University Hospitals Plymouth NHS Trust (UHPNT) is committed to creating a single, secure digital health record for every patient, accessible from any location, at any time. The decision was made to digitise the records in-house and the Trust set up an in-house scanning bureau equipped with Alaris production scanners and Alaris Capture Pro Software.
Throughout the deployment, Alaris Professional Services supported the scanning bureau team in making the capture workflow as productive as possible. Alaris worked closely with the Trust team to confirm and identify the capabilities of the hardware and software to support the Trust’s scanning strategy. “The Professional Services team helped fine tune the solution to make the scanning process as efficient as possible,” said Rob Harder, Head of IT Infrastructure and Support Services. “That’s been a huge benefit. When you are trying to get a scanning bureau up and running you need to ensure that all of the different elements are working together as effectively as possible,” he added.
The Trust also worked alongside Elisabeth Belisle, a long-term Alaris partner who set up one of the UK’s first BS 10008-accredited specialist scanning bureaus. She provided expert support, collaborated on creating new procedures and delivered hands-on training, thus helping the Trust to work towards achieving BS 10008 accreditation, something it expects to attain by autumn 2019. Once accreditation is achieved, the Trust will be able to start to destroy paper records.
When the project went live, the bureau scanned live patients’ notes, firstly within the Paediatrics speciality and then moving on to digitise Hepatology patients’ records. “Alaris helped us streamline the scanning process making sure we captured the appropriate metadata and, because we use barcodes to streamline some of our processes, they ensured the software was configured to identify those barcodes. All of that really helped with the project in terms of making processes more efficient and effective.” Harder explained.
As part of the digital transformation project, the Trust developed its own scanning application. “This is linked to our use of barcodes in association with our Scan4Safety programme,” Harder said, adding: “The App helps us track paper records through the scanning process.”
Since becoming fully operational the Trust has scanned a total of almost 24,000 case note volumes – just over half of which were for deceased patients – and 20,000 day forward files.
Scanning Bureau Manager Rachael Sargeant, said: “We typically process circa 1,300 case notes and 2,000 day forward files each month. Our peak throughput was 3,800 volumes and 2,650 files in January 2018, and the scanners have proven to be robust and reliable throughout.”
With this paperless project, the Trust is looking to reduce costs, increase productivity and further improve patient care by providing clinicians with faster access to records. Health Records Manager Vanessa Bennett, said that enabling clinicians to have instant access to records and for the notes to be available in more than one place at any one time, was a key criteria. Feedback from the medical staff has been extremely positive. “They really like the ability to access the patient notes when they see the patient instead of having to think ahead and request the notes out of the Records Library,” she said, adding: “Another benefit is that once digitised, the patient record can be seen by any other speciality, so whilst the project has to date been centred on Paediatrics and Hepatology, if a patient in either of those specialities is referred to another department, we will digitise those notes as well.”
Speaking of the ‘loose filing’ issue that affects every Trust, Bennett continued: “We were faced with a colossal backlog of loose filing going back many years – it was a mammoth task and if we had to physically file all the paper documents, we would never have got through it.”
Scanning has improved this process. In addition to the number of volumes cited above, the Trust has also scanned almost 400,000 loose filing sheets. “We have been able to clear the loose filing backlog and most importantly make that information accessible to clinicians. They can now simply logon to e-notes and access missing information – if we receive any loose filing for Paediatrics/Hepatology or ENT, we simply scan it as it comes in now,” Bennett explained.
The Trust is currently reviewing the need for back scanning. The reason behind the review is that the back scan is relatively unstructured. Harder said: “Our intention is to roll out digitised health records to all specialities within the hospital over a three year period. Whether this will be day forward or day forward and back scanning in tandem, will be dependent on the outcome of the review.
“There is a requirement to review the storage capacity within the warehouse and our objective is to reduce the cost associated with physical storage. Once the organisation is clear on its direction of travel, we will be able to achieve these goals, whilst still adhering to NHS Records Management Code of Practice, and being able to pull data in a reasonable time frame,” he concluded.
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