The NHS’ Frontline Digitisation programme is making great strides in advancing the rollout of electronic patient records (EPRs) across secondary care. While this initiative is integral to the much-needed transformation and digitisation of services, it's equally crucial for healthcare systems to strategically plan for the sustainability and optimisation of their EPR following go-live. Optimisation should be considered at the business case stage in Trust plans to ensure adequate funding is allocated to the stabilisation and optimisation phases of the programme.
Effective optimisation will not only ensure the sustainability of the solution within the Trust, but can also play a pivotal role in delivering benefits to patients across a region. This is particularly critical as clinical solutions continue to scale up and converge across integrated care systems (ICSs).
Here are tips compiled by our consulting team for sustaining and optimising your EPR to drive successful adoption and maximise its benefits across your Trust and ICS.
- Build on organisational leadership — EPR implementations require active engagement from clinical, operational, and digital leaders representing all departments, services, and specialties. This involvement is equally as important after go-live. Leaders play a pivotal role in enabling optimisation, addressing concerns and communicating progress to their respective services. Strong operational governance provides a framework for the organisation to learn about how staff is using the system and what challenges they may be facing. Leadership alignment and good governance will help ensure the EPR continues to evolve and is adopted long-term.
- Sustain clinical buy-in — The input and support of clinical informatics, CCIOs, CNIOs, digital NMAHP, pharmacy and clinical champions, etc., that were fundamental in the implementation stage should continue to thrive beyond go-live. Clinical leaders play a critical role in ensuring a two-way communication loop between the clinical workforce and digital teams so the EPR’s functionality is scaled to meet evolving needs, and improvements to workflows are developed to support clinical processes and working practices.
- Nurture speciality champions — Project champions play a vital role during the programme’s implementation stages and are key to ensuring best practices are shared between individuals in their speciality. After go-live, this is particularly important as staff rotate within a department or new team members join the organisation. Ensure these individuals receive additional necessary training and equip your champions with the resources and authority to actively provide feedback and implement any improvements.
- Empower your workforce with role-specific training and education — Well-managed, comprehensive, and role-specific education programmes are essential for successful EPR optimisation. Enabling continuous learning through annual education programmes will help staff stay up to date on enhancements and new features released from suppliers. It can also help eradicate troublesome workarounds. Users should also be encouraged and empowered to explore online training resources and share knowledge with colleagues to ensure the Trust gets the best benefits from the solution.
- Identify bottlenecks and inefficiencies in workflows — This feedback should be gathered from clinicians and operational staff and shared with the EPR team through existing governance frameworks. System optimisation should focus on enhancing efficiency, safety, and user experience and should be championed by multidisciplinary clinical and administrative teams. Fostering cross-departmental collaboration regarding best practices and tips can help establish shared processes and protocols.
- Understand your data — Data ownership within the EPR is everyone’s responsibility, from administrative services, clinical noting, coding, reporting, and data quality. Organisations should ensure everyone inputting data understands their responsibility for data quality and its importance; Trusts often spend disproportionate time validating data for use rather than it being used to drive and inform optimisation decisions and plans.
- Integrate third-party systems — Ensure there is an understanding of how the EPR interoperates with other clinical solutions and applications used by frontline staff and consider the technology that is used more widely within your ICS. Thinking about longer-term integrations will help your organisation scale up systemwide. Plan to develop an integration roadmap that prioritises the sharing of data and removing of barriers across ICS partners.
The bottom line - adapt and evolve; don’t wait.
It is never too early to build your optimisation plans; consider starting during implementation. Optimisation can initially be driven from deferred go-live configuration and functionality. Regularly review and refine clinical workflows based on feedback from colleagues, patients, and changes with other technologies. Pay attention to statutory requirements and data sharing, and experiment and adopt new strategies that improve efficiency and patient outcomes.
Regardless of the software supplier, an efficient EPR cannot single-handedly improve operations and patient experience in isolation; it requires a holistic approach that combines business transformation, change management, and technology. A well-optimised EPR empowers healthcare staff to deliver better care with increased efficiency.
Optimising your EPR demands a comprehensive strategy that prioritises organisational engagement, effective training, robust change control, resource management, thorough testing, and a people-centric approach to technology adoption. By addressing these key areas, NHS Trusts can maximise the benefits of EPR implementation while improving overall patient care and safety, operational efficiency, and sustainability. Continued investment in multidisciplinary resources to continuously improve your EPR solution will help you realise the promised benefits outlined in your original business case and can maximise future benefits.