This is Part 3 of our 3 Part Project Spotlight featuring Calderdale & Huddersfield Foundation Trust (CHFT) in the United Kingdom. The HCI Group played an instrumental role in supporting this large Cerner implementation. Part 3 features CHFT Managing Director of Digital Health, Mandy Griffin's perspective one of the most successful EPR Implementations to date in Europe.Bradford Teaching Hospitals and Calderdale and Huddersfield are working together to improve healthcare across the north of England through a new joint electronic patient record. Professor Clive Kay, Chief Executive at Bradford Teaching Hospitals, told Digital Health News the deployment represented “the largest deployment of an EPR system by Cerner in Europe to date – and we have been told it has been one of the most successful”.
The following is a full transcription of the video interview with CHFT Managing Director of Digital Health, Mandy Griffin.
One of the stated goals of the programme was to achieve EMRAM Level 6 by Go-Live. How do you view your overall level of wired, especially compared to other UK Trusts?
I’m the Managing Director of Digital Health for the Trust where I have some responsibility for the Trust, as well as The Health Informatics Service and as part of that role, I became the IT lead for the EPR Programme. We have had quite a speedy digital transformation over the last two years, and that probably started 12 months before we started to build the EPR. We have always had our sights on the stage 6 and yes, it was part of our ambition let’s say, to become a stage 6 at go-live. Looking back that would have been really difficult to achieve so what I have done since, I have done a gap analysis and the Trust came in at a score around 4.5 which sounds like a massive gap from a 6 but actually it is just two areas. We had started our digital journey by looking at different clinical and non-clinical systems, so two years before the programme we started to scan notes so that we used an electronic document management system, so we were slowly getting our staff and workforce used to accessing information through technology, rather than pieces of paper. We also introduced a number of other systems to again grow the digital maturity of the Trust and the people because it is really important when you do a big project like this, that you take people with you. We introduced Vital Signs by Nervecentre, which meant that literally every clinical person in the Trust needed to be able to use technology to care for the patients and we then introduced a maternity system, and a theatre system. These were all precursors to the bigger project around EPR, but they were all part of our journey around engaging workforce and technology.
Did you do any infrastructure work to support this initial work?
Oh, absolutely. So before we actually even started to deploy these clinical systems we did a whole infrastructure refresh, and that included WiFi enabled hospitals - both sites. We knew we couldn’t deploy clinical systems without getting a really good infrastructure in place. You need the foundations, otherwise no matter how good the product is, it is not going to work without a good infrastructure behind it, so that was the year before even the tacticals started.
Which elements of HCI’s culture did you find yourself bringing back in to the Trust and which elements of CHFT’s culture did the HCI contractors need to take on themselves?
I am a great believer in spending time with the people that work for you and I think the CHFT culture is very inclusive, and I believe my role was to make the HCI team feel like they work for CHFT, and so working with them was no different to working with a CHFT colleague. I think we did a good job of that, and I didn’t see any resistance from HCI, I think most of the people that worked on the project, who came from HCI didn’t feel they were contractors or had hoped they wouldn’t feel, because we spent a lot of time trying to work with them so as an exec I could have an office in Trust headquarters and sit behind a desk in front of a computer every day but that wouldn’t be the way I would manage a project like this. I would be right in amongst it, accessible.
How was the HCI team able to learn and work within the CHFT culture that you run?
I mean I must admit it was the first time I had come across HCI, and actually it was the first time I had done anything on such a big scale when it came to employing so many contractors to complement the skill base that we already had in the Trust, so for me I would have been looking at that point for some maybe supporting advice, to do the right thing, and I think that was there from memory because it is almost two years ago. The response to our resourcing was quick, and it seemed to me that HCI did have a large pool of skills to pull from’.
It has been called the most successful Go-Live in Europe. What was HCI’s contribution to this from your perspective?
HCI held the right skill mix for what we needed so that helped towards a successful go-live. They were responsive as in you used to often ring and say, ‘I need somebody for the patient administration system,’ or, ‘I need somebody with some specific data migration skills’ and I always felt there was responsiveness towards that. In hindsight we were firefighting a little bit and maybe there was that sort of preamble of understanding what was coming and having a little bit more time to do that might have made things happen smoother. Without having these skills as part of the programme, it wouldn’t have been a success. Something like this cannot be delivered by pure Trust staff, it would be almost impossible.
Who have never done it before?
Who have never done it before, never touched the product before so having that skill base, which we clearly had did actually contribute to successes, there is no way of getting around that, that did help.