Kings College Hospital EHR: The Journey of a lifetime Richard - - PowerPoint PPT Presentation

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Kings College Hospital EHR: The Journey of a lifetime Richard - - PowerPoint PPT Presentation

Aug 27, 2022 389 likes •830 views

Kings College Hospital EHR: The Journey of a lifetime Richard Yorke, Head of EPR Large University General hospital in South East London Serving a population of 600,000 1600 inpatient beds 260,000 admissions 210, 000 ED

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King’s College Hospital EHR:

The Journey of a lifetime

Richard Yorke, Head of EPR

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Large University General hospital in South East London

  • Serving a population of 600,000
  • 1600 inpatient beds
  • 260,000 admissions
  • 210, 000 ED attendances
  • 1,600,000 OPAs
  • 10,000 staff (IT dept 107 FTEs)

Tertiary care for:

  • Liver Transplants
  • Neurosciences
  • Cardiothoracic
  • Haemato-oncology (including bone marrow transplants)
  • Nephrology
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The slow burn

1999 – 2003

01 02 03

The steeplechase

2004 – 2008

The 26 mile hurdles

2009 – 2016

The sprint finish

2017 – 2018

Race to the moon

Onward

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2001

2nd supplier change

2000

1st supplier change

1999

Go-live cardiac

1998

Signed contract with HealthVISION

2000 – 2003 Roll out

The Slow Burn

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01 02 03 04

2004 2004 2004 – 2008 2008

National Programme for IT!! ePMA v1.0 The Software House (King’s Development Framework)

  • Clinical Correspondence
  • Electronic Clinical Notes
  • PACS

ePMA v2.0

The Steeplechase

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2013 2012 2015 2009 –2011 Aug 6th

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2013 to 2015 – Database hell

ePMA roll out Open Source Integration Engine Acquired Princess Royal University Hospital Ranked #1 in National Digital Maturity Index Allscripts Sunrise Clinical Manager Go-Live

The Marathon

New EHR Procurement Contract with Allscripts Executive Board implosion v1.0

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5th Aug 6th Aug 6th Aug 6th Aug 6th Aug 6pm

Old EPR – read only

12am

Db upgrade complete, Allscripts configuration began

9.30am

KCH configuration began

1pm

Data validation, System Testing & Integration Testing began

11pm

Upgrade complete

Go-Live (i)

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Go-Live (ii)

  • 7th Aug 10am Sunrise released to first 3 wards followed by ED
  • 7th Aug 12pm Sunrise released to the Trust
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Go-Live (iii)

  • 7th Aug 9:50am:

– RY delivers Henry V Speech

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Go-Live Issues (i)

  • 7th Aug 10.05am:

– Floor-walkers get stuck in the lift

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Go-Live issues (ii)

  • 7th Aug 10.40am:

– Floor-walkers escape

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Achievements

  • Migration

– Total Results Migrated 239,911,678 (e.g. Hemoglobin or neutrophil count etc.) – Total Orders migrated 64,040,293 (e.g. FBC, Liver function, referrals, drugs, etc.) – Total Form data successfully migrated 23,005,317 (e.g. fields in a VTE assessment) – Total Documents Migrated from iCM 13,390,642

  • Volume of new activity (at 15/08)

– Total Results in SCM since 7th of August 571,224 – Total Orders in SCM since 7th of August 174,102 – Total IP prescriptions in SCM since 10th Aug 35,000 – Total TTA prescriptions in SCM since 8th Aug 9,869 – Total A&E GP letters in SCM since 7th Aug 6,300 – Total eDNs Created since 7th of August 1,422 – Total letters completed in letter-maker since 7th August 22,500

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Achievement

  • Data loss =

0 bytes

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Achievement

  • Pharmacy completed the transcription and checking of over

22,000 prescriptions from paper back to ePMA in 2 days

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Feedback

  • “The hospital has not

stopped”

  • “Very smooth transition”
  • “It looks the same, so why

did you bother?”

  • “Fantastic job”
  • “When can I have my

changes that you promised me…?”

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Integration with second LiMs

2017

Go-Live Princess Royal University Hospital

  • Order

Communications & Result Reporting

  • New electronic

Discharge Notification

  • ePMA
  • National Early

Warning System (NEWS)

  • Patient risk

assessments

2017/2018

November Financial special measures

2017

Executive board implosion v2.0

  • eNoting (30th

Oct 2018)

2017

The Sprint Finish

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So What?

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Structures Clinical Documentation using PRSB- AoMRC Standards and Driving “flow” and quality

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Results Review

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Vital Signs

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Rapid roll out of eObservations to all wards

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ePrescribing

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ePrescribing

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ePrescribing

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Developing the Learning Health System – The VTE Story

Get Digital Data Analyse Digital Data Intervene

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A Learning Health System - Example

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Learning Health System Example-

VTE Assessments 1: Get Digital Data, Analyse Digital Data

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eAlert

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Learning Health System Example- ATE assessments

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Repeating the tricks- resuscitation status

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Resuscitation Status- Going Nowhere

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Resuscitation Status with eAlerts

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Resuscitation Status- some other helpers

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Race to the moon: Linking Clinical Records across South East London

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Results in King’s EHR

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Results in SE London Local Care Record

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Sharing imaging in the LCR

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Hang on… the patient was seen at GSTT two weeks ago!

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Sharing vital documents across the network

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Local Care Record- Usage

  • Accessed 2.1 Million times
  • Accessed 130,000 per month
  • 363,000 patients have had their records

accessed

  • 22,000 unique users
  • All supervises by and concordant with SEL

IG Group Is it any good?

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What next? Truly sharing clinical data between Primary, Secondary and Tertiary care to finally achieve the single source of truth across care settings. Patients and citizens to have full access to THEIR clinical information Our Healthier South East London Partnership has successfully bid for funding to go to the next level.