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How digital change became cultural change at Medway NHS Foundation Trust

At Altera Digital Health, our partnerships are key to our success. Our partnership with Medway NHS Foundation (MFT) is a recent example of how our blended teams worked together as it went live with Sunrise™ EPR. Despite intense clinical and operational pressure from Covid, the trust deployed its EPR in less than five months. Here, I’ll dive into how the innovation and collaboration between the EPR team and Altera created what the trust’s Director of IT called, “the smoothest roll out [he’d] ever seen.” But maybe more than a smooth shift from paper to digital was a great shift in the culture of the trust.

Starting position

Since 2015, Medway NHS Foundation Trust has been working with Altera Digital Health (then part of Allscripts) when it went live with a new Patient Administration System (PAS). Although the trust found benefits, such as improved patient flow, the functionality was focused on the administrative and reporting aspects of the organisation. There were approximately 80 different siloed clinical systems running alongside the PAS and clinicians were relying heavily on paper documentation. In November 2021, the trust went live with Sunrise™ EPR to begin its journey towards digitisation of all clinical processes and eliminating siloed clinical systems.

Building the foundation

A good foundation is essential for success. Like a house, if the foundation is unstable, the home won’t stand. Therefore, when Altera and Medway partnered, we intentionally started by fostering a culture of clinical engagement, underpinned by a clear digital strategy and executive board sponsorship. Brought together by a compelling need for change, the EPR team engaged clinicians through multi-media communication channels. From business case and strategy through to benefits realisation, this ensured users were involved, understood why decisions were made and took ownership. This cross-profession and cross-specialty engagement ensured that all parts of the organisation were involved and were aligned with the phased EPR roadmap and perfectly positioned to take on a role as digital champions.

Go-live strategy

The phased approach enabled the trust to evolve and transition from its old systems to the EPR whilst also iterating its delivery to incorporate lessons learned along the way. Users were trained in good time and a full dress rehearsal that simulated the transition contributed to the calm and efficient go-live. There was a buzz across the organisation that fueled momentum and established the importance of its digital champions. These digital champions were instantly recognisable and present in all clinical areas—underlining that this change was cultural, not just an IT project. Altera and Medway drove this partnership forward to empower the trust to go live in record time.


1,460 clinicians were trained to use the system and the trust is averaging 398 users per day. In the early days, trainers were continually available for support. Speaking on the success of the go-live, Dr Dilip Pilai, Consultant Orthopaedic Surgeon and CCIO, MFT stated, “Whenever I had a difficult question, the Altera team members were able and happy to answer it. I have been so impressed with how embedded the Altera team is with ours. It was a major reason why the go-live went so smoothly.”

Medway is already creating more than 8,000 documents per day and an EPR dashboard highlights compliance with documentation standards and opportunities for targeted training. The move from paper has saved junior doctors an average of 30 minutes of administration work per patient, enabling them to have more time to deliver safe, patient-centric care.

What the future looks like

While the next phases of Emergency Department and electronic prescribing and medicines administration are on the horizon, Medway plans to maintain the cultural and organisational readiness changes that occurred during this transition. Leadership is also working with neighbouring trusts to share lessons learned and support Medway’s contribution to the Kent and Medway Shared Care Record.

This was one of the fastest EPR deployments on record in England and made Medway an award-winning organisation.

To watch a webinar about this partnership and hear more about how the trust delivered this cultural shift that enabled the smooth go live, please see below or click here.

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