

The trust introduced Alert into the A&E department at the Princess Royal Hospital last October and the Sussex Eye Hospital in November 2013.

The plan was to go-live in A&E at the Royal Sussex County Hospital this spring, but this has been delayed.

“Generally within the country there’s a lot of pressure on A&Es so introducing a new systems is very hard,” Steen explained.

The trust is still working through things at the PRH with the aim of bringing in extra developments before setting a date for go-live at county hospital.

She said different staff groups at the PRH have different views on how the EPR is working. While administrative staff and nurses are fine with it, the consultants are having trouble recording information in different ways.

“We are trying to work through as many issues and queries as they have got and trying to get it settled down and as stable as possible before we move to county, because we don’t want outstanding issues and concerns, so it will be several more months to get us to that point,” she said.

“It’s been such a big change, some people find it difficult to cope.”

The hope is that there will be good feedback coming out of the outpatient clinics which will “prove the EPR in an outpatient setting”.

Brighton is also taking a new release of Alert into a test environment at the end of this month. Once that is in place it will look for an early adopter of the system in an inpatient environment.

“The next steps are testing this new release, rolling out more outpatients and trying to plan for the next A&E go-live,” Steen said.

“It’s a very slow process to try and get an EPR rolled out so to do the whole lot will take another few years, but we are trying to look at ways for accelerating and bringing benefits as far forward as we can.

“It’s frustrating because it’s slow, but it has to be right. You have to balance the want to push the implementation as fast as possible to get the benefits, but we don’t want any clinical concerns so we have to steer pretty carefully.

“Once we get this batch going and good feedback we’re banking on being able to prove that it’s a success and roll-out faster.”

Steen said clinical engagement is fundamental to success. The senior responsible owner for the programme is the medical director and the lead clinician on the EPR programme is an acute physician. A clinical lead is also identified in every area where the EPR is rolled out.