Patient notes are finally entering the 21st century as Basildon and Orsett Hospitals lead the way with a groundbreaking electronic medical records (EMR) system.

Basildon and Thurrock University Hospitals NHS Foundation Trust have just celebrated one year anniversary of the launch of its EMR system, which was designed and led by the clinicians who use it.

Last week the NHS Commissioning Board's informatics chief, Tim Kelsey, told delegates at a conference on Healthcare Efficiency through Technology that the first ever government mandate issued to the board would "contain a commitment for a paperless NHS".

Basildon and Thurrock's EMR system allows doctors, nurses and medical secretaries round the clock electronic access to their patients' case notes. Doctors can immediately view the records, test results, appointment times of the patient they are treating. The system improves safety for patients by ensuring medical records are always available to all the health professionals involved in their care and treatment.

A team of 35 have been scanning patient's medical records into the EMR system. To date, 200,000 sets of patient's case notes are available electronically for medical staff to use and all remaining paper based medical records will be scanned by early 2014.

Clinicians at the Trust helped create the program, led by a Clinical Advisory Group of 12 of the Trust's most senior doctors and surgeons, and chaired by Mr Ian Linehan, a consultant colorectal surgeon.

The clinician-led system is the first project of its kind in Europe and its success has led to two academic papers being prepared to present the results to the worldwide health community.

Paul Williams, EMR Deployment Lead, said: "We really are pioneers with this system and it is creating a lot of interest from other Trusts. Although similar projects have been launched at other hospitals, the success here has rested on the way the Trust implemented it.

"It is not an IT project; it has been designed and driven by the clinicians who use it. Putting a system like this in place is a major challenge and we needed universal acceptance of the project from medical staff

Ian Linehan, Clinical Lead for the project, said: "Clinicians are entirely dependent on notes, but paper notes can only ever be in one place at one time. Patients may attend a number of clinics and each time the notes are out of circulation for five or six days. EMR fixes that problem".

"This project makes it easier to access information and means more than one person can access it at the same time. This is a huge change to the way we are all used to working, but we can all see the benefits."

The system provides stricter security than the old paper-based system. It is just for hospital staff, and patient confidentiality rules mean that not everyone can see everything. Safeguards are built into the system to avoid any abuse.

It is also straightforward to use, with colours and icons allowing doctors a quick overview of a patient's medical history and prompt access to relevant information.

EMR first went live in Paediatrics in October 2011. Paul adds: "This department was chosen because it is a mini-hospital within its own right, with its own A&E, outpatient clinics, multi-disciplinary teams etc. Within the second week, patients registered on EMR were being seen in other specialities within the hospital."

It quickly gathered pace, with Ear, Nose and Throat, Dermatology, Rheumatology, Surgery and Fracture Clinic, all seeing EMR patients within weeks of the launch. To date the paediatrics, maternity, gynaecology, dermatology and some other outpatient clinics are on the EMR system. Within the last six months, 19,000 patients have been treated using EMR rather than paper records, in 25 different specialities.

Phil Burke, EMR Programme Manager, said: "Thousands of patients have now been seen using electronic records throughout the hospital and the majority of our consultants have been trained on the system. There is no specialty or department that has not seen an EMR patient. Some of our paediatrics patients were particularly interested in the novel way that clinicians can now access their health information."

Mark Magrath, Director of Strategic Development, said: "We are very proud of the way that the EMR programme has proceeded. This is a ground-breaking initiative, which will benefit patient care and safety and support innovative clinical processes. It is the most sophisticated solution of its type in the United Kingdom and we hope by the start of 2014 to have transferred all our patient notes over to it."

Additional EMR Facts and figures:

• There are 450,000 casenotes in the medical records library, containing around 45 million sheets of paper.

• Over ten years the deployment costs for the project is £6.9 million

• From 2014, the running costs for EMR will be £925,000 annually and it will release £2.6 million per year in savings.

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  • Basildon and Thurrock University Hospitals NHS Foundation Trust
    Nethermayne, Basildon
    Essex  SS16 5NL
  • Switchboard 01268 524900

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