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Whole Trust Transformation using Electronic Document Management

Mark England Executive Director of Reengineering and Informatics Luton and Dunstable University Hospital NHS Foundation Trust spoke at today’s Electronic Document Management conference on 

• a daunting project: where to start and end with EDM in an Acute Trust
• what we do and what is outsourced in the EDM project
• Our approach to EDM at Luton & Dunstable with Xerox, including managing the remaining paper records going forward
• engaging clinicians in electronic document management solution design
• handling the privacy impact of EDM.
• the ePR effect on EDM: is it just an evolutionary stage?

In his presentation Mark commented; 

"There is very little paper control in the NHS document world...

EPR - Delivering safe & efficient care without the need to request, or wait for, paper records...

Speed is everything – you need to get the right infrastructure and the right design...

Preparation for scanning is the real cost...

Understand your capabilities – scanning is not our core business!  Outsource this...

It is key to have access to audit trails"

Abstract of Mark's talk: 
Title: Whole Trust Transformation using Electronic Document Management (EDM) - a daunting project: where to start and end with EDM in an Acute Trust


An Electronic Document Management (EDM) approach to transforming healthcare is a complex, but valid approach. It does require considerable diligence, and partnership, to be successful. Even then it is only a step towards a unlocking the full potential of an electronic patient record (ePR). 

It is vital to understand any current Paper Record in use, and the supporting infrastructure, including any costs. There will be some elements of an electronic patient record in place and these need clearly understanding, and any gaps being filled by paper currently identified and scoped.  

The design of any metadata tagging and taxonomy, the integration of “day forward” paper once scanning has begun, and also any approach to OCR need clear clinical guidance and ownership. They will be severely strained once live. Commercially this is a complex undertaking and any organisation needs to be honest about what is can deliver itself, particularly around the industrial scanning required. 

Privacy needs to be considered from the first design. Audit trails, and a well communicated plan to use them in a systematic manner is critical. The ease of access for clinical purposes creates potential risks that need addressing. 

Finally a scanned document is not an ePR. A scanned observation chart is not an intelligent NEWS score alert for a deteriorating patient. A scanned drug chart does not support safe prescribing with decision support. There are limits to an EDM but it is an inevitable step within healthcare as so much of the relevant legacy is locked in large paper archives, whose costs are spiralling out of control. 

Mark's presentation is available for download at the end of this page.

Mark joined the Trust in 2008 from the London Borough of Croydon where he had been a Chief Information Officer for Children's Services for four years. There he delivered high-quality, commercially competitive technology services to almost 150 schools, whilst leading multiple high profile eGovernment projects. Many of these were Pan-London, including leading the technical delivery of the award winning shared eAdmission portal used by 100,000's of parents each year. By enabling electronic channels of payment Croydon was also the first authority to take cash transactions out of all schools, releasing considerable financial and quality benefits. His first exposure to the NHS was working to develop an early Children's Index with local NHS providers in South London.

Prior to that he spent five years working as a Project Manager on the development, and global implementation, of a web-based multilingual Enterprise Resource Planning (ERP) system. This was focussed on supporting the delivery of Reproductive Health services in the developing world, and was implemented in 140 countries in 4 languages. Qualified as a software engineer, specialising in multi-lingual application design, he worked across multiple sectors on commercial internet based applications for many years


Future related conferences:

Electronic Prescribing In Hospitals: Moving Forward
Wednesday 22 April 2015 
ICO Conference Centre, London

Developing Patient Accessible Electronic Patient Records
Wednesday 29 April 2015 
ICO Conference Centre, London

Cyber Security in Healthcare: Assuring and securing information in the NHS
Tuesday 12 May 2015 
Hallam Conference Centre, London

Electronic Document Management in Healthcare: Delivering a Paperless NHS
Wednesday 1 July 2015 
Manchester Conference Centre, Manchester


Download: Mark England presentation

2 February 2015

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