Achieving a paperless NHS with PCTI Solutions' electronic document management

Jan. 16, 2013 - PRLog -- When patients attend hospital, information on their consultation and any associated outcomes must be delivered to the patient’s GP practice, traditionally this has taken place by the Hospital sending a physical paper letter. In 2010 the NHS introduced a target for all hospitals to deliver their discharge summaries to GP practices within 24 hours, in most cases this was taking several days. A new electronic sending system was introduced to the NHS by PCTI in 2010. This enabled Hospitals to send their letters electronically, immediately following a consultation or discharge, meaning that GP practices received them well within the 24 hours targets.  This innovation enables the NHS to achieve significant cost savings whist providing better and more timely patient care.

Ric Thompson, Managing Director of PCTI Solutions a healthcare software company specialising in helping organisations become paper free “two years ago when the discharge summary target was introduced it was a real driver for Hospital Trusts to look at a more efficient method of transferring patient letters to meet the target, the only real solution was to send electronically.”

For a Trust to meet the target, it would mean moving away from a paper process where letters would be printed, folded into an envelope and moved to a mail room before being transported on to a GP practice to process the paper.

Discharge summaries are only part of the communications between healthcare organisations, this has opened the opportunity for Hospitals to look at transferring all their clinical documents electronically, creating a huge potential for significant time and cost savings.  Other document types include discharge letters, 111 messages, encounter reports, radiology letters and Out-of-Hours reports.

There are now over 75 NHS Hospital Trusts, including the whole of Scotland who have taken PCTI’s electronic document transfer solution to deliver their clinical correspondence electronically and benefit from the associated cost savings.

This solution from PCTI called EDT Hub integrates with secondary care IT systems delivering and in most cases automating the internal processes used to send clinical correspondence to GP practices over the secure NHS N3 network.

This solution provides a real benefit for the GP practices, enabling them to process their daily hospital letters, which for a large practice could be as many as 400 per day.  Previously each letter would have to be handled manually and scanned into a system for processing.  Now they are received electronically with a rich set of demographic and clinical data enabling a safer more efficient way of processing the information.  If the practice is using Docman the GP’s chosen solution for workflow within the practice, even greater levels of automation and savings can be achieved.

The Hub system was implemented at NHS Tayside as part of NHS Scotland’s National deployment. Lesley McLay Chief Operating Officer, NHS Tayside, said “We are now recognising many of the benefits attributed to putting EDT in practice such as improved patient safety, improved patient information quality and cost savings. NHS Tayside is now processing over 150,000 documents a month within 8 document sources ranging from the Out of Hours Episodes, Immediate Discharge Letters and Lab Results.”

Dr Beena Raschkes, GP & Joint Clinical IT Lead NHS Tayside "EDT has made a huge difference. Letters arrive promptly, are legible, complete , clear, concise, contain much more useful information, do not get lost either in the hospital or the practice , and most importantly it has radically improved patient care and communication about the patient and the care they have received and need and medication changes "

“The most powerful example was an elderly lady being discharged home with multiple medications. Her Daughter was very concerned as her mother had a poor memory, and needed a prompt to take medication. The discharge letter was sent through EDT at lunchtime, I spoke to the daughter later that afternoon, rationalised her medication, issued a script, pharmacy collected it that afternoon and the drugs were delivered the next morning. With the old paper discharge letter we probably would never have received it, and it would still be in her handbag, on her mantelpiece!”

University Hospitals Birmingham NHS Foundation Trust recently documented their savings, Dean Grinham, IT Head of Programme Delivery “The cost of sending paper to GP practices at a minimum is 50p per item, without taking into account paper, envelopes, printing, and the time to do this process means that the Trust could save a minimum of £10,000 each month.”

“We have a process in place so that before a patient is discharged, the discharge letter must be completed. Some practices in the area are collecting from the Hub every 15 minutes; this means that a GP could be reading the patient letter before the patient has even reached the lift to exit the Hospital.”

Thomas Horton, GP Liaison Manager, Royal Free NHS Foundation Trust “Feedback from practices is that they love the Hub and want to receive everything through this way. The next phase of the project will be to increase the range of clinical correspondence we send through the Hub. The time taken for delivery can make a considerable difference, until the GP receives the letter; patient care is effectively put on hold.”

“The obvious benefits are that the Hub removes the need to print letters and documents are delivered within a good time frame. Our aim is to get as many practices connected to the Hub as possible and to deliver many more documents through it.”

Úna Rice, Project Manager, Informatics Strategy and Programmes, NHS Buckinghamshire and Oxfordshire Cluster “We chose to use the EDT Hub for the 111 service as it was already central to our transfer of information strategy in Oxfordshire.  Our practices were already using it to receive discharge and A&E summaries from the Oxford University Hospitals Trust so the infrastructure was already in place and in use.  We wanted 111 messaging to fit in with that strategy.  

The Greater Manchester (GM) health economy consisting of 10 Hospital Trusts serving 2.8 million patients across 450 GP practices have signed a contract for up to 5 years with PCTI to deliver the EDT Hub electronic document transfer solution.  This solution will be responsible for sending in excess of 5 million electronic items of clinical correspondence each year providing massive savings across the health economy.

Howard Gray, Chair of the GM ECC Programme Board said, “This is a strategic landmark for Greater Manchester, and builds on the strong partnership and collaboration we have with our NHS organisations across the region.  This project will provide a higher quality service for the patient and also deliver tangible financial benefits.  We see this project as the start and are excited by where we can take this in the future.”

The benefits of sending electronic clinical correspondence are well documented and include patient safety, improved efficiency of delivery timescales and staff processing time, improved patient experience and significant cost savings.  The cost savings alone across the GM community of Trusts are expected to well exceed £1,000,000 and this excludes the savings that will be made by GP practices.

Dr John Hampson, Greenmount Medical Centre, Bury commented “Receiving documents electronically will play a significant role in delivering integrated care to the highest standards. The solution means that I can have access to patient letters immediately after they are produced, with the knowledge that they have arrived through a secure, auditable system. Improved speed of access to information and the efficiency savings enables us to have a streamlined and efficient back office. This is especially important as demands on administrative staff and GPs are exponentially increasing.”