Transforming Healthcare: the path to successful EPR implementations

The long-awaited ‘NHS budget‘ is now with us. There are eye-watering amounts of increased day-to-day spend, largely to fund existing, overdue pay awards and additional elective pressure. There will also be £3.1bn of additional Capital spend to fund new surgical hubs and diagnostic scanners, addressing RAAC and rebuilding the country’s pandemic preparedness and health protection. Then, £2bn will be allocated for NHS technology, coupled with a 2% increase in productivity. A key priority for the additional functionality is a further expansion of Electronic Patient Records. It presents an exciting new opportunity, but it can be a mixed blessing (cf. the mixed experience of Trust recently adopting EPRs).

That’s because the journey to successful implementation is often riddled with challenges. Let’s dive into the key issues and discover how to overcome them for a high-impact, productivity-enhancing  EPR implementation. 

Why it’s complicated

EPR implementations are notorious for their long delivery timeframes. These projects can take over five years to complete due to complicated and sometimes changing financial hurdles, slow procurement, and insufficient clinician involvement.

The shift towards more community-based care adds another layer of complexity. EPR systems need to extend their functionality to support the move of care closer to home.

Finally, joining up the NHS (so there is a single view of the patient record) depends on effective EPR solutions that can talk to each other.

Key challenges

• Clinical process optimisation: EPR implementations provide an opportunity to review and optimise clinical processes before implementation, ensuring they are well-defined and efficient.
• Clinical adoption: successful EPR implementations rely heavily on clinical adoption, requiring clinicians to be involved in all stages of the lifecycle and integral to the solution. In today’s diverse workforce, this can be both a bonus (many different experiences make for a better, more rounded service) and a challenge (overcoming different levels of maturity in technology).
• Functional efficiency and integration: EPRs should minimise process steps, accurately reflect local data, and meet reporting requirements. They must also integrate seamlessly with other applications and devices.
• Comprehensive testing and data migration: EPRs require thorough testing, including participation from clinical representatives and validation using representative data. Rigorous testing is also necessary for data migration from older systems to ensure accuracy and compatibility.
• Security and performance: EPRs must have robust security measures to protect sensitive data and control user access based on roles. They should also handle workload peaks without significant performance degradation and comply with healthcare regulations and standards.

Five key priorities  to consider

1. Confirm clinical outcomes and use them to shape the implementation plan: collaborate with clinical stakeholders to define requirements, covering functionality, workflows, performance, and security.
2. Clinical engagement and empowerment: involve representatives from all relevant clinical groups throughout the implementation, empowering them to act on behalf of their groups.
3. Waterfall planning, iterative delivery: consider a phased approach based on priority and ROI, potentially using an iterative methodology to realise benefits quickly.
4. Quality assurance and data migration: define quality thresholds for each phase, collaborate with stakeholders to monitor progress, and verify data mapping, migration processes, and migrated data through thorough QA and testing.
5. Review security and performance: ensure patient data is secure, meets regulatory standards (e.g., GDPR, HIPAA), and includes encryption, access controls, and authentication tests. Confirm that the EPR meets performance requirements using specific tools and techniques.

What we can do at Trustmarque to help you

At Trustmarque, with more than 35 years of working with the NHS, more than 200 NHS clients, and £210m+ of NHS spend already through our books in 2024, we understand the issues faced when implementing technology. We have experience in end-to-end complex EPR delivery. In partnership with other leading Healthcare IT and implementation partners, we can help you find the skills to deliver a great EPR programme.

Two of our own specific areas of expertise are:

Acutest, a division of Trustmarque, has over two decades of experience in helping clients maximise the value of their technology investments through our quality assurance and testing services. When this expertise is applied to Electronic Patient Record (EPR) implementations, it leads to increased clinical engagement and adoption, as well as significant reductions in deployment time and costs.

Trustmarque is already working with major technology suppliers to support the infrastructure needed for the frontline. These suppliers include Microsoft, Cisco, IBM, and Dell. Our huge network of partners and comprehensive framework coverage mean that we can increase the pace of implementation, improve value for money, and de-risk delivery.

Contact Calum Macleod or Guy Boyce Cam if you would like to know more.

About the authors

Calum Macleod is the Head of Healthcare at Trustmarque. Since 2015, Calum has focused on supporting high-growth organisations to bring new or proven technology to patients and the NHS frontline. Prior to this, Calum led Local Government and Healthcare organisations at KPMG/Atos KPMG, Capgemini, and CGI.

Guy Boyce Cam is an Assurance Principal Consultant at Acutest (Part of Trustmarque). With over 25 years in the testing industry, Guy specialises in designing and delivering testing services across healthcare, finance, commercial, and leisure sectors. His expertise includes leading QA and testing for a major public sector EPR implementation.