Overview

Healthcare Innovation Consortium (HIC) conducted an extensive piece of discovery on behalf of Cambridgeshire and Peterborough Integrated Care System (ICS) to explore Electronic Patient Record (EPR) renewal and procurement options. 

This was an important, strategic deliverable for the ICS and their acute trusts, which required our support to help them understand the true picture of financial envelopes available to the ecosystem, procurement, contractual and legal implications, and the most appropriate way to proceed given the mixed economy of EPR implementation. Extensive engagement with the ICS, trusts and NHS England regional teams took place to capture and understand their EPR barriers, challenges, and opportunities. 

From April – September 2023, HIC collaborated with the trusts in the ICS to understand the commercial, procurement, clinical and financial options and to enable informed decisions at a trust level. 

 

About the ICS

C&P ICS is a partnership of health and care organisations, local councils, and Voluntary, Community and Social Enterprise (VCSE) that aims to improve the health and wellbeing for around one million people in the region. The ICS hosts three trusts: Royal Papworth Hospital; Cambridge University Hospitals; and North West Anglia NHS Foundation Trust.

The trusts operated with a diverse range of patient records, including one ready for renewal, another with an established EPR, and the third still relying on paper patient records. This introduced a level of complexity, particularly when assessing the pros and cons associated with a single EPR vs a hybrid approach. 

 

Challenges

The diverse trusts, with varying EPR solutions, needed a unified way forward – and one that worked in the interests of the trusts and the ICS and wider ecosystem too. With this came challenges that included: 

Doctor types in notes to an electronic patient records
  • Reaching consensus on a strategic option that aligns with the requirements of individual trusts and the overarching ICS 
  • Identifying financial limitations and insufficient capital, to determine the practical affordability for the ICS when procuring EPR capability  
  • Functionalities required by the trusts to achieve a higher HIMMS Level, while considering that each trust was at a different level 
  • Establishing standardisation in clinical practice to facilitate the seamless flow of data across clinical services, pathways, and various EPR systems 
  • Addressing unwarranted variation in EPRs, which introduced complexity and led to increased downstream configuration and maintenance costs 
  • A prompt decision to move forward with the renewal and procurement processes.  

 

Solutions

Over the five-month period, HIC worked extensively by: 

  • Collaborating with the ICS and trusts to identify a long list of seven, which was reduced to a final shortlist of three options through a rigorous process of evaluation and weighted scoring 
  • Researching and presenting estimated costs of each option and identifying the funding gaps
  • Presenting a final report and complementary artefacts with an indication of the costs and a high-level view of gaps between these and what is currently affordable for each trust. 

Clear governance with delegated authority experts was suggested and mobilised post project to move forward with the procurement process. 

 

Outputs

Following stakeholder engagement and in-depth market analysis and intelligence, the ICS, and the individual trusts, received a bespoke options appraisal and financial analysis. Our work was able to provide a fresh lens on the options available to the system, taking a long list of options into a shorter, more informed, and thought-out list – which in turn informed local trust board thinking and decisions on how best to proceed. 

HIC produced the following artefacts to support the Options Appraisal process: 

A list of the artefacts including stakeholder insights report, EPR product review, EPR landscape review, and Financial Appraisal

 

Benefits

The exploration of Cambridgeshire and Peterborough EPR renewal and procurement allowed the ICS to understand their landscape and provided financial clarity. It has enabled them to make informed decisions based on their clinical, commercial, and operational interests and promised a strategic pathway forward.

This discovery has enabled the trust boards and ICS central team to work together to proceed with a regional solution, as opposed to working in silos. It has brought key stakeholders together, including brokering a relationship with NHS England, and provided strategic oversight of what would work best for them. As all trusts aim for full EPR adoption by March 2025, it is important that EPR discovery is undertaken at the outset to set them up for a successful implementation.

If you are part of an ICS or trust and wish to explore how HIC can assist you in EPR discovery, implementation, and achieving success, please fill out the online form or schedule a meeting to discuss. 

 

 

Want to read more about EPRs? Take a look at our EPR blog series: How to decide the right EPR for your staff and patients.