When Thomas Poulter arrived at the Clatterbridge Cancer Centre in 2008, he was given a tour of the medical records office.
This gave him a good idea of just how reliant the organisation was on paper – and of the scale of the challenge that he would face in removing it.
“I was quite surprised to see these massive suitcases – about 100 of them – with records that had to be physically moved around the different sites. I immediately made it my personal challenge and ambition to get rid of those suitcases,” he says.
Heart in the public sector
Poulter says his interest in technology started at a young age. “I was always interested in IT when I was at school,” he says. “When I left school to go to sixth-form college, I started out doing A-level computing.”
However, his eagerness to join the workforce led him to drop out and join a scheme run by Cheshire County Council.
Poulter then spent several years working in a range of different departments including finance, HR and contracts, before eventually ending up as an IT project officer; where he found his metier. “I had a real aptitude for it, I was interested in it, and I really enjoyed working on the projects,” he says.
After taking IT positions at several other councils, where he focused on social care information systems, Poulter decided a move to the private sector was necessary to develop his career.
He spent one year working as a senior consultant at Deloitte, before the position at Clatterbridge came up in 2008. Poulter always planned to return to the public sector, where, he says: “My heart has always been”.
“The nature of the services you deliver here touch on so many people’s lives, because everybody knows somebody affected by cancer. We’re working in an organisation that makes a difference to people’s lives, and that appealed to me.”
Poulter, who has a background in project management, says one of his first tasks at Clatterbridge was to develop a new IM&T strategy for the trust with “a clear vision and work programme”.
The three-year strategy – the first of three Poulter has produced – focussed on developing the trust’s existing IMS Maxims EPR system, completing delayed projects and investing in the Kainos Evolve electronic document and records management system to start the transition away from paper-based records.
Poulter has also helped the trust to introduce systems for order communications, e-prescribing, and imaging; but one of his biggest projects is only just beginning.
Clatterbridge recently announced that it had signed a contract with Centennial MIT for the Meditech Version 6.0 EPR, with a go-live planned for October next year.
Poulter said the trust chose the EPR system because of its flexibility and level of integration, as well as its ability to meet its specialised requirements: the trust is set to be a ‘first of type’ NHS site for an Anglicised version of Meditech’s oncology module.
“It stood out as being the best integrated and comprehensive system, and it met more of our detailed functional requirements as an oncology centre,” he says.
“Other trusts have referral to treatment time targets and a functionality safeguard for that: we do as well, but there is much more of an emphasis on cancer waiting time targets.”
No space for suitcases
The procurement is also linked with the trust’s Transforming Cancer Care project, centred on a £118m specialist cancer centre in the heart of Liverpool, set to open in 2018.
Poulter says the new hospital will not have storage room for physical records, meaning the success of the EPR implementation at its existing Wirral site is a critical part of plans to go paperless by 2018.
“We did a major EPR upgrade two years ago, so I’m not underestimating the complexities of the process.
“We want to make as many advances as we can with the clinical system and the IT infrastructure so everything is ready by the time we open the doors, and staff and our working practices are stabilised and improved so we can make a smooth transition across.”
Poulter says that transition will be made easier by changing attitudes towards IT, with clinicians now less sceptical about the benefits of technology than when he first arrived.
“When I first started, I felt I had support from the board in taking things forward; but I don’t think the clinical staff were on board with it.”
However, the growth of the trust, and consequent arrival of younger clinicians, has made it easier for him to find advocates of the electronic approach.
A recent change to the management structure has also helped, providing Poulter with support in the form of chief clinical information officer Dr Richard Griffiths.
“There’s just been an increasing recognition that ICT is critical really to the future success of the organisation.”
Eyes on Hunt’s target
Neither Poulter nor Griffiths sit on the trust’s board, reporting instead to the deputy chief executive and medical director respectively.
Although he attends board meetings regularly, Poulter believes he could benefit from having a seat to represent the IT perspective as the major transformation project continues.
“It makes sense given the scale and complexity of the work programme we’re delivering, and other, bigger organisations increasingly have the direction of IM&T at board level.
“However, I don’t know whether we will reach that stage at some point in the future.” Regardless of what happens with the board, Poulter is confident that Clatterbridge is on track to meet its “ambitious” goals.
“We’re making good progress towards paper-light, and it’s my personal belief that paperless by 2018 [the challenge set for the NHS by health secretary Jeremy Hunt] is an achievable target that we should be working towards.”
All going well, he will be able to see the back of the briefcases stuffed full of paper records once and for all.
|Job title:||IM&T director, Clatterbridge Cancer Centre NHS Foundation Trust|
|Time in current role:||Six years|
|Key project:||Implementation of Meditech EPR|
|Favourite technology:||Garmin Forerunner GPS running watch: “I love my iPhone, but I’m yet to find an app that I prefer to the wristwatch.”|
|Best thing about job:||“The people I work with: both the clinical staff and the non-clinical staff, it’s a privilege to work with my colleagues and it keeps me really motivated.”|
|Worst thing about job:||“Worrying about technical things going wrong and IT systems not being available. We’ve done a lot of work to create resilience, but systems are very complex and there’s always a risk of technical faults.”|
Read more about the trust’s IT plans in the site visit: ‘Cancer – the big IT’ http://www.ehi.co.uk/insight/analysis/1340/cancer—the-big-it