Peterborough and Stamford Hospitals and DocFinity®: First-Rate Patient Service with Automated Medical Records Management

BACKGROUND

After more than half a century of patient care, Peterborough and Stamford Hospitals NHS Foundation Trust has gained a reputation for achievement and innovation in patient services and operations. As part of England’s National Health Service (NHS), the hospitals in the Trust exist to deliver health services to all patients, free at the point of care, and based on need, not ability to pay. As a Trust, the three hospitals are dedicated to providing targeted services that meet the needs of the local communities of Peterborough and Stamford, rather than being under direct control of the national Department of Health.

During the many years that they have continued to serve the changing needs of their patients, the hospitals in the Trust have accumulated millions of patient notes. In fact, in 1997, when Diane English, health records and patient services manager at Peterborough, began looking for an electronic document management system (EDMS), the hospitals were keeping records for over 1 million patients, and they were producing an average of 15,000 more patient records each year. The hospitals are currently creating new medical records on about 25,000 patients every year, and that number doesn’t include additions to pre-existing files.

British law stipulates how long medical records must be kept on file. For example, birth records must be kept by the birth hospital until a person reaches age 26. Add to that the patient notes from every other department in the hospital—accident and emergency (A&E), pathology, therapy, etc.—and Peterborough’s health records department is responsible for a massive volume of documents.

In 1997, the records department decided that it was time to do something about all of the paper-based records because they were running out of storage space and purging old records was too time-consuming for the hospitals’ staff. The committee formed to find a solution came up with three options. The first choice: return to microfilm, which they had used in the past until the process consumed too much time and took up too much of their budget. The second option was to ship the documents to an off-site storage facility, but they decided that was likewise too expensive and time-consuming. A third possibility was to convert to an electronic document management system (EDMS), which the committee ultimately decided would be the best option for the Trust.

THE FIRST TRY

The goal for the search committee at the time was to find an EDMS solution that would eliminate the massive amounts of paper records to which the hospitals were adding every day. At the time, their only interest was imaging, indexing, and storing information on a limited basis. Always the innovator, Peterborough was one of the first NHS sites to implement an EDMS solution for their medical records, so they had to visit insurance companies and other non-medical sites to see the software in action. At the conclusion of their search, the committee selected an imaging system, to fulfill their imaging needs.

Although the earlier imaging system helped Peterborough take a major step forward in automation, the Trust’s imaging requirements and the resulting process were limited for several years. Not all documents were scanned. Rather, scanning and archiving was viewed as just that—archiving. The staff continued using their paper-based system for frequently accessed records and scanned only those that they anticipated not needing. The previous supplier provided the hospital with a retrieval system in case they did need to recover archived files, but their goal was not scanning and retrieval, it was compliance with record retention laws.

THE DOCFINITY SOLUTION

The Trust is scheduled to complete work by 2010 on a new hospital which will be located on the existing Edith Cavell Hospital site. Rather than transfer the millions of patient notes to the new hospital, Diane English, an innovator in her own right, as enthusiastic about and dedicated to improving patient care as the trust itself, decided that it was time to take their document management to the next level and to find an EDMS solution that allowed them to fully leverage the latest technology for maximum return on investment. At an Institute of Health Records and Information Management (IHRIM) trade show, Diane met Archie Menzies of Optical Image Technology UK Ltd. (OITUK), who convinced her to let them take a look at their current system.

“While the hospital’s previous system worked well for Peterborough and met their initial requirements, it was not able to provide the expansion and functionality Peterborough required to move forward,” said Archie Menzies, the NHS Sales Manager of OITUK.

After consulting with OITUK, Diane and her team decided to utilize the DocFinity software suite to improve their records management process. In 2003, OITUK installed the DocFinity EDM System to replace Peterborough’s old system. The DocFinity system runs on a Windows-based platform and utilizes a MS SQL database. The records staff uses a Kodak 3520D scanner to create images of patient records which are stored on RAID.

The Trust also mandated the need to migrate their existing scanned records into the new system. “We provided a facility to migrate some 13 million images from the old system into the new DocFinity system,” said Vijay Magon, Technical Director of OITUK. “Peterborough’s records staff carries out the migration using the tools we provided, including a quality assurance facility for verifying scanned and imported images.”

LOOKING AHEAD

Currently, Peterborough is utilizing DocFinity software only in its patient records department, but they are looking to expand upon that use. The A&E department and the Therapy Services department are presently testing the software for use in their own respective departments, and their systems are linked through to the main EDM system within the Records Department.

“Peterborough selected OITUK because of our track record in the National Health Service sector and because we are able to offer solutions that go beyond chasing and capturing paper-based information,” Vijay said, so it’s only natural that they are beginning to explore those options now.

In the past, when a patient left the A&E department, the Trust would hold the patient’s records there, rather than file them in the hospital’s central repository. In the current A&E test scenario, OITUK has installed a scanner within the department. Now, when patients leave, their records are scanned and routed to the EDM system’s records department where they are appropriately filed. Similar tests are being carried out in the Therapy department and Diane English anticipates more tests elsewhere in the near future. Other departments, she says, are lining up to be next. They are seeing the results in A&E and therapy, and they want the same for their departments.

RESULTS

Diane and the rest of the records department continue their efforts to image all of the hard-copy records that British law requires them to keep. She is certain that with proper resources from the Trust, they’ll have it done in time for the move.

However, her team is already reaping the benefits of the software. Her office gets about 2,000 requests for patient records every day—and that’s just for clinical. Plus, they have about 1,000 new records that they need to file on a daily basis. The EDMS system is making the work lives of her staff a lot easier. Additionally, the improved efficiency of the records department is saving Peterborough NHS time and storage space and allowing the hospitals to automatically comply with retention law. All those benefits translate into real cost savings for the NHS as they have scanned some 15 million documents since the imaging project started.

Across Great Britain, NHS records departments lose an average of 5-7 percent of their patient records, according to Diane. But she is proud to say that her department maintains over 99.999 percent of its patient records. That number is sure to creep closer to 100 percent as they convert more of their hard-copy files into electronic images. That statistic leads directly to a better bottom line for Peterborough, as a large portion of the NHS site’s government funding is based on the success of its annual records management audit. Another key reason for selecting DocFinity from OITUK is that as the Trust’s requirements grow, the DocFinity software can be further expanded to meet the requirements and continually improve business processes. This is directly reflected in the provision of continually improving patient care.

For more information or to schedule a demonstration, please Contact DocFinity now.