St Helens and Knowsley Teaching Hospitals NHS Trust has begun roll-out of a electronic patient record based on a scan-on-demand document management system.

The new system allows relevant patient records to be scanned a few days before a patient attends an appointment. The aim is to make latest patient information available to authorised clinicians and medical secretaries when they need it.

The introduction of electronic health records will remove the need for 1,200 paper patient records to be physically delivered each day across the trust’s three main sites. This will increase the availability of records and enable them to be accessed by more than one person at a time.

The trust initially considered scanning its whole health records library, of 1million records, to make every patient record available electronically but realised it would take ten full-time staff thirty years to complete the process.

The system cost more than £1.2m in IT and staff but is expected to pay for itself within three years. Over a five year period the trust expects the systems will enable it to achieve savings of over £3.2m.

The trust is using Kodak scanners and C-Cube software developed by the trust and OITUK to import the 150 million pages of patient case notes needed in the outpatients department.

Neil Darvill, director of informatics at the trust, told E-Health Insider: “The basic thrust of the project was to increase widespread record availability of patient records from 98% to 100%.”

He added: “Even at only two percent down we felt that the project would give significant benefits to patients and staff alike and a paper based system would be difficult to sustain in the long term as growth continues.”

The trust is scanning the records on a priority basis with outpatients records given priority due to the high volume of attendees.

Darvill said: “By using a scan-on-demand concept we only scan the necessary documents at the front-end, live part of the library and not the notes at the back that may not be needed again in a clinical environment.”

The new scan-on-demand system aims to allow patients who have made more than one appointment on the same day to have their records viewed across several departments without the delay of transferring it manually.

Roll-out of the electronic document management system began in September 2008, with the system now live in respiratory, dermatology, cardiology, rheumatology, ophthalmology and gynaecology departments. Orthopaedics is expected to go live in June.

Since September 50,000 of the 250,000 case notes have been scanned with 40 full-time clerical staff scanning 2,000 case notes per week, each of which consists around six hundred pages.

Darvill added: “One in three patients are now supported by an electronic patient record. We intend to have it fully rolled out across the trust by March 2010 and at the moment there is a very high chance of achieving that deadline.”

The director of informatics told EHI that because the trust is part of St Helen’s and Knowsley shared informatics service, the scanned records can be viewed across the whole local health economy by staff with appropriate access.

He said: “My strategy is that we connect everything together. We already have sites connected so the 50,000 case notes that are scanned in are available to GPs at the 92 practices in the area.”

Despite the widespread use of the system in several different locations, including access from home, there is no facility for patients to opt in or opt out of record sharing.

Darvill said: “The patients do not get given a choice, what we’re trying to do is manage their records effectively so from a patients point of view we either deliver the paper or deliver the paper electronically.”

He added: “We are hoping that the national programme will deliver something that we can eventually use and that this is complimentary to it but we are not prepared to sit around and wait.”

Vijay Magon, managing director of IOTUK, said: “The software is now ready to be rolled-out elsewhere, it is ready to and is constantly evolving and functionality is being added.”

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St Helens and Knowsley Teaching Hospitals NHS Trust