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Durham goes digital

Better patient care is on the cards as a new electronic medical records system is rolled out in Durham and the surrounding area

The total investment in the EMR solution over a 10-year period is predicted to be £33 million
The total investment in the EMR solution over a 10-year period is predicted to be £33 million

County Durham & Darlington NHS Foundation Trust has introduced a new electronic medical records (EMR) system to enhance its operational efficiency and improve patient care.

The EMR system removes the headache of managing the preparation, distribution and collection of paper-based notes and enables clinical staff in different sites to access electronic medical notes on desktop PCs and mobile devices – a major benefit as patients often require multi-disciplinary medical care.

The total investment in the EMR solution over a 10-year period is predicted to be £33 million. During this time, the Trust expects to generate savings of £4.5 million through reduced paper use.

The Trust, which manages six community hospitals and two acute hospitals 21 miles apart, handles around 650,000 outpatient attendances, plus 70,000 planned and 70,000 emergency admissions each year. As the Trust has modernised its services, patients move around more within its system. For example, someone may go to Durham for an outpatients appointment and then to Bishop Auckland for surgery.

Moving hard copy records around with patients created significant logistical difficulties for staff at the Trust’s three record libraries located at Durham and Shotley Bridge Hospitals and a warehouse in Darlington.

Sarah Perkins, County Durham & Darlington NHS Foundation Trust’s associate director of operations and performance, said: “Whilst our 100 records staff have delivered a very good service in terms of notes availability, there was a constant level of stress about moving them about to get paperwork to the right place at the right time and then filed away correctly, such that at any one time 25% of our library was out and in use.”

The Trust started a pilot of Civica WinDIP records management software in August 2013 in the dermatology and plastic surgery units. The implementation team included the Trust’s IT department, plus 14 other staff including an overall project manager and health records expert, change management specialists and training personnel. It was rolled out to the rest of the hospital by December 2013.

To date, 4,000 staff have been trained to use the EMR system which they can access directly via an icon on their desktops or through an iSOFT-based system that integrates with it. The EMR solution displays information in a time line and via tabs so that staff can quickly see and access associated records.

On-demand scanningThe scanning of the Trust’s existing medical records was undertaken by TNT Business Solutions using high performance ibml ImageTrac scanners and SoftTrac Capture Suite software supplied by Kodak Alaris, with Kofax software used to classify document images.

Alex Morris, TNT Business Solutions’ General Manager Operations, said: “We took over the Darlington library facility which was converted into a scanning bureau. Every patient has been given a unique barcode so we know where every single record is. Now records are digitised, it will make it far easier for everyone working in the Trust and, of course, patients themselves will be better served by immediate notes availability.”

A core group of 80 staff were allocated to the project by TNT Business Solutions. At its peak, this team grew to 200 people on-site, processing 1 million scanned images each day.

To avoid scanning notes unnecessarily – typically notes are destroyed if an adult has not been to hospital for eight years – the Trust has adopted a scan-on-demand approach rather than digitising everything. This means that people coming in for outpatients appointments have their paper notes scanned in advance of clinic and made available electronically via WinDIP. Individuals arriving at the Trust’s emergency department receive their complete digitised notes within three hours.

This approach removed the need to scan 55% of the estimated 900,000 folders the Trust held in its three libraries – each containing an average of 229 pages – saving time and money and reducing the total amount of folders scanned and stored in the purpose-built data warehouse storage system to around 400,000.

County Durham & Darlington has now closed its three libraries and is using ImageTrac scanner and software technology for allday forward scanning. Every day, handwritten updates to the records of people who have come in and seen a clinician are collected and scanned into the system within 48 hours.

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2018