Content by Mike Fuller, Regional Director of Marketing, InterSystems
Spurred on by the need to adapt to the pandemic, healthcare organisations have made great progress in recognising the need to be bold and innovative to overcome a variety of business, operational, and technological hurdles. Now, however, as resources post-pandemic are dwindling, so has the pace of innovation. During those hard years the sector learnt important lessons and one of them was that the right systems enable care organisations to be agile and resilient, especially the electronic patient record (EPR).
Embracing innovation – a renewed drive for change
Integrated care systems (ICSs) continue to play a pivotal role in revolutionising the English healthcare landscape by joining-up places of care to deliver coordinated, cohesive experiences, and patient outcomes. However, many ICSs are still hobbled by siloed operational systems that are too costly and difficult to extend, with disjointed process and practices that hinder agility, impede workflows, and impair user experiences and patient care. This is not just within the individual departments, but also across GP systems, hospital, laboratory systems, and even the first generation of shared care records.
We should not be surprised as healthcare systems without constant investment become outdated. The good news is that the focus on digital transformation continues with the next wave of EPR implementations supported by NHS investment and expert guidance. In February 2023 the NHS reported that 86 percent of NHS Trusts have an EPR in place and this was expected to rise to 91 percent by December 2023.
Often departmental systems function as a transactional system of record, developed for the specific job that they do well. Whereas shared care records provide access to information from different systems. However, it is the EPR in which the patient information really comes together for curation and quality. The EPR provides a longitudinal view all around and about the patient for insight – and action. If innovation and agility are needed everywhere, the foundation of resilience is the EPR. This is because it is the EPR that creates one shared reality by unifying disparate data from different systems into a holistic view from which to act on a patient’s needs and plans.
Preparing, then nurturing change
That said, choosing, purchasing, implementing, and maintaining an EPR is not easy. The health organisation needs the mindset, culture, and vision of success to ensure the profound digital health transformation that the EPR can leverage, will not fall short of its promise. To optimise patient care and operational efficiency the EPR must be equipped with the right infrastructure. This infrastructure must include interoperability through integration with the specialist systems of record and the shared record systems, with secure and robust deployment, which today leads most to deploy the EPR off-premises, hosted, or in the cloud. Therefore, it’s not surprising that its widespread practice for buyers to contract independent consultants as coaches in this complex adoption phase, as the full value an EPR can provide may not always be recognised right from the outset.
Over the past four decades I have personally seen too many NHS trusts that believe they can only use an EPR tailored to fit their current operation, when in fact the most successful balance personalisation with standardisation and evolution. This is evidenced by the ‘Making the most of your electronic patient record system’ guide that published its sixth edition earlier this year. While acknowledging it can take 5-10 years to realise the benefits of an EPR, they will be substantial, helping improve areas such as:
- Increased patient safety and satisfaction through synchronous data entry at the point of care
- Elevated staff satisfaction with an easy-to-use system to capture and use data
- Enhanced productivity from reduced time spent entering, searching for, and discovering data
- Better population health management, by drawing on the data to recognise trends that inform service transformation to meet the needs of patient cohorts and wider preventative public health programmes
Given the long-term value of an EPR and the inevitable changing needs of an ICS, so continuous adaptive change is needed, rather than time-constrained technical change. Though, planned periods of stability allow for use to refine and standardise practice. This all means the EPR must be able to flex, supported by comprehensive change management, with firm support from the EPR vendor as a responsive and long-term partner.
The foundation for a patient-centric, digitally mature healthcare future
In conclusion, the challenges faced by the healthcare sector require a cultural and technological paradigm shift towards innovation supported by agility and resilience. An EPR is one of the most important investments an ICS can make to simplify information sharing and management inside and outside of the ICS, and scale clinical safety and efficacy, process, and resource efficiency.
Embracing adaptive change and being open to guidance from experienced partners, healthcare providers can use a unified EPR as the foundation of holistic patient-centric care and evolving digital maturity that continuously optimises the experiences and outcomes for patients and care professionals alike.