While fundamentally an electronic patient record is a digital repository of information, such systems might also hold the promise of greater transformation – if the right conditions are in place

An electronic patient record is, says Phil Britt, an important asset. Mr Britt is programme director of Tomorrow’s NUH at Nottingham University Hospitals Trust – the organisation’s plan to develop its services and meet future need – and recognises the value of a digital rather than paper repository of information. But he also sees much greater potential in such systems.

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“For me, there’s how do we then maximise the innovation and transformation potential of our EPR. How do we make it not just a repository of information? For example, how does it enable clinical decision making on the ground by automating and connecting other systems? And then how do we use our EPR for longer-term planning and future decision making, so it is a management tool as much it is a clinical decision making tool.”

That includes consideration, he says, of how the trust’s EPR might support communication with other partners across an integrated care system – including sharing information to better plan services and meet patient need.

In other words: how might the aggregated data from an EPR be used in a different way, to yield benefit across a whole patient population rather than just for one individual. “There’s really interesting things for me about the potential of a well embedded EPR, designed by our clinical teams.”

In the current climate, Mr Britt recognises that clinical involvement in planning for the future is a challenge. “Having a core set of clinicians and operational people who are working with you on this journey is really essential. I can’t sit in a darkened room and come up with a digital plan for the Tomorrow’s NUH programme, because that plan has to be designed around our clinicians’ needs, so I need our clinicians there.

“If you’ve got that core group of people, that really helps you develop the story and the narrative about how we’re going to get to that end point. And that’s been a challenge just because of covid. If I’m completely honest, it’s been two years of not really being able to do it as fully as we would like. But we’ve all been in the same boat [across the NHS].

“We continue to push it forward, and actually as we now move into this kind of next phase of how we work as organisations, then we’re going to be able to do it more.”

Seeing digitisation as part of a bigger picture