1. Trust Interim EPR Developments. Paul Crane-Whatmore. ICT Project Manager. Anne Spencer. Nursing and Midwifery Informatician. Southern Institute for Health Informatics. Friday 30 th September 2005.

2. Presentation Objectives.  Why the ‘Interim’ EPR?  What are the current contributing systems?  EPR Repository (Data Warehouse).  Electronic Discharge Summaries.  Electronic requesting of Pathology.  EPR - Current roll out plans.  Future developments.  Challenges.  Benefits.

3. Geographical overview Royal Hospital Haslar (RHH) Gosport. St. Marys Hospital Portsmouth. Queen Alexandra (QAH) Cosham, Portsmouth.

4. Why the ‘Interim’ EPR?  (EPR) Electronic Patient Record.  Today – Multiple systems (and passwords!)  EPR offers a ‘single view’ of multiple systems.  Growing clinical need for an EPR:  Clinicians benefit from a ‘bigger picture’.  Users have less systems to access.  Information from the EPR can feed Electronic Discharge Summaries.  ‘Interim’ until ‘NPfIT’.

5. The Reality in Practice.

6. Current Contributing Systems.  EPR is based in the Graphnet application.  Today, the EPR is being developed to provide:  EPR Repository (Data Warehouse).  Graphnet based Departmental workflows.  Workflow generated E-Discharge Summaries.  Electronic Pathology Requesting via Anglia.  Interface from Graphnet EPR to Anglia Requesting.

7. EPR Repository (Data Warehouse). Graphnet EPR Front End. PAS. Pathology Requests & Results (Anglia & Apex). (RIS) Radiology Reports. MAU* ‘Workflow’ Clinical Notes. MAU* ‘Workflow’ Clinical Notes. (and others over time). Singular View & Input. User input to existing systems.  Today, Data is received from feeds at PHT/RHH.  Improvements being made in ‘matching’. * MAU (Medical Assessment Unit)

9. Electronic Discharge Summaries.  Extension of workflow application used in MAU.  Workflow enhances bed management.  Clinical patient data captured.  Workflow drives the patient journey.  By adding TTO data the workflow can produce an Electronic Discharge Summary.  Discharge summaries live in MAU (400 p/w).  Future requirement to send electronically to GP.

10. Input Screen Output Document

11. Electronic Requesting of Pathology.  Allows Pathology tests to be requested ‘on line’ as opposed to handwritten form filling.  Offers users customisable test sets (profiles).  User can maintain their own patient lists.  Requests can be made in advance of the event.  Improved data inwards to Pathology.  Samples scanned in upon receipt at laboratory.  In development: Interface linking to Graphnet.

13. EPR - Current Roll Out Plans.  EPR Repository (Data Warehouse):  To be piloted in MAU – work in progress.  Theoretically available Trust Wide.  Workflow based Electronic Discharge Summaries:  Live in MAU, since May 2005.  Customisation required to move beyond MAU.

14. EPR - Current Roll Out Plans.  Electronic Requesting of Pathology:  Live in Renal.  Current deployment to Critical Care (DCCQ).  Further deployments in 05/06 programme.  Ultimately will link to Graphnet workflow.  Other departmental workflows:  Live in MAU.  Developing in : Dermatology, Oncology, ENT.  Futures: Colposcopy, Rheumatology (amongst others).

15. Future Developments – Application.  Application Software:  Further enhancements of e-discharge document.  Workflow / E-discharge beyond MAU.  Electronic transmission of e-discharge.  Interface other departmental systems to EPR.  Completion of departmental workflow documents.  Completion of interface to Pathology requesting.

16. Future Developments – Geography.  Geography:  Workflow / E-discharge – Medical Division.  ‘Self service’ launches of EPR Repository.  Accelerate electronic pathology requesting roll out.

17. Challenges.  Patient matching from disparate systems.  Clinical engagement and awareness of the bigger picture (CfH).  Training:  Resources.  Differing training approaches.  High volume.  Funding – client & other ward hardware.  Lack of IT resources in some clinical areas.  Ergonomics.

18. Benefits.  Single point of access to Trust systems.  Singular view of multiple Trust systems.  Legible discharge summaries – (Legible discharge summaries).  Improved quality of management information.  Timely provision of patient information offering:  Improved patient care / clinical governance.  Enhanced clinical decision making.  Supports Pathology ‘demand management’.

19. Summary.  ‘Interim’ EPR prior to ‘Connecting for Health’.  The EPR consists of:  EPR Repository (Data Warehouse).  Departmental Workflows.  E-Discharge summaries.  Electronic Requesting of Pathology.  Future work to increase scope of Repository.  Roll out to continue beyond MAU.  Challenges ahead, but benefits to be realised.

20. Question and Discussion Period. Southern Institute for Health Informatics. Friday 30 th September 2005. paul.crane-whatmore@ports.nhs.uk anne.spencer@porthosp.nhs.uk