Largest EPR implementation programme in UK already reporting benefits

Medication administration incidents have significantly reduced following the go live of an electronic patient record (EPR) at the largest trust in the UK, its leaders have said.

Speaking at Rewired 2023, Sarah McGovern, chief transformation officer at Manchester University NHS Foundation Trust, said workflows supported by the new EPR have avoided 36 critical medication administration errors in the past six months.

She reported financial savings too: £500,000 on printing consumables and £300,000 savings through reduced use of legacy systems since the go live. Turnaround time on outpatient letters, meanwhile, has fallen to seven days.

“Our activity levels are also now back up to where we were pre-go live, both in outpatient and inpatient environments,” McGovern said.

She was speaking on the National Policy and Keynote Stage during day two of Rewired, in a session reviewing the trust’s progress post-go live and considering lessons learnt during implementation.

The Hive programme – which is centred on the Epic EPR – went live last September. It covers 10 hospitals and means that all staff at Manchester University NHS Foundation Trust are working on the same system. It is the largest Epic implementation in Europe to date.

Planning for the go live began as far back as 2017, when the trust was created through a merger. The constituent trusts were at that stage using different EPRs and patient administration systems (PAS).

“We very quickly made the decision that we needed a new solution for the organisation,” said Dan Prescott, the group’s chief information officer. “What we did have in place was not suitable to be expanded across the whole organisation.”

At that point a single digital service was established, a programme to consolidate patient identifiers began, and a huge data migration and integration effort was launched.

“We had to make some tough scoping decisions on migration,” Prescott told delegates. “We had a rich patient archive and it was a complex integration.”

A transformation project

Despite these complex technical decisions, he said the programme was never ‘just’ an IT project. “It was a major clinical transformation programme and it was clinically led, operationally delivered and digitally enabled.”

Board-level support, grounded in this understanding, is said to have been critical to the project’s success. A year before the go live, it was decided that the trust’s chief operating officer would work full time on the programme.

Dave Pearson, Hive programme director, stressed, however, that this wasn’t a programme “just delivered by the 250 members of the central Hive team”.

“It was delivered by the whole organisation.”

One of the notable lessons learnt, the speakers said, was the value of relying on one’s own organisation for training.

“The best people to train your people are your people,” said McGovern. “They know how you work, know your services, know your teams.”

“We had 156 different training tracks,” added Pearson. “We could have reduced that down and could have focused on peer training more. Later on in the scheme we seconded 25 full time nurses to train their colleagues, and that’s when the training really started to fly.”

While the past five years have been focused on go live as an end point, the focus now is on realising the benefits that were envisaging during planning stages.

“We’ve now aligned our Hive transformation plans with the wider transformation plans of the organisation,” said McGovern. “It’s no longer really about implementing Hive; it’s about how do we deliver the organisational priorities with Hive a key enabler and driver in doing that.”