EPR Implementation –
LTHTR
Heather Binkle
EPR Project Manager
11 December 2003
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Lancashire Teaching Hospitals NHS Trust
Lancashire Teaching Hospitals NHS Trust
Trust Activity in 2003 – 2003
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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
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5,400 staff
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Lancashire Teaching Hospitals NHS Trust
Current IM&T Position
Theatreman
A&E
system
Paper
Casenotes
PAS
Radiology
X-ray
films
Intranet
In-house
clinical
developments
Email
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Other
systems
Lancashire Teaching Hospitals NHS Trust
Future IM&T within clinical areas
Internet/
Intranet
Specialist
Clinical
systems
Pathology
EPR
email
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Lancashire Teaching Hospitals NHS Trust
The Solution
Misys CPR
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Lancashire Teaching Hospitals NHS Trust
EPR – 3 year implementation
Nov 2002
April 2004
March 2005
March 2006
Phase 1
Phase 2
Phase 3
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Lancashire Teaching Hospitals NHS Trust
Phase 1
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1st Phase – Nov 5th 2002 to April 2004
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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
Preparatory work
Nov 2002
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Casenotes
April 2004
End phase 1
Sept 2004
Lancashire Teaching Hospitals NHS Trust
Phase 2
Nov 2002
April 2004
March 2005
March 2006
Casenotes
Phase 2
Phase 2 – Electronic requesting of tests and services
throughout Trust, documentation of Nursing Care,
Clinician screens, GP access
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Lancashire Teaching Hospitals NHS Trust
Phase 3
Nov 2002
April 2004
March 2005
March 2006
Phase 3
Phase 3 – Electronic Drug Prescribing, Clinical
Pathways
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Lancashire Teaching Hospitals NHS Trust
Issue – Infrastructure readiness
12 month implementation
project:
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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
Lancashire Teaching Hospitals NHS Trust
Lessons Learned
Experience is a hard teacher because she gives
the test first, the lesson afterwards.
Vernon Sanders Law
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Lancashire Teaching Hospitals NHS Trust
Organisation of Project
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Smaller project teams with appropriate
leadership and corresponding analyst
Discovering appropriate forums for advisory to
project by different user groups
Target groups differently
Lancashire Teaching Hospitals NHS Trust
Don’t underestimate the work
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Appropriate resources are required
Understanding the role of the on-site analyst
A huge amount of configuration is required to
make the system “ours”
Data collection –
the key to success
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Lancashire Teaching Hospitals NHS Trust
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
Lancashire Teaching Hospitals NHS Trust
Technology versus Change
Management
Putting a PC on every desk and at every nursing
station does not make an EPR
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Lancashire Teaching Hospitals NHS Trust
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
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Lancashire Teaching Hospitals NHS Trust
Communication
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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
Lancashire Teaching Hospitals NHS Trust
Scope of the project
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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
Lancashire Teaching Hospitals NHS Trust
If computers get too powerful, we can organize
them into a committee -- that will do them in.
Bradley's Bromide
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