North Middlesex starts 1m note scanning project

North Middlesex University Hospital has gone live with the Unity electronic document management system as part of its strategy to be fully digital in 2017 at the earliest.

The solution, from Fortrus, is available as a standalone or through the trust’s home-grown portal enabling clinicians to view not just the scanned record but also any other clinical system through a single interface.

Musadiq Subar, IT programme manager, said: “We built our portal in 2013 and have any number of systems linked to it but our clinicians were held back by the physical notes. So now we are making them electronic.”

The project was part paid for by NHS technology fund money, and has involved setting up an in-house scanning bureau to scan100,000 sets of live notes over the next 18 months – an estimated one million documents.

Subar said: “We chose Fortrus and Unity because the system allows us to replicate paper notes. The scanned record looks like a medical record in the way it is structured so it is very usable by clinicians.”

Clinicians can annotate the record and complete electronic forms within the portal.

Scanning in paediatric outpatients began in November 2015. A trust-wide programme was due to go live in January this year but was postponed to allow adoption of a new version of Unity and extra time to prepare for implementation.

Subar said: “The architecture is very complex and it has taken some time to get it right. There are several components to scanning any paper record including archiving.

“We are using BS10008 standards so the electronic record can be used in court by solicitors.”

He said clinicians had reacted “positively” to the new system and having clinical notes available on-line anywhere in the organisation viewable either through the Unity app or through the portal.

The focus now is on “live” notes on patients with the scanning bureau prioritising those with an outpatient appointment up to six weeks ahead.

“We are still deciding on key hot spots and key documentation for the rest of the year,” said Subar. “Our aim is that by this time next year, 80% of active records will be scanned.”

The Unity EDMS is part of a wider project to create a “digital care campus”. The hospital is one of the busiest in London serving a population of 350,000 people.

The trust is now mapping business processes, including order comms, to remove paper wherever possible.

Subar said: “This is not an IT project but an operational transformation programme. We need to review how we handle documents, what documents we use and whether they still applicable and workable for doctors and nurses.

“We will be mapping the paper trail, capturing it electronically and then making it available to clinicians.”

Over the next year, the trust plans to make electronic notes available to patients’ GPs enabling them to see “the whole picture” of the patient, including test results.