Why you can’t build an EPR on sand

When it comes to implementing electronic patient records, starting with the right foundations is crucial for ensuring patient safety, efficient workflows and effective reporting. If you build your EPR on sand, problems will ultimately start to arise without a solid base.

At the core of this foundation lies integrated patient administration, which serves as the bedrock for all other clinical and admin processes. A well-established patient administration system not only streamlines admin workflows but also enables seamless integration with clinical workflows, supporting a cohesive and efficient healthcare delivery system.

The consequences of neglecting a strong foundation can be severe – it can lead to compromised patient safety, inefficient workflows and a lack of visibility into key performance indicators. By building on a solid PAS foundation, NHS trusts can take their EPR live with confidence, knowing that they have a stable platform to support their clinical and administrative needs which can be scaled up as needed.

Reporting provides transparency around patient safety

Reporting capabilities are another critical aspect that highlight the importance of a solid foundation. Statutory national reporting is crucial for financial, operational, and clinical quality oversight, enabling trusts to identify areas for improvement and make informed decisions and a lack of reporting means trusts don’t get paid. Without robust reporting, organisations may find themselves operating in the dark, unaware of potential issues or areas that require attention. This transparency means the data often makes its way into local and national headlines when performance or safety is compromised, particularly when related to high-profile issues like waiting times, emergency care, and maternity and neonatal care.

This has really come to the forefront over the past couple of weeks, with articles in HSJ and the BBC highlighting NHS organisations that are still struggling with major safety, operational and reporting problems years after going live with their EPR systems. In some cases, these issues have even led to tragic events and loss of life. So, it’s clear that digital transformation and maturity in healthcare is about a whole lot more than just the software you choose. It’s just as much about the people, the processes and the culture changing along with the tech.

Getting value for money

Given the significant variation in EPR project costs ranging from tens to hundreds of millions of pounds, and the grave implications of inadequate reporting, we must prioritise securing the best value for money and getting the basics right. This is especially important when it comes to large-scale EPR projects that involve a complex interplay of technology, people and processes. Connecting existing high-quality systems across integrated care systems delivers quicker value and lower costs than wholesale replacements. A one-size-fits-all approach is costly and time-consuming but tailored implementation, based on an organisation’s digital maturity, addresses specific needs and minimises disruptions.

We’ve supported organisations with some of the highest profile challenges in terms of legacy technology and have learnt that what and how you deliver an implementation is really important. A recent success story is the go-live of System C’s EPR at Shrewsbury and Telford Hospital Trust, which encountered no reporting issues just one month after deployment – a first for the NHS according to NHS England. Even with meticulous planning, go-lives can bring some trepidation about the unknown, but SaTH’s implementation was seamless, and it is now ready for further enhancements as part of the trust’s digital transformation.

Don’t rip and replace

Many billions of pounds have been spent on tech in the NHS over the past 20 years. So rather than changing out often perfectly good solutions on the promise that something shiny will miraculously solve all the problems, we need to prioritise building on investments made to date. While the promise of cutting-edge technology may seem enticing, replacing a whole new system often involves significant investment, potential disruptions and a prolonged implementation timeline, ultimately delaying the time-to-value realisation. Plus, the continuous cycle of learning new systems, diverting focus away from patient care, is exacerbating fatigue among an already overburdened workforce within the healthcare sector.

If we don’t look at administrative, operational and clinical workflows holistically this is likely to cause issues later down the line. Establishing the right foundations, like a robust PAS and transparent reporting, is paramount when implementing EPRs. By building on existing investments, healthcare organisations can achieve a smoother, safer and more efficient EPR transition, minimising disruptions and realising benefits faster.