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Client Story

A look into Maidstone and Tunbridge Wells NHS Trust’s rapid digital transformation

A collaborative approach to digital change

A collaborative approach to digital change The trust has an EPR team, comprising project managers, business change agents, digital fellows, training, configuration and testing teams. These groups were split up and given different elements of the EPR to develop-enabling configuration to occur across multiple departments at a time.

Jo Kelly, Senior Nursing Informatics Officer at the trust said, "We're at the point where we are constantly changing and configuring the system, and each week it becomes more specialised to our specific needs. We are training teams of nurses so that there is clinical representation on each of the wards, so we can understand where the gaps in functionality might be and have sight of where compliance might drop. Most importantly, we're doing this so that clinicians feel empowered to ask for changes, and to tell us when things aren't working. Every week the requests we get become more specialised and having such a flexible EPR means we're able to make helpful changes very quickly, directly responding to clinicians' needs."

Clinical documentation functionality
New processes have transformed clinical pathways and patient experience
Developed advanced 10-year digital transformation strategy
Ranked fifth in the country for patient care

Refine and repeat

With more clinicians feeling empowered to play a role in shaping the EPR, the volume of configuration requests has steadily increased over the last 12 months. To satisfy these requests, Jane Saunders, Programme Director for EPR and Digital Transformation at the trust explained, "We created a test and development process to follow, enabling us to continuously refine the EPR when we receive requests. Having a defined 'refine-and-repeat' model to follow has been integral to our rapid digital transformation." Project managers have been integral to this smooth, rapid digital transformation. Explaining their role, Jane said, "We are constantly juggling smaller, simpler configurations with larger, more complicated projects.

Our project managers make sure we keep to time on everything we're working on, and also ensure we plan around larger projects, such as the recent electronic prescribing and medications management (ePMA) deployment. Doing this has made sure we've been able to continue responding to requests from clinicians and make the EPR suit them, while still fulfilling strategic priorities for the trust."

Jane also explained that working closely with Altera Digital Health colleagues has played a significant part in the rapid transformation at the trust, saying, "We've been able to tap into their experience to create the foundation for our digital change and build from it as we go. Having this alongside our internal proactive business change team has meant we've been able to make changes week on week and build a bespoke EPR to fit the needs of our different clinical teams."

"What we have been able to achieve in a short space of time is extraordinary and is nothing short of transformational in terms of the impact to patient care. Our EPR is the spine of our digital transformation journey, and we've really hit the ground running to make it the best it can possibly be." 

Dr Alex Slack

Chief Clinical Information Officer

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:


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."


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."


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."


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."


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."


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  • Clinical documentation functionality activated on all 32 inpatient wards, three paediatric areas, Emergency Department (ED); order communications, EPMA and outpatient services.
  • New processes have transformed clinical pathways and patient experience.
  • Developed advanced 10-year digital transformation strategy.
  • Ranked fifth in the country for patient care.


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