Over the previous ten years, we now have targeted efforts on enabling our workers, throughout Cambridge College Hospitals, to make use of superior digital expertise to enhance affected person security and help the supply of constantly and ever-increasing high-quality affected person care.
Relying beforehand on paper affected person data and a number of aged IT methods with restricted integration and capabilities, our eHospital digital maturity programme, established in 2010, was born out of our need for data-driven scientific care and security enhancements by using digital expertise. In 2013, following enterprise case approval and exterior assurance, we embarked upon an NHS first-of-its-kind digital transformation; comprising a ‘constructed by our hospital workers for hospital workers’ totally built-in digital affected person document (EPR) system mixed with a trust-wide refresh of our whole computing property and IT service help.
Investing in our folks has been important from the outset. Over 100 hospital workers with various expertise and experience – clinicians, scientific help workers, directors, operational, managerial and analytical workers – joined the eHospital programme staff in 2013 and configured the Epic Basis System for the UK. The latest (2019) Epic implementations undertaken by Nice Ormond Avenue Hospital and College Faculty London Hospitals have been based mostly on this UK Basis platform, as will the Royal Devon & Exeter implementation due this summer time (2020).
A digital revolution
Since implementing our EPR in October 2014 throughout our two hospitals, Addenbrooke’s and The Rosie, the supply of affected person care has been utterly reworked. Clinicians have entry to complete digital well being data for his or her sufferers, in a single place on the contact of a button, enabling them to view and doc all scientific info, in real-time, at any time when and wherever required. This has decreased our use of paper affected person data throughout our hospitals by 99%.
On the time of implementation, we launched over 800 built-in handheld and cellular gadgets to allow clinicians to doc care in real-time and on the bedside. We additionally linked all physiological screens and ventilators in 40 theatres and 148 excessive dependency/vital care beds with our EPR to automate the move of knowledge from medical gadgets instantly into affected person data.
By whichever route a affected person arrives at one among our hospitals – as an outpatient, by our emergency division, or admitted as an inpatient – the staff caring for them can see their well being document in its entirety within the system. All of them have entry to the identical details about the affected person, which is significant to well timed and constant care in addition to security.
Supporting others throughout the NHS
Elevated digital maturity helps enhancements to affected person security, care and expertise, and helps to scale back pointless duplication of checks and delays to care and remedy. Inside a 12 months of EPR implementation we moved from a HIMSS EMRAM Stage 1 ranking to Stage 6. Digital maturity is just not although solely concerning the expertise carried out. For us this achievement mirrored our digital and scientific collaboration to result in profound advantages to affected person care by the adoption of supportive digital expertise.
Since attaining EMRAM Stage 6 in October 2015, we now have been specializing in offering steady care enhancements by our digital maturity efforts.
For instance, in 2015/16, when reviewing our knowledge on systemic sepsis, it was clear that there have been alternatives for actual enchancment. Work began with our acute drugs physicians, together with our infectious illness staff and our in-house eHospital digital staff, about how we may assemble a workflow that might be actually supportive of our clinicians, utilising expertise to rapidly determine sufferers with sepsis and so making certain that their remedy and outcomes had been higher.
We all know for each hour that antibiotics are delayed in sufferers with sepsis there’s a 7-8% enhance within the danger of mortality. We tailored our scientific workflow and reconfigured our EPR to include modern sepsis alerts and motion options after which skilled workers in how one can use it. Since introducing this in-house configured performance, there was a 70% enhance in sufferers receiving antibiotics for sepsis inside one hour of arrival in our emergency division and a 50% enhance in inpatients receiving antibiotics inside one hour of the alert triggering within the system. This has resulted in at the very least 64 lives saved prior to now 12 months and a 42% discount in sepsis mortality throughout our two hospitals.
By way of additional scientific and digital engagement and collaboration we explored, devised and carried out closed-loop treatment administration workflows throughout all of our 51 wards, 5 vital care areas and the emergency division; enabling workers to ‘scan for security’ to assist guarantee the suitable treatment and dose are given to the suitable affected person and in the suitable means, every time. Now we have since launched closed-loop human milk administration throughout maternity, paediatric and neonatal areas.
These efforts, amongst others, have led to nationwide and worldwide recognition – together with validating in opposition to the more durable HIMSS EMRAM Stage 6 requirements in October 2018 – for the collaborative work throughout our hospitals in embracing and adopting new applied sciences and capabilities to constantly put sufferers on the very coronary heart of our digital hospitals.
To assist help different digital maturity work carried out throughout the NHS, we not too long ago printed our eHospital digital journey. These matters will probably be explored in additional element on the HIMSS Digital Maturity (DM) occasion happening in Cambridge on 28 January.
Dr Afzal Chaudhry, director of digital and CCIO at Cambridge College Hospitals NHS Basis Belief, will probably be talking on the HIMSS DM occasion later this month. Healthcare IT Information is a HIMSS Media publication.
