Cost vs benefit: Insights from a digital health leader

One of the biggest misconceptions about EPRs is that they must be expensive to implement and function. Aside from deployment being disruptive it may take years for real benefits to emerge—which can make justifying the investment even harder.

In our work with clients around the UK, Altera experts know that EPRs don’t need to be as expensive as some perceive. They can be affordable, usable and deliver speed to value and value for money across the health ecosystem—for patients, clinicians and to the wider health economy, whilst being flexible and adaptable to enable incremental functionality to be added as both requirements and resources evolve. Most importantly, trusts don’t need to wait several years to see tangible benefits even if they implement functionally incrementally.

Firstly, let’s address the cost. Yes, EPRs can be expensive, but they don’t have to be, and options are available that deliver incredible value for money for a lower investment. Trusts don’t need to rip-and-replace everything. Concentrating resources on implementing the strategic components that will deliver the greatest value can deliver key functionality and efficiencies faster, instead of going for a one-size-fits-all solution. This is not only more cost-effective, but it also takes a significant pressure off the organisation in terms of deployment effort and change. Additionally, with advancements in technology, cloud-based systems reduce the need for more capital investment inexpensive hardware and infrastructure.

Shortly after Mark Hutchinson arrived at Gloucestershire Hospital NHS Foundation Trust (GHFT) in October 2018, the trust received one of the lowest HIMSS EMRAM digital maturity scores on record. When Mark joined GHFT he knew the trust had a long way to go on its digital journey. He set his sights on quickly addressing the situation, with an ambition to make the most amount of benefit to patients, in the shortest time possible.

“Starting from nowhere to getting there in four or five years would be a phenomenal achievement, to do it in three would be even better.”

How?

1. The introduction of a modular and configurable EPR that could be deployed in phases was transformational for the trust.

2. The single biggest enabler for them to make big strides in their digital maturity, and to be able to do so quickly, was to implement an electronic patient record without changing their patient administration system.

3. Why? Most EPR programmes seem to start with spending the first two years replacing a PAS. It costs millions of pounds and takes years. Gloucester left their PAS in place and wrapped clinical functionality around it.

Adoption was crucial.

• The challenge then was about adoption across the whole organisation. The key was clinical engagement.
• Gloucester is an organisation that hasn’t used, or had access to, many digital tools in the past, and a workforce who historically haven’t been used to working in a digital way.
• When Gloucester first went live with nursing documentation and risk assessments, 58 nurses from across the organisation got involved in the design of that documentation. It’s quite easy to build a system quickly, throw it out there and it all go wrong. The key for Gloucester was to build it quickly, put it out there and for it to be used as well as it has, which was all down to clinicians being keen and enthusiastic about working differently.

Mark’s takeaways: eat the elephant one chunk at time.

Mark’s experience has taught him to set goals in “manageable steps” among these other lessons:

1. Implementing an EPR or clinical change doesn’t have to take years of procurement and an eye watering budget.
2. I always say you don’t have to eat the elephant in one go—take a “one-bite-at-a time” approach.
3. Gloucester’s clinicians had already had a negative experience of digital change programmes. They had to rebuild trust.
4. The trust’s leaders focused on quality, safety and where they could reduce paper and have the most impact.
5. It was acknowledged that Altera’s Sunrise? had been tried and tested by other hospitals and Gloucester were able to show their nursing teams that this approach had worked before.

To learn more, download our eBook, EPRs Uncovered: Debunking the Myths Around EPRs.