Client Story
Psychology service digitised and integrated into trust-wide EPR at Liverpool Heart and Chest Hospital
The Clinical Health Psychology team at Liverpool Heart and Chest Hospital NHS Foundation Trust (LHCH) has digitised its service and integrated with the trust-wide EPR. This digital change is enabling patients’ psychological care to be documented alongside medical care for a fuller record. The innovation is releasing considerable and far-ranging benefits, such as streamlined processes, time savings, improved communication and care coordination and increased patient safety.
Fuller patient record: Psychological care recorded alongside medical care
Utilisation of a proven and highly configurable EPR system
Streamlined processes and efficiency savings
Innovation Drivers
Coping with changes in health, or with a long-term condition, can be difficult. Sometimes mental health difficulties can also make it more challenging for a person to look after themselves or engage in their medical care. That’s why the Clinical Health Psychology team was set up at LHCH to support people to live a meaningful life while managing their condition.
Psychologists are embedded within all services across the trust, covering Adult Congenital Heart Disease (ACHD), Critical Care, Cystic Fibrosis, Inherited Cardiac Conditions (ICC) and Implantable Cardioverter Defibrillators (ICD). However, the team didn’t have a formal way of documenting its patients’ notes and sharing appropriate information with medical staff and the wider multi-disciplinary team (MDT).
Psychology patient notes and records were gathered on paper forms and spreadsheets in multiple locations. These methods were also used to manage patient questionnaires, appointments, referrals, discharges and communication with the MDT, making the processes inefficient, duplicated and siloed.
Objective: One flexible digital system to manage a unified patient record
Psychology set out to deliver its service using one digital system that could manage a unified patient record to better support the team and patient care.
To support psychology effectively, the team needed a flexible solution that was capable of making notes available or confidential to other members of the MDT. This was crucial functionality given the confidential nature of psychology case notes and being able to maintain a patient’s privacy wishes, if required.
Other vital functionality requirements included:
- A comprehensive note system that could manage the measures the service used to support patients. Including the distribution of questionnaires for patients to complete on depression, anxiety and general wellbeing, the recording of data and the automated scoring of results. This would then enable members of the team to retrieve the scores and monitor progress and improvement throughout their therapies.
- Facilitating the collection of meaningful data to monitor and report on specific psychology key performance indicators (KPIs), which differ hugely to medical KPIs.
Utilisation of a proven and highly configurable EPR system
With the project objectives agreed upon, the team decided the best approach to meet its digital needs was to utilise the trust’s existing Sunrise ™ EPR system provided by Altera Digital Health.
Sunrise was already enabling the trust to be 99.9% paperless and to complete all clinical documentation, order communications and prescribing. The integrated EPR has supported the LHCH’s digital transformation, enabling it to receive an “Outstanding” CQC rating twice and to achieve HIMSS EMRAM Stage 7 in its latest digital maturity assessment. It is a proven tool that effectively provides clinicians with all the patient information they need at their fingertips through a single tab function on the system.
In a matter of months, Psychology, Altera Digital Health and the trust’s digital team worked together to use Sunrise as a robust foundation and configure the system to meet the unique needs of the psychology service. Today, the service is using the system to manage patient questionnaires, appointments, referrals, discharges and communicate with the MDT.
Discussing the difference the system is making, Dr Alexandra Boughey, Principal Clinical Psychologist – Cystic Fibrosis Service and Operational Lead, said: “With our patient’s psychological notes now managed on the EPR and integrated with the patient’s full medical record we can set up a team of specific users that have access to view the psychological notes. We’re saving so much time from being able to input our notes directly into the system and automatically share with the MDT. It’s been game-changing, when you consider how time consuming the process was before. Previously, we would have to make notes on paper, transcribe them into word documents, file the document and email/visit the wards to update the MDT with our recommendations.”
Joined-up patient information and informed care
Enhanced patient safety and care coordination with the MDT
Improved data collection and reporting
Considerable, far-ranging benefits
Streamlined processes and efficiency savings
Replacing disjointed and outdated processes to manage patient questionnaires, appointments, referrals, discharges and MDT communication with seamless digital workflows has significantly reduced duplication and made substantial efficiency savings.
Joined-up patient information and informed care
With all patient data together in one place, in real time, it’s providing staff with a fuller picture of a patient, supporting all members of the MDT to make more informed care decisions at the point of care. Communication across the trust has radically improved. Psychology staff are able to see confidential psychology records that hold information on past psychological difficulties and any other information not directly related to patients’ conditions. Psychology teams can use the medical record to inform decision-making and the therapy services provided. Staff feel much better supported to closely monitor patients and manage psychological distress.
Enhanced patient safety and care coordination with the MDT
LHCH manages a lot of critically unwell patients and manages 120,602 patient visits every year. This makes the service that the Clinical Health Psychology team provides to the Intensive Therapy Unit (ITU) absolutely vital. The increased risks to patients cared for in the ITU makes an integrated system even more important, supporting the team to manage escalations and monitor patients more effectively with accessible notes and alerts for patients that require mental health support. The risk of losing paper notes and electronic files has also decreased, which is contributing to enhanced patient safety.
Improved data collection and reporting
The solution has been developed in alignment with the teams’ specific KPI reporting requirements to ensure data collection is meaningful. In turn, this has made the process of reporting significantly smoother with everything in a central system and gathered automatically. Previously, reporting was a complex and lengthy exercise to compile limited data from various files saved in multiple locations.
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