Guy’s does e-noting

Guy’s and St Thomas’ NHS Foundation Trust is digitising 130 hospital forms to be accessed via a portal being developed by an in-house team.

The trust is rationalising the number of forms in use and making those that are needed available electronically as part of its move towards paper-lite processes.

A transformation team found there were about 1,400 forms in use at the trust and worked to significantly reduce this number.

Staff will get access to the 130 e-forms via a portal being built in-house using Microsoft SharePoint software.

The portal also brings together read-only feeds from various other systems including the A&E and community systems with just one log-in.

Group IT director Scott Sommerville said the e-noting project essentially replaces the blue forms used for collating patients’ paper notes and reduces duplication as forms can be pre-populated with data from the patient administration system.

It includes electronic recording of nursing observations, calculation of patient risk scores and pain assessments.

The 18-month, £7m e-noting project started about a year ago. A pilot begins in two wards and some outpatient areas later this year.

This first phase is reliant on the trust’s iSoft electronic patient record system, but phase two will be stand-alone.

The next phase will also include integration with the trust’s new electronic prescribing and medicines administration system, Medchart, when it goes live next year.

In the meantime, clinicians can record a patient’s medication using an e-form.

Fifty iPads and 15 computers on wheels are being deployed for the pilot to ensure clinicians always have necessary hardware on-hand.

The trust has also updated all of its Hospedia patient bedside computers, which can be used by clinicians to view the patient’s record and to enter information and observations.

Scanners are being deployed to allow staff to scan and upload the limited number of specialist paper forms that will still be in use.

Head of product development Gary McAllister said the ‘agile scrum’ development process involved constant testing and feedback with clinical staff who will be using the e-forms via the portal.

Different health professionals will have different views of the portal, including a summary view of a patient’s most important information.

A task list will let staff know what needs to be done for a patient and they can add alerts to the record, such as if a person has dementia.

The ultimate aim is for the portal to drive a huge range of reports and dashboards using real-time information.

A feed will also be made available for researchers to download into Microsoft Excel, but with no patient identifiable information attached.

Full paper notes will be still be available for the first three months of the pilot going live, but then only available on request.

The £7m e-noting project is part of the trust’s wider plans to invest £213m in IT over five years, including the procurement of an electronic patient record system, clinical portals and mobile devices for staff.

Sommerville believes the e-noting project will take the trust “all the way” to achieving health secretary Jeremy Hunt’s target of a ‘paperless NHS’ by 2018.