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EPR modification exchange: sharing EPR customisation code between Trusts

An opportunity to exchange code snippets, approaches, capabilities, design skills between Trusts to make the process of customising an Electronic Patient Record (EPR) more efficient and effective.

Read comments 7
  • Proposal
  • 2022

Meet the team

Also:

  • Paul Altmann, CCIO
  • Matt Harris, Head of Digital

What is the challenge your project is going to address and how does it connect to the theme?

Electronic Patient Record (EPR) systems are often customisable for optimal use. However this requires significant digital resource. In our own Trust there is a backlog of 2-3 years of requests for EPR modifications, which impacts the effectiveness of clinical teams. We know that other Trusts face similar issues and are often doing similar work themselves – effectively duplicating effort.

While Trusts across the UK have some unique requirements, there are many similar technical needs. Reuse of code could save hours or days of technical time to implement. There is also significant benefit to sharing approaches, skills and capabilities and working on projects together.

We propose to start the project initially through existing connections with Reading, Milton Keynes and Chelsea and Westminster, from there expanding to the 32 Trusts that use a Cerner EPR, followed by other systems. By applying an improvement methodology to test and learn we will optimise the approach.

What does your project aim to achieve?

This project aims to optimise customisation of EPR systems across the NHS, saving time for overstretched digital resources, improving wait-times for EPR modification requests, and providing equal service across different geographies.

Some informal knowledge sharing is already happening between EPR teams, but it is insufficient. We propose an exchange of ideas and resources across those teams including a community of practice and online library of code/configuration information.

Objectives of this project:

  1. Scoping of platform and approach with partners
  2. Identification of priority projects with significant potential for efficiency
  3. Initial events / exchanges of ideas on priority projects
  4. Review of approach and improvements

The future solution: an online library of EPR modifications accessible across the NHS, with a “librarian” function to aid Trusts looking for solutions / requiring configuration support and a community of practice to obtain informal support and best-practice sharing.

How will the project be delivered?

The project will be led by TheHill, a digital innovation team at Oxford University Hospitals with significant expertise in project and event management, community building and digital, supported by the QI and digital teams at the Trust and the CCIO. We will work through existing relationships to build the core partnership, subsequently expanding out through the CCIO network.

We will conduct meetings by Teams and will use existing software platforms for sharing code to minimise costs. Some face-to-face meetings will be necessary to build relationships.

For this pilot we will prioritise EPR modification challenges which require significant effort and where sharing of expertise and prior work will therefore be of most benefit.

We have established that there is appetite for the project amongst digital teams thus minimising the main risk of lack of engagement. The project will measure time saved and poll participants to establish the value they have gained.

How is your project going to share learning?

As a pilot community of practice, dissemination is baked into the project objectives. We will start with a small group and expand out through the CCIO network and other connections to engage further digital teams.

A key question of the project is the amount of time required for configuration of others’ code to be suitable for a local environment, and hence the time saved by sharing prior work. As we progress with the pilot projects we will measure and share this learning, which we expect to be applicable not just to EPRs but to all digital solutions within the NHS.

We have a number of routes to wider dissemination including:

  1. Our existing digital innovation community and network, including partners such as Digital Health Networks
  2. The CCIO network
  3. Publication of project results on our website and social media, and via the Q community
  4. Appearance at conferences and events

How you can contribute

  • Partners interested in being part of the community of practice
  • Comments from digital / EPR team members about feasibility and challenges
  • Comments from clinical teams on the benefits this might generate

Plan timeline

4 Apr 2022 Initial conversations with core partners
23 Jun 2022 Project kick-off meeting if funding successful
1 Sep 2022 Pilot projects identified and discussed, selection meeting
2 Sep 2022 3 month period of work on pilots, PDSA cycles
1 Dec 2022 Review and evaluation meeting to reflect on pilots
5 Dec 2022 Promotion of pilot results with wider group
9 Jan 2023 Evaluation of pilot period and next steps planning
9 Jan 2023 First quarterly community of practice meeting for wider group
3 Apr 2023 Second quarterly CoP meeting and continued dissemination of results
15 May 2023 Final report provided to the Health Foundation
12 Jun 2023 Continuation of CoP and code sharing if deemed useful

Comments

  1. Guest

    Mike Wright 3 months ago

    A great idea and a great opportunity to share best practice, saving developer time and resource. In addition to sharing 'code snippets', it would be good to share experiences of approaches to developing code, what has worked well, what has not. Finding ways of optimising the time from request for a process/ code to delivery of solution is a high priority for us.

  2. This is an excellent idea. The Royal Free in London recently started using Cerner and may also be interested? Would be good to see how the "code snippets" could be curated over time.

    1. Thanks Laurine! Apologies for the delay in replying - got hit by covid last week so just recovering. It would be great to have the Royal Free on board as part of the network.

  3. A great idea Megan.

    I wonder if this same principle/ platform could be utilised for no-code or low-code Power Apps on the Microsoft suite?

    As this needs less digital expertise and is used by even more NHS trusts, it would be even more impactful. I could put you in touch with other trusts that could also benefit from/contribute to this.

    1. Sounds like a great idea Hesham! Would love to explore this. I agree there's lot sof potential with the power apps that I haven't yet unlocked myself.

       

  4. Collaboration with other Trusts is so important for this idea. It would be nice to see some comments and views from your core partners. I think that this is such an important project for the reduction in lead time for improvement in the EPR. A 2-3 year waiting list is just not acceptable today. Is there a set of code standards that can be used to standardise the 'code snippets'?

    1. Thanks Tom, some very helpful thoughts here!

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