Guy’s and St Thomas’ progresses e-noting

  • 1 August 2014
Guy’s and St Thomas’ progresses e-noting

Guy’s and St Thomas’ NHS Foundation Trust says it is planning to start a full roll-out of its e-noting project by the end of the year.

The trust received £4m in the first round of NHS England’s technology fund for the project.

It is digitising 130 hospital forms to be accessed through an in-house portal, developed using Microsoft SharePoint software.

The portal also brings together read-only feeds from various other systems including the A&E and community systems with just one log-in.

Different health professionals will have different views of the portal, including a summary view of a patient’s most important information.

Work started in 2012 on the e-noting solution, which includes electronic recording of nursing observations, calculation of patient risk scores and pain assessments.

Cormac Breen, the trust’s chief clinical information officer, told EHI the e-noting project is intended to support the trust’s moves towards becoming paper-light and a “properly digital organisation”.

 “We want [e-noting] to replace the bulk of the clinical content that you would record as part of clinical care, from the first visit to outpatients through to discharge.”

Breen said the focus is on rolling out the core aspects of e-noting across the organisation, such as writing notes, recording a diagnosis or operation, and allowing the information to be displayed through clinical dashboards.

He said the trust is also working on developing and deploying an application to allow the forms to be accessed through a mobile device such as a tablet, as well as through a PC.

Breen said the pilot phase is “in flight”, with e-noting live in three clinical areas – colorectal assessment, endoscopy and the HIV unit.

He said the e-noting application has already proven beneficial for the units, with each increasing in the volume and complexity of the clinical information being captured.

“Each of the clinical areas is reliant on the app day to day, and they’re close to being able to see the back of paper.”

He said the trust’s current focus is on “optimising” the system and addressing technical and clinical issues.

Breen said the electronic forms and portal will eventually be integrated with the trust’s electronic prescribing and medicines administration system, which also received money from the first round of the tech fund and is still being rolled out.

The portal is still reliant on the trust’s iSoft electronic patient record system, but Breen said he is hopeful that it will become independent from the EPR soon.

“We’re not yet integrated [with e-prescribing], nor have we quite got to the point where we have deployed the e-noting application in a way where it is independent of iSoft, but we expect to be doing that over the next few months.”

The portal will help the trust to support its best-of-breed systems by providing a single view of them through the portal, while also driving a range of reports and dashboards using real-time information, he said.

“Once we do that and e-noting starts to function as an independent portal, it will be easier to see things using the portal to show a number of clinical systems in the same place, rather than integrating in a tight two-way integration way.”

Breen said the trust is still working towards a date to roll out e-noting across the whole trust, with plans to start the process by the end of this year.

 “We’re trying to make sure we’re going at an appropriate pace for such a complex set of technical and clinical work,” he said.

 

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