Electronic Health Records

Adoption & Implementation News

UK Hospitals See EHR Implementation, Data Transfer Issues

A new EHR implementation results in major appointment scheduling issues and a 20,000 person increase on a UK hospital waitlist.

By Sara Heath

An EHR implementation has introduced hospitals in the United Kingdom to a considerable number of complications, according to a Hull Daily Mail article.

ehr implementation scheduling issues

After the East Yorkshire Hospitals NHS Trust installed its new Lorenzo electronic personal record (the British version of an American EHR), there was a considerable lag in transferring some of the electronic health information, including in appointment scheduling.

What resulted was nearly 20,000 patients being given only one day’s notice before an outpatient appointment.

According to Hull Daily Mail, the switch over to Lorenzo involved the transition of nearly 100 million records, causing this lag in the electronic scheduling systems and the appointment issues. There was also reportedly a waitlist increase of from nearly 40,000 patients to 60,000 patients.

Despite these reported scheduling issues due to the EHR switch, representatives from the East Yorkshire Hospitals NHS Trust confirmed that no core clinical data had been lost during the transition. The trust also reports that it is doing a review of all patient information to ensure that no further information is missing.

Since the initial implementation and subsequent scheduling problems, hospitals within the trust have been able to better adjust to the change.

“As staff are becoming more familiar, this number is starting to come down as they are able to process changes more quickly and accurately,” said IT manager Martyn Smith. “We appreciate staff will have had their fair share of frustrations as they get used to something new, but people are getting quicker and more proficient in its use.”

The trust, which includes affected hospitals such as Hull Royal Infirmary and Castle Hill Hospital, is reportedly taking other measures to alleviate the stress of the EHR implementation, such as setting up IT teams to handle urgent complications, operating one-on-one training sessions for staff, and setting up hands-on employee training with IT professionals.

The trust announced it would adopt Lorenzo in the middle of 2015, agreeing upon a 10-year contract with the vendor. According to a document released by the trust Board, the implementation was intended to be completed in two phases, with the first being completed by summer of 2016.

The trust adopted Lorenzo to replace its 20-year-old EHR system and to join the rest of the UK in transitioning to entirely paperless health records.

Other hospital trusts in the UK have also had trouble with their EHR implementations. In September of 2016, hospitals in the Cambridge University Hospitals Trust encountered issues with their Epic EHR implementation.

Following their EHR adoption, Addenbrooke’s and the Rose Birth Centre received a low grade for patient safety from the government’s Care Quality Commission (CQC). According to the CQC report, the hospital’s Epic installation may have had something to do with the poor rating:

  • Introducing the new EPIC IT system for clinical records had affected the trust’s ability to report, highlight and take action on data collected on the system. Although it was beginning to be embedded into practice, it was still having an impact on patient care and relationships with external professionals.

  • Medicines were not always prescribed correctly due to limitations of EPIC, although we were assured this was being remedied.

Although the CQC report continued to cite several areas where the Epic EHR fell short in protecting patient safety, it did also indicate that there were other contributing factors, such as the hospital’s environment, to the low grade.

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