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Sooraj Shah

Contributing Editor

Sooraj Shah is Contributing Editor of New Statesman Tech with a focus on C-level IT leader interviews. He is also a freelance technology journalist.

How Covid-19 has sped up digital transformation at Bolton NHS Foundation Trust

Phillipa Winter began her role at Bolton NHS Foundation Trust back in 1998, and worked her way up to become chief clinical informatics officer in August 2014 and then chief information officer in July 2016.

There had been a digital strategy in place when Winter got the CIO role, but she looked to refresh it as it was a five to ten year strategy which was no longer fit-for-purpose, considering that technology is advancing so quickly. To combat this, Winter wanted to put in place a two-year approach that could be constantly reviewed.

“We’ve just completed most of that strategy and I’m now rewriting our future strategy because most of the elements of the previous strategy we’ve already delivered, which is great,” she tells NS Tech.

One of the ongoing projects preceding Winter’s time as CIO was an ambition to bring in a new Electronic Patient Record (EPR) system, and under her role as CIO, she managed to get the green light for opting to use Allscripts’ Sunrise Acute Care system. Allscripts had been a supplier to the trust prior to the EPR selection, and this played a part in the decision. The trust did look at some open source solutions, but Winter says that these were very new and immature four or five years ago when the trust first started looking into solutions. Another key reason Sunrise was selected was because Bolton NHS Foundation Trust’s bordering partner hospitals in Salford and Wigan were also using the same product.

“It was really important to look at how we can interoperate with those hospitals, with the future for the health of our citizens locally and how we can manage those pathways better,” she states.

The organisation went live with the first phase of the EPR, which was for all clinical documentation orders and referrals.

“It was a big ask for us to do because we were quite an immature organisation but we’ve done that successfully for phase one,” she states.

The trust has been able to retain its third-party patient administration system, and is wrapping the Sunrise Acute Care clinical functionality around it. Bolton’s emergency department is now using Sunrise for electronic prescribing and order communications, while its wards are live with e-prescribing, order communications, clinical documentation and Sunrise Mobile.

In regards to return-on-investment (ROI), it’s still too early to tell, as the organisation is just over six months into deployment but the trust has set up a benefits realisation group which is going to be owned and run in the organisation by the operational team.

“They’re going to be driving out the savings, not IT team, so it’s really key that the ROI and those benefits are driven by the operational and clinical departments,” Winter explains.

Early benefits of the deployment have included the ability to extract information easily which improves patient safety – the staff now have a clearer overview of patient treatment and care –  and the ability to understand more around medicine management as a result of automation within the system. These will both have an impact on ROI in the future.

An external consultant is also set to come in to look at the lessons learnt from the implementation and what the trust could have done better in a few months.

Covid-19 means change of plan

While long-term plans are ongoing including with its EPR, there has been some other necessary technology changes in response to the pandemic. Winter explains that the organisation has made its unified communications more accessible, so that virtual conferencing is enabled for all of its staff. This is especially important as the trust has enabled the CCG, GPs and over 800 staff – who normally work in a health setting – to work from home.

In addition, the trust has implemented the NHS Offer of Attend Anywhere across specialities in a two week sprint to support virtual clinics including dermatology, rheumatology, ophthalmology, respiratory, audiology and community nurses.

As well as this, Winter explains that the trust has enabled an ‘email letter to your loved one’ option and devices for certain types of patients.

“The email option supports families sending letters to their relatives at times when they are unable to visit or comfort their loved ones, and the devices allow families to contact their relatives to have virtual calls in palliative and COVID areas,” she says.

The future strategy

Winter says that artificial intelligence will play a crucial part in the organisation’s future strategy.

“I was having discussions with radiology about AI. AI would also play a big part in some of the back office services such as finance, HR, appointments. It’s important to look at getting to a solid state in some of the foundation processes with AI, and this will support some of our difficulties in the future with the workforce we’re faced with,” she says.

Winter has also been working with the trust to see if it can implement chatbots to support management of health and wellbeing of certain chronic conditions in the community. These are just some of the areas that Winter and her team have been focusing on, but with the constant reviews of strategy, there’s likely to be a lot more to come – in the meantime, the trust is doing its best support the government guidelines during the pandemic, with more home working, virtual clinics and assessments, and social distancing all being used.