How to establish IT processes to achieve clinical cost efficiencies

In 2008, Barts and The London Trust established a pathology IT board to manage and monitor the trust’s investment in IT and ensure that it delivered real benefits to both patients and clinicians.

The board, which consists of stakeholders from pathology management, clinical leadership and IT, together with representatives from the trusts’ key pathology software supplier, CliniSys, had recognised that IT was to play a major role in the continuing commercialisation of pathology services and wanted to ensure that the trust was able to capitalise on this both by increasing its existing business and securing new business opportunities.

Over the following three years, the board has presided over the winning of a number of competitive tenders, overseen the successful implementation of some 15 projects, and recorded a 58 per cent increase in the number of electronic requests which have now risen to over 7 million per year.

This has been achieved by ensuring that the pathology systems involved are not just “linked” to other external systems, but that they demonstrate true integration and interoperability.

In 2008, Barts and the London provided Barking Havering and Redbridge University Hospitals Trust with just a handful of tests. Today, the improved data quality and result turnaround has resulted in BHRUT consolidating the majority of referrals with Barts and the London which now provides 136 different orderable tests under the SLA.

“As a trust we recognised the key role that IT has to play in providing a market leading pathology service,” explained Alexis Henley, head of pathology at Barts and the London. “By developing an infrastructure that meets our immediate objectives and provides the foundation for future growth, our services have become a benchmark for pathology in terms of efficiency, quality and innovation. The technology capability provided by Barts and the London is the key differentiator.”

The trust’s three year investment in IT has resulted in an 85 per cent achievement level on external requests submitted electronically and over 95 per cent of all internal requests using Cerner Millennium integrated with the WinPath LIMS. The figures speak for themselves: Where a manual request takes, on average 65 seconds to complete (including labelling and verification), the same request in electronic form takes just 10 seconds to complete – a reduction in time of 85 per cent. Handling an additional 2,550 daily electronic requests, the trust is saving 39 man-hours each day. Thie eqautes to a return on investment of £108,000 per year in this area alone.

As both primary and secondary care results are available electronically to the GPs, the pathology department has been able to demonstrate real savings by reducing the number of GP prints from 8,838 to 4,888 per week – a saving of £13,500 per annum which is projected to rise to £20,000 in the coming year.

Steve Ryan, BLT’s medical director says: “I have been very impressed with the development and uptake of electronic requesting. Not only has it shown its cost-effectiveness but it has reduced the amount of unnecessary or duplicate testing. The ease of requesting and the direct reporting has considerably reduced the possibility of error, with genuine improvement in the quality of the service to our patients.”