1. 1 Lancashire Teaching Hospitals NHS Trust EPR Implementation – LTHTR Heather Binkle EPR Project Manager 11 December 2003

2. Lancashire Teaching Hospitals NHS Trust 2 Trust Activity in 2003 – 2003 575,514 patient contacts 90,363 inpatients in 1,174 beds 89,684 new outpatients 229,112 follow-up outpatients 105,923 A&E patients 3,568 births 5,400 staff

3. Lancashire Teaching Hospitals NHS Trust 3 Current IM&T Position X-ray films Email Radiology PAS A&E system Theatreman Other systems In-house clinical developments Paper Casenotes Intranet

4. Lancashire Teaching Hospitals NHS Trust 4 email Specialist Clinical systems Internet/ Intranet EPR Pathology Future IM&T within clinical areas

5. Lancashire Teaching Hospitals NHS Trust 5 The Solution Misys CPR

6. Lancashire Teaching Hospitals NHS Trust 6 EPR – 3 year implementation Nov 2002April 2004March 2005March 2006 Phase 1 Phase 2 Phase 3

7. Lancashire Teaching Hospitals NHS Trust 7 1 st Phase – Nov 5th 2002 to April 2004 – Replaces 2 PAS systems – Replaces 2 Radiology systems – Replaces 2 A&E systems – Replaces Theatre system – New interfaces to pathology for better result reporting – Introduce access to archived scanned casenotes Nov 2002 April 2004 End phase 1 Sept 2004 Phase 1 Casenotes Preparatory work

8. Lancashire Teaching Hospitals NHS Trust 8 Phase 2 Nov 2002April 2004March 2005March 2006 Phase 2 Phase 2 – Electronic requesting of tests and services throughout Trust, documentation of Nursing Care, Clinician screens, GP access Casenotes

9. Lancashire Teaching Hospitals NHS Trust 9 Phase 3 Nov 2002April 2004March 2005March 2006 Phase 3 Phase 3 – Electronic Drug Prescribing, Clinical Pathways

10. Lancashire Teaching Hospitals NHS Trust 10 Issue – Infrastructure readiness Organisation wide network upgrade Wireless network on wards 400 mobile, wireless computers for use on wards Additional PCs Barcode readers, printers, security Resilient, centralised data storage Windows 2000 and MS Office 2000 12 month implementation project:

11. Lancashire Teaching Hospitals NHS Trust 11 Lessons Learned Experience is a hard teacher because she gives the test first, the lesson afterwards. Vernon Sanders Law

12. Lancashire Teaching Hospitals NHS Trust 12 Organisation of Project Smaller project teams with appropriate leadership and corresponding analyst Discovering appropriate forums for advisory to project by different user groups Target groups differently

13. Lancashire Teaching Hospitals NHS Trust 13 Don’t underestimate the work Appropriate resources are required Understanding the role of the on-site analyst A huge amount of configuration is required to make the system “ours”

14. Lancashire Teaching Hospitals NHS Trust 14 Data collection – the key to success Getting the right people involved Begin standardising the processes well in advance Helping people to an early understanding of standardisation Understand how the data will be used

15. Lancashire Teaching Hospitals NHS Trust 15 Technology versus Change Management Putting a PC on every desk and at every nursing station does not make an EPR

16. Lancashire Teaching Hospitals NHS Trust 16 Talking the talk versus understanding what it means That is what learning is. You suddenly understand something you've understood all your life, but in a new way. Doris Lessing

17. Lancashire Teaching Hospitals NHS Trust 17 Communication American system – differences in language and health care system Complex organisation Large number of staff with different interests Team approach to getting the message out

18. Lancashire Teaching Hospitals NHS Trust 18 Scope of the project Stick to the scope in each of the phases Help the end-users understand that it is a phased process Beginning to plan for Phase 2 now

19. Lancashire Teaching Hospitals NHS Trust 19 If computers get too powerful, we can organize them into a committee -- that will do them in. Bradley's Bromide