CCIO Penny Kechagioglou unravels the complexities of EPR implementation, offering a roadmap for a future where technology seamlessly enhances patient care in the NHS
CREDIT: This is an edited version of an article that originally appeared on Digital Health
The NHS Long Term Plan has set an ambitious course for digitally empowered care, aiming at equitable access, individualised medical records, and seamless clinician connectivity. At the heart of this vision was the push to have 90% of trusts equipped with Electronic Patient Records (EPRs) by the end of 2023, with full coverage reaching 100% by March 2025.
Currently, only a third of NHS trusts have successfully implemented EPRs, delaying the realisation of crucial benefits in patient safety, service efficiency, and paper reduction. This delay also hinders the proactive treatment of patients in the community, impacting both care effectiveness and workforce sustainability.
Understanding the implementation hurdles
To assess the challenges hindering widespread EPR adoption, we need to examine the micro-level dynamics of user adoption, the meso-level organisational readiness, and the macro-level complexities of system infrastructure, interconnectivity, and resourcing.
Micro-level dynamics: User adoption insights
User adoption presents a spectrum, ranging from proactive support to active resistance. Engaging both clinical and operational end-users is essential for high-quality data collection, enhancing clinical coding, and improving care evaluation. Bridging the digital divide is critical, requiring consideration of patient needs to ensure universal EPR and patient portal adoption.
Meso-level readiness: Organisational preparedness
Establishing robust IT infrastructures, ensuring strong Wi-Fi connectivity, and developing an individualised device strategy are pivotal early steps in the EPR implementation journey. Emphasising end-user workflow design from the outset, alongside investment in patient and clinician user groups, helps identify pain points and transform pathways through design thinking. Streamlining benefits by selecting a concise, measurable catalogue keeps stakeholders engaged and aligns energy with meaningful outcomes.
Macro-level complexity: System infrastructure challenges
Ensuring organisational EPR accessibility within integrated care systems fosters coordinated care, enhancing clinical effectiveness and patient experience. The time lag between different Integrated Care System (ICS) providers in EPR implementation often leads to delays in patient care coordination. Building a digital infrastructure prioritising community care and facilitating secure digital communication is crucial. Additionally, joined-up resourcing among system providers ensures talent creation, knowledge sharing, and workforce sustainability, crucial elements in this expensive undertaking of EPR implementation.
For practice managers, embracing these key steps in EPR implementation—from understanding user dynamics to ensuring organisational readiness and fostering macro-level system advancements—becomes integral in navigating the complexities of digital transformation, paving the way for enhanced patient care and operational efficiency in primary care settings.
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