Digital Journey
Digital Journey - 2012-2020
CHFT is an integrated Trust providing acute and community health for the populations of Huddersfield and Calderdale. In 2012 CHFT developed a Digital clinical systems strategy and high-level plan that described how the Trust planned to use technology to fundamentally change the way it delivers its services. The strategy made a number of recommendations mainly relating to the clinical systems functionality and how it would be deployed to digitize the patient record. With an emphasis on improving the quality and safety of patient care.
In order to deliver the strategy, the Trust needed an underlying modern and reliable infrastructure and made a commitment to continue to invest in the Trust’s IM&T Infrastructure in order to ensure it was capable of supporting the delivery of the plan. As a result, the following elements were procured and deployed:
- New wired infrastructure for both hospitals.
- Improved computer room facilities at CRH and new facility at HRI.
- Resilient Data storage platform.
- Cross site resilient server platform.
- Wireless Network across all CHFT sites.
- Updated, site resilient email platform.
- Improved PC Estate.
A list of further additions to the infrastructure were also approved and deployed:
- Single Sign-On.
- Input Devices (PC’s, Laptops, Tablets etc)
- Unified Communications (single bleep, single number reach inc mobile etc).
- Video Conferencing.
- Managed Data Services.
- Limited Virtual Desktop Infrastructure (VDI).
- Manage Print Services.
"The infrastructure work plan gave the Trust a solid foundation/platform to build future technology solutions that underpin this digital strategy"
Stage | Himss Analytics EMRAM EMR Adoption Model Cumulative Capabilities |
|---|---|
| 7 | Complete EMR; External HIE; Data Analytics, Governance, Disaster Recovery, Privacy and Security |
| 6 | Technology Enabled Medication, Blood Products, and Human Milk |
| 5 | Physician documentation using structured templates; Intrusion/Device Protection |
| 4 | CPOE with CDS; Nursing and Allied Health Documentation; Basic Business Continuity |
| 3 | Nursing and Allied Health Documentation; eMAR; Role-Based Security |
| 2 | CDR; Internal Interoperability: Basic Security |
| 1 | Ancillaries - Laboratory, Pharmacy, and Radiology/Cardiology Information systems; PACS: Digital non-DICOM Image management |
| 0 | All Three ancillaries not installed |
Whatever product the Trust chose as its strategic option, it was acknowledged that it would take some time to procure and implement a core product set. At that time there were some emerging issues that the Trust faced, issues that technology could help alleviate by deploying some new technologies. As result several business cases were approved to procure the following systems.
✓Bluespier Theatre System deployed in October2014.
✓Electronic Document Management System deployed February2015.
✓NerveCentre E-Observations deployed in October2015.
✓K2 Athena Maternity EPR deployed in June 2015
The Trusts ambition was always to assess its status with regards to an accepted model for measuring progress towards achieving a full EPR and chose to work towards the HIMSS European EMR Adoption Model, evidence shows that when Trusts achieve these later stages of this model the real benefits start to accrue for both the health professional and patients.
In August 2019 the trust completed an assessment against the new standards the Trust was confirmed as a stage 5 hospital, putting CHFT well above the UK (2.3) and European (2.1) average for a Trust of our size (Appendix 1). The Trust has maintained their commitment to invest in digital, and as a result CHFT has moved to the top of the NHS England’s national Clinical Digital Maturity Index (CDMI) from a position 2 years ago of outside of the top 100, cementing its position as one of the most digitally advanced Trusts in the country. Further evidence can be taken form the Digital Maturity self-assessment that takes into account the broader digital perspective this was last completed in 2017 the Trust once again demonstrated considerable progress, over the same 2 year period CHFT has risen from 113th in the country to a position of 13thplace There are plans in place to improve this position with an ambition to reach HIMSS stage 6 in 2020.
Digital Journey – Next steps
Whilst the long-term Strategy for the Trust is being developed it was agreed that several Digital Next Steps needed to be implemented to ensure the digital maturity continued to progress. Subsequently a report was developed and approved by the Board in June 2018. The Digital Next Steps described a phased approach that would address issues systematically as prioritised by the Trust and would act as the interim to the overall Digital strategy.
The plan was to approach the issues in three phases:
Phase 1 Stabilisation - which addressed some key changes to improve the overall efficiency of the system.
Phase 2 Optimisation - which focused on the completion of a number of projects that had been put in place to improve access to other systems that were not part of the original scope. The majority being solutions that Cerner did not offer such as Medisoft the Ophthalmology EPR. But also included the introduction of virtual clinics and the switch on of the patient Portal
Phase 3 Obtaining and Improving Functionality – Prioritising a number of digital solutions that needed replacing or would be better placed as a Cerner solution.
Collectively these phases would aim towards delivering a single access one source of the truth patient record whilst reducing our reliance on paper
Digital Journey – EPR
The most significant deployment of our digital journey being the introduction of the Cerner Millennium Electronic Patient Record (EPR). CHFT in partnership with Bradford Teaching Hospital Foundation Trust successfully deployed a single instance of the Cerner Millennium EPR across well over a third of the population of the West Yorkshire & Harrogate Health and Care Partnership footprint. Labelled as one of the biggest and broadest Big Bang deployments in Europe.
The Trust’s progress on the introduction of digital technology is enabling clinicians and patients to access and interact with ‘real-time’ patient records and care plans wherever they are. All GPs in Calderdale and Greater Huddersfield are now able to view the hospital electronic patient record within their own patient record and hospital clinicians can also view the GP record for all Calderdale and Greater Huddersfield patients within the hospital Cerner electronic patient record. Calderdale Community Service staff can also view the Calderdale GP record for both SystemOne and EMIS.
Work has also commenced to progress digital interoperability with the Calderdale Social Care System to enable integration of the adult health and social care records by early 2020. There is still more to do to ensure all local health partners are fully integrated the intention is to connect with mental health, ambulance services and other local community healthcare organizations. Utilising a similar concept in line with the national programme LHCRE.
The Trust has some of the highest utility of the national electronic staff record (ESR) and has been successfully using an App (application software) for the recruitment of bank staff and an e-rostering solution for nursing. The Board of Directors and Executives lead by example, all meetings are now paperless, and meetings can be accessed virtually The level of organisational adoption already achieved at CHFT gives the Trust a distinct advantage for rapid progression to a fully paperless environment.
