Historically, patients in Milton Keynes were being treated by a range of healthcare professionals in a variety of locations without a co-ordinated clinical information system.
The NHS Arden & GEM CSU Clinical Systems team developed, implemented and managed an 18 month programme which has migrated 27 GP practices onto a single shared electronic patient record system. The integrated system offers many benefits to patients and delivers practice cost savings of over £400k per annum.
The challenge
Patients in Milton Keynes were being treated by a range of NHS healthcare professionals in a variety of locations without a co-ordinated clinical information system.
In addition to duplicating patient records, and consequently time and cost, this situation had potential implications for patient safety as clinicians may not have had a full picture of the interventions, treatments and medications being delivered to an individual.
While local GP practices were committed to using a single shared electronic patient record – SystmOne – there were significant barriers to overcome in implementing a new system including standardising processes, training users, replacing or upgrading IT equipment and enabling secure access for users.
Our approach
In order to overcome the barriers in implementing a single clinical system, NHS Arden & GEM used a robust project management methodology underpinned by a team with expert IT knowledge and a thorough understanding of the complex environment which clinicians work in.
With each project manager in the Clinical Systems team actively managing five deployments at any one time, it was essential that robust project schedules were created, and progress continually monitored against them, to ensure that tasks were completed in a timely manner and key milestones were properly prepared for and not missed.
Working closely with NHS Milton Keynes Clinical Commissioning Group (CCG), the team established a clinical group to determine pathways for specific illnesses and conditions. By agreeing a standard pathway, clinical templates could then be set up in the system to support business process standardisation across the patch.
The CSU was also responsible for ensuring that the practice hardware was able to support use of the new clinical system, including the installation and upgrade of patient arrival touchscreens and patient call systems. Finally, training programmes were delivered to staff at all 27 practices which took in over 600 people in total.
In total, over 260,000 records were migrated onto the single shared electronic patient record system.
The outcomes
By creating a truly integrated patient record, primary care professionals have already seen the following benefits:
- Better communication between clinicians
- Reduction in repetition of treatment
- Reduction in practice costs and overheads
- Increased clinical safety.
For patients, there is confidence that all health professionals they are seeing have access to their full medical records and history. They no longer have to explain repeatedly their symptoms and issues.
"I really like the way I can see what has been ordered or when I am allowed to order my medications. I also like the fact I can see a view of my record, it only has a few items but useful for me to know what my GP has down in my record for my past medications."
Steph, Local Patient.
The system has already been extended to settings outside of the GP practice. Primary care outpatient clinics (PCOC) for areas such as dermatlogy and gynaecology are able to access a patient’s GP records, add their own notes to the same record and even leave messages or tasks for the patient’s GP.
Similarly, the same system is being rolled out to the local hospice so that patients receiving palliative care, which can often involve an intense regime of medication, can be reassured that there is robust communication between clinicians.
SystmOne also includes functionality for scanning, SMS messaging, appointment management and patient online access, allowing existing contracts to be cancelled, which has contributed to practice cost savings in excess of £400k per annum.
Next steps
Following the successful implementation of SystmOne, the team are now managing a pilot with Milton Keynes Council which will bring together health and social care systems. Using the same software, multidisciplinary teams will be able to access a patient record where appropriate. This will offer service users pratical benefits, such as a worker being alerted to the fact that medication if due for collection for one of their patients.
Continuing the integration of primary, social and community care the project’s next phase will see a rollout to Central and North West London NHS Foundation Trust (CNWL) who provide community health and mental health services within the region.
Then, by accessing resources from the Prime Minister’s Challenge Fund, the same system will also be implemented in the local urgent care centre.
The appetite from local commissioners, providers and GPs for continued expansion of the system, all managed by the Arden & GEM team, is testament to the substantial benefits delivered to both clinicians and patients alike.
"I am an avid user of SystmOne. The benefits for GPs are numerous incuding being able to quickly and easily see all the patient information needed, being able to send direct text messages to patients, and being able to permit sharing of records with other health professionals such as physiotherapists or cardiologists. This aids clinical safety and efficiency as well as providing practices with a cost effective solution."
Dr Luke James, NHS Milton Keynes CCG
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