Rapid digital transformation

From the initial go-live, the trust had clinical documentation functionality activated on all 32 inpatient wards. As a result, the EPR has been highly configured across different departments, accelerating digital maturity, transforming the ways of working and improving patient experiences.

Jane said, "We've taken significant steps in our EPR journey over the last year, bringing about major digital change that has contributed to the trust recently being ranked fifth in the country for overall performance in terms of its duties to patient care."

These changes include:

VIRTUAL FRACTURE CLINIC

The EPR team has been able to configure an end-to-end pathway for fracture patients using Sunrise. Saunders described this as a "one-stop shop" for these patients arriving in the Emergency Department.

According to Jane Saunders, "Previously, fracture patients coming to hospital through ED were assessed and referred using a paper system and Excel spreadsheet, so they spent a lot of time repeating themselves to different members of staff. Now, every time a patient is reviewed, the documentation is pre-populated with their information. This is the case across the entire pathway, from ED to radiology, theatre, inpatient, physiotherapy and outpatient services.

"Having the entire digital fracture clinic process embedded in Sunrise is enabling major reductions in admin time when it comes to filling in forms, which is helping patients to be triaged and receive the right care more quickly as they move through the hospital."

AUTOMATED POINT-OF-CARE TESTING

Improvements are being made to patient safety and experience by embedding point of care testing within Sunrise. Results from the three key tests-blood glucose, blood gas, Covid-19-are now automatically uploaded to the system and can be viewed by any clinician, anywhere in the hospital.

Previously, staff members would need to complete the tests and go find a computer to manually upload them, transcribing from their handwritten notes. Automating this process has eradicated transcription errors, improved patient safety and reduced admin time for clinicians. Jo Kelly said, "Our nursing team helped us to prioritise this development. They recognised they were spending time away from patients to enter results or needing to rerun tests because they couldn't read some handwriting. We're encouraging more feedback like this so we can stay focused on developments that truly streamline care processes and improve patient experience."

FAST AND ACCURATE IDENTIFICATION OF SEPSIS

The trust has also been able to take advantage of the high configurability of the EPR to implement and prompt consistent use of sepsis documentation, which is helping prioritise the sickest patients and promote the continuity of care. Jo said, "If a patient has a high NEWS score, the clinician will see information on our tracking boards to complete an assessment for sepsis, which is helping to keep clinicians on top of all their patients and ensuring they're getting the care they need in a timely manner."

STREAMLINED RADIOLOGY REFERRALS

Most recently, the trust integrated the national clinical decision support tool, iRefer, into the order communications module of Sunrise. When clinicians make a specific radiology request, iRefer is triggered within Sunrise and clinicians are guided to request the most appropriate test based on the symptoms. This is saving valuable clinic time as patients will receive the correct test in a timely manner. As a result, ordering errors are reduced, as are delays in diagnosis and treatment. It is also reducing the number of cancellations and unnecessary radiology referrals.

Jane said, "We were able to integrate the iRefer functionality into Sunrise with ease alongside the Altera development team. Having a system that interoperates so well is helping us continue to digitally evolve at pace and respond to national needs and guidelines."

FASTER DOCTOR HANDOVERS

The trust is also live with a new doctor-handover process within the EPR which has helped foster a wholesale change in clinical behaviour. The functionality enables doctors to quickly complete a handover document within the EPR and add them to a list for the weekend team to review, rather than having to use multiple systems. This is helping to reduce the admin burden on staff at the end of their already busy clinical shift.

Jane said, "While this functionality is new, we are already seeing how beneficial this will be for patients to receive the treatment they need over the weekends, when delays can occur. We've also found this help to save time during the week when industrial action is taking place. In conjunction with functionality such as point-of-care testing, this is improving the visibility that clinicians have of their patients, and I expect it to be of great benefit to our staff and patients alike."

Ambitious next steps

As of November 2022, the trust activated Altera Digital Health's ePMA functionality as part of its 10-year digital transformation strategy. Ahead of this go-live, the trust trained pharmacists as super users who were supporting other clinicians to get up to speed before the functionality was activated.

Additionally, Sunrise will integrate with the Kent Oncology Management System, enabling the oncology staff to order radiology and blood tests electronically through the EPR. It will reduce the administrative burden on phlebotomists, who no longer have to handwrite on sample bottles when taking bloods, speeding up the time taken for patients to receive test results. Once this is complete, the trust will be virtually paperless for order communications.

In 2023, the trust will introduce Provation® iPro, Altera Digital Health's anaesthetic record solution, as well as the Sunrise™ Surgical Care module, at the same time, becoming the first trust in the UK to do so.

"Since our initial go-live, we've been really ambitious with what we've wanted to achieve and we've covered a lot of ground in a very short space of time," said Dr Alex Slack. "It has been a huge undertaking, which wouldn't have been possible without the joining together of multidisciplinary teams. This is still very much the beginning of a big journey, but it's a major step towards delivering on our digital transformation strategy."