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

King’s 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 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 2

Race to the moon Onward The sprint finish 04 2017 – 2018 The 26 mile hurdles 03 2009 – 2016 The steeplechase 02 2004 – 2008 The slow burn 01 1999 – 2003 3

The Slow Burn 1998 Signed contract with HealthVISION 1999 Go-live cardiac 2000 1 st supplier change 2000 – 2003 2001 Roll out 2 nd supplier change 4

The Steeplechase 01 02 03 04 2004 2004 2004 – 2008 2008 National Programme for IT!! ePMA v1.0 The Software House ePMA v2.0 (King’s Development Framework) - Clinical Correspondence - Electronic Clinical Notes - PACS 5

The Marathon ePMA roll out Open Source Acquired Princess Ranked #1 in Allscripts Sunrise Integration Engine Royal University National Digital Clinical Manager Hospital Maturity Index Go-Live Aug 6 th 2009 2012 2013 2015 16 –2011 2013 to 2015 – New EHR Procurement Database hell Contract with Allscripts Executive Board implosion v1.0 6

Go-Live (i) 5 th Aug 6 th Aug 6 th Aug 6 th Aug 6 th Aug 6pm 12am 9.30am 1pm 11pm Old EPR – read only Db upgrade complete, KCH configuration Data validation, System Upgrade complete Allscripts configuration began Testing & Integration began Testing began 7

Go-Live (ii) • 7 th Aug 10am Sunrise released to first 3 wards followed by ED • 7 th Aug 12pm Sunrise released to the Trust 8

Go-Live (iii) • 7 th Aug 9:50am: – RY delivers Henry V Speech 9

Go-Live Issues (i) • 7 th Aug 10.05am: – Floor-walkers get stuck in the lift 10

Go-Live issues (ii) • 7 th Aug 10.40am: – Floor-walkers escape 11

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 10 th Aug 35,000 – Total TTA prescriptions in SCM since 8 th Aug 9,869 – Total A&E GP letters in SCM since 7 th Aug 6,300 – Total eDNs Created since 7th of August 1,422 – Total letters completed in letter-maker since 7th August 22,500 – 12

Achievement • Data loss = 0 bytes 13

Achievement • Pharmacy completed the transcription and checking of over 22,000 prescriptions from paper back to ePMA in 2 days 14

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…?” 15

The Sprint Finish Executive board Integration with Go-Live Princess November implosion v2.0 second LiMs Royal University Financial special - eNoting (30th Hospital measures Oct 2018) - Order Communications & Result Reporting - New electronic 2017/2018 Discharge Notification - ePMA - National Early Warning System 2017 2017 2017 (NEWS) - Patient risk assessments 16

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So What? 18

Structures Clinical Documentation using PRSB- AoMRC Standards and Driving “flow” and quality 19

Results Review 20

Vital Signs 21

Rapid roll out of eObservations to all wards 22

ePrescribing 23

ePrescribing 24

ePrescribing 25

Developing the Learning Health System – The VTE Story Get Intervene Digital Data Analyse Digital Data 26

A Learning Health System - Example 27

Learning Health System Example- VTE Assessments 1: Get Digital Data, Analyse Digital Data 28

eAlert 29

Learning Health System Example- ATE assessments 30

Repeating the tricks- resuscitation status 31

Resuscitation Status- Going Nowhere 32

Resuscitation Status with eAlerts 33

Resuscitation Status- some other helpers 34

Race to the moon: Linking Clinical Records across South East London 35

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Results in King’s EHR 37

Results in SE London Local Care Record 38

Sharing imaging in the LCR 39

Hang on… the patient was seen at GSTT two weeks ago! 40

Sharing vital documents across the network 41

Local Care Record- Usage Is it any good? 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 42

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. 43