Client Story
Clinically driven digital maturity: How Medway NHS Foundation Trust achieved one of the fastest EPR deployments on record
The need for electronic patient records
Medway NHS Foundation Trust has been working with Altera Digital Health (formerly Allscripts) since 2015, when the trust went live with a new Patient Administration System (PAS). Despite realising benefits such as improved patient flow, the trust found that with approximately 80 different clinical systems running alongside the PAS, it was having to rely heavily on paper documentation and that it was still struggling to manage siloed data. To address the problems it was facing, in November 2021, the trust went live with Sunrise™ EPR to join non-integrated systems, increase time to care and streamline clinical processes.
Safeguarding against future pressures
The deployment of Sunrise EPR was planned during a highly pressurised period of the pandemic. At the time, many digital technology programmes across the NHS were being deprioritised. However, the trust committed to its proposals after Michael Beckett, Director of IT, and executive teams agreed that the rollout of an EPR was a strategic priority that would safeguard against future pressures.
Beckett explains, “As a trust, we have wanted to improve our level of digital maturity for a number of years. So, in spite of the pandemic, we decided to continue working on the project, safe in the knowledge that we were pursuing a long-term ambition that would serve us well now, and in the future.”
Fast and effective deployment
With collaboration between the programme team, clinical team and Altera Digital Health prioritised from the very start of the project, the trust was able to deploy Sunrise in less than five months—the fastest Sunrise EPR deployment to date.
Streamlined processes and improved patient outcomes
On-call clinicians are saving up to half an hour of time per patient, as they can now login to the EPR remotely and obtain a full view of the patient record, resulting in faster decision making, thus, improved patient outcomes.
Developing a clinically led solution
In the face of challenging circumstances, to ensure the EPR was deployed on time, a larger-than-average implementation team was assembled, made up of staff from IT, operational, clinical, nursing and administrative backgrounds. In total, there were 83 “Digital Champions” involved in the project, with clinical, nursing and ward support staff working alongside four clinical leads across the 24 inpatient wards. Having a large, diverse team was instrumental to the success of the project, and meant that it was considered as a culture change programme, rather than an IT project being imposed upon clinical staff. “A key part of our success was the high level of clinical engagement we encouraged from the planning stages of the implementation,” explained Beckett.
Described by Beckett as “the voice of the EPR,” the clinical leads were intrinsic to the planning and implementation of Sunrise, attending weekly meetings with the programme team and Altera Digital Health to make sure that important clinical needs were considered in the development of the solution. Working collaboratively in this way meant that every aspect of the EPR was built around the specific needs of the trust, ensuring that it would work not just in theory, but also in practice. The trust’s NHS transformation blueprint is now set to be used by other trusts embarking on similar transformation projects.
"We wanted the project to be clinically led, developed by the people using the technology on the frontline. Having them involved made a big, big difference."
Michael Beckett,
Director of IT
Fast and effective deployment
The trust took a phased approach to the deployment of Sunrise, initially going live with clinical documentation. Introducing new functionality incrementally ensured that staff could learn the system thoroughly without becoming overwhelmed by too much change, or suffering further fatigue caused by pandemic pressures. The trust’s leaders also recognised that, having already changed a PAS, they needed to consider the level of change possible in relation to staff appetite for further digital transformation initiatives.
As part of this process, the EPR team delivered a comprehensive training programme, setting up a Digital Hub in the dining room and encouraging staff to visit and learn how to use the new system. Incentives were offered to wards that completed their training the quickest. To date, more than 1,200 clinicians have been trained to use Sunrise.
A few days before go-live, the trust conducted a dress rehearsal to relieve any anxieties and make sure staff members were comfortable with the new system. It also helped the programme team to identify any snags and pre-empt any issues that could arise. As a result, Sunrise went live without a hitch, with Medway becoming the first organisation to roll out the latest version of the software.
On the whole, staff members were impressed with the low level of disruption caused by the implementation, including Dr Dilip Pillai, Consultant Orthopaedic Surgeon and EPR Clinical Lead. “You can usually expect quite a lot of disruption to workflows with a deployment, but everyone was very calm and the roll out went incredibly smoothly,” Pillai explains. “People really hit the ground running, and by taking a phased approach we were able to carefully manage the transition from paper to electronic records.”
Stacey Spence, IT Project Manager at the trust, adds, “Altera Digital Health provided us with the flexibility to take a phased approach to roll out, ensuring we didn’t overwhelm the workforce. And throughout the deployment, clinical leads and digital champions were visible on the wards. This meant there were continued touchpoints between the clinical and programme teams, and clinicians could be assured they were using the system correctly and remaining compliant.”
In the first 24 hours, more than 2,000 documents were created in the system. Just three weeks in, almost 115,000 documents had been created, with more than 1,000 daily users. As more of the system went live, the EPR team, including clinical leads and digital champions, were on the wards supporting colleagues, dealing with concerns and mentoring staff who may have been apprehensive about the new technology.
Medway also benefitted from guidance provided by other organisations that had gone live with previous iterations of Sunrise, such as Gloucestershire Hospitals NHS Foundation Trust. “Having insight from other organisations was a huge benefit,” explains Spence. “It made sure that we were prepared and understood how to deploy the technology in a way that was centred on the clinician.”
Instant impact
Almost immediately after deployment, the trust began to realise the benefits that Altera Digital Health (Allscripts) has promised to deliver. “The roll out went really smoothly. Less time was spent getting colleagues up to speed with the system because staff were engaged from the offset, meaning that there was already a high level of familiarity,” explains Pillai. “Instead, teams were actively checking in with the IT department to make sure they were using the system correctly and requesting data so they could work more efficiently with the technology.
In less than two weeks, clinicians were recording measurable benefits. On-call clinicians, for example, are saving up to 30 minutes of time per patient, due to the fact they can log into Sunrise remotely and obtain a full view of the patient record. As a result, they are able to make decisions without having to take a doctor away from their clinical work to read out a patients’ paper notes.
Beckett adds, “We were delighted with how quickly we began to realise the benefits of the new EPR. Much of our success is down to the meticulous planning from Altera Digital Health and our implementation team, who worked tirelessly to foster an environment that could produce a cohort of highly engaged clinical and nursing staff, who were eager to see how else they could draw benefits from the system. I don’t think the process could have gone any smoother.”
Reflecting on some of the immediate benefits that were felt post deployment, Emma Hughes, Chief Nursing Information Officer at the trust said, “we are very excited about EPR because with our patients, we used to often only get temporary notes and limited information such as their name, what they presented with and limited medical history. With EPR, we are able to get the whole picture.
“Patients no longer have to constantly repeat their medical history and medications to different people all the time. EPR follows them from department to department, even hospital to hospital, so we don’t have to spend time chasing others for more information about a patient’s past care.
“Some may think that EPR takes nurses away from the bedsides and leaves them stuck behind a computer. It does the opposite of that. We are able to quickly record everything on just one system, giving us more time to care for our patients.”
"Before the implementation of Sunrise, we were on the digital backfoot. We are now on track to achieving digital maturity."
Michael Beckett,
Director of IT
Inspiring others
Due to the speed and success of the deployment, and as the first trust to successfully roll out the latest version of Sunrise, Medway has become a significant contributor to the “Altera Digital Health Blueprint,” which will be shared with NHS organisations embarking on similar digital transformation journeys.
The trust intends to roll out the next phases of its EPR every few months, to ensure that digital transformation remains a central priority. This will ensure that the implementation is carried out as part of a wider cultural shift in ways of working, rather than a series of isolated IT projects. For the second phase, Medway will introduce the EPR to the Emergency Department, before rolling out ePMA across the trust.
One of three acute trusts in Kent to be live with Sunrise™ EPR, Medway is now involved with the development of a regional shared care record as part of wider ambitions to work collaboratively across the region and unlock the potential for more connected care delivery.
Reflecting on the partnership, Paula Ridd, General Manager UK and Ireland for Altera Digital Health, explains, “We are delighted with the outcome of this project, and it fills me with great pride to see clinical staff realising the benefits of Sunrise EPR so soon after deployment. It has been the most incredible deployment I have worked on, and the success of the implementation is a testament to the hard work and collaboration demonstrated by programme and clinical teams, as well as the sustained drive to put clinicians at the centre of each stage of the implementation process. I am looking forward to seeing how our relationship evolves, as we move towards an integrated model of care across the region.”
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