UK-Kendal: electronic data management (EDM)

Provision of an electronic document management system (EDMS).
University Hospitals of Morecambe Bay NHS Foundation Trust (UHMB) has a
requirement to procure a provider of an electronic document management
system on either a fully managed service basis or via an internal scanning
Solution supported by existing Trust staff.
Trust profile.
University Hospitals of Morecambe Bay NHS Foundation Trust is a large
acute hospital organisation serving the population of South Cumbria and
North Lancashire. The Trust operates from three main hospital sites, Royal
Lancaster Infirmary (RLI) in Lancaster, Furness General Hospital (FGH) in
Barrow and Westmorland General Hospital (WGH) in Kendal serving a
population of circa 363 000 spread across an area of over 1 000 square
miles.
Each hospital has a range of ‘General Hospital’ services, with full
accident and emergency departments, critical / coronary care units and
consultant led beds at Barrow and Lancaster plus a Primary Care Assessment
Service with GP led inpatient beds in Kendal. All 3 sites provide a range
of planned care, including outpatients, diagnostics, therapies, day case
and inpatient surgery. In addition a range of local outreach services and
diagnostics are provided from a number of community facilities.
The Trust employs approximately 5 000 staff (4 300 WTE’s) and had a total
income in 2010/11 of approximately 254 000 000 GBP.
Activity 2010/11.
Inpatient visits 77 000.
Outpatients visits 400 000.
A&E attendances 90 000.
The Strategic context.
The Trust has recognised that medical records management is an area for
improvement. It has already taken short-term actions following the
external review of medical records.
At present University Hospitals of Morecambe Bay NHS Foundation Trust is
faced with an expanding requirement to manage medical records. There are
specific problems of space to store records, timeliness of delivery and
availability of records across multiple sites.
There is a pressing need to improve the service to clinicians so that they
can be sure that they have access to essential patient information when
they need to, where they need to, in a secure and reliable way. This in
turn will improve services to patients ensuring that those associated with
their care have up-to-date and timely information available throughout the
hospital.
The strategic case for this investment is therefore very strong. It
addresses an immediate clinical and operational requirement, improves
services to the patient, supports the Trusts Informatics strategy and
improves the security and confidentiality of patient records.
The prime drivers for this initiative directly address these
recommendations with respect to the health and safety of Trust staff and
equally importantly the care and safety of patients to whom the Trust
serves. Clinical care and therefore decision making, is only as good as
the information it is informed by. The solutions offered via this
procurement must remove the Trusts reliance on the physical case note and
at the same time improve information coverage, accuracy and clarity
delivered at the point of clinical care.
Scope.
The Trusts Health Records Service (the Service) is currently facing
unsustainable pressures, manifested most visibly in its libraries, which
are packed beyond capacity. The trust has invested in some short term
interim additional storage that will provide adequate case note storage
capacity up to August 2013. This procurement has the fundamental objective
of providing a long term case note management solution through the use of
electronic document management systems capability that will integrate
tightly with the Trusts electronic patient record system (Lorenzo).
Lorenzo ePR phase one deployment went live October 2008 with phase 2,
replacement patient administration capability live in June 2010. The
system is being delivered to UHMB using the national programme for
information technology (NPfIT) local service provider (LSP) contracts,
computer science corporation alliance (CSCA) are responsible for the
Lorenzo deployment project at the Trust. The Lorenzo system is being
deployed within University Hospitals of Morecambe Bay NHS Foundation Trust
as a true clinical portal, providing a one stop shop for clinicians to
access or input any patient information they require through a single
secure log on. Any resultant systems capability offered through this
procurement must adhere to this principle.
This procurement aims to reinforce compliance with the Trusts own medical
records policy objectives by providing:
— Better quality of clinical records - improved patient care,
— Better storage and retrieval of clinical records,
— Improved control of clinical records,
— Compliance with legislation and standards,
— Improved disposal of clinical records and
— Reduced costs.
The Trust requires a significant improvement in the percentage of notes
available at all patient facing events, typically the Trust achieves only
on average 90 %-95 %. The Trust requires 100 % as a result of this
project.
The prime driver for this procurement is the improvement of patient care
in terms of both efficiencies and safety.
The 2 lots described in this OJUE notice aim to give suppliers flexibility
in how they construct a service able to satisfy the Trusts objective,
however the Trust expects to contract with a single prime contractor who
will deliver the full capability required.
The supplier and solution should be compliant with and preferably
certified to the following standards:
— ISO 9001:2008 quality management,
— ISO 27001 information security management,
— ISO 14001:2004 environmental management.
The Trust requires a complete successful deployment of this service by
August 2013.
Key business drivers.
There is a significant organisation devoted to ensuring that the paper
record is kept up to date and is available to those who need to use it.
This includes over 98.7 WTE staff in the medical records and outpatients
department, a proportion of these staff have a dual responsibility for
both the case note management and the outpatient appointment / reception
processes.
This current situation has led to a multitude of problems:
— Existing paper patient notes are often unavailable, difficult to find,
in a poor state or incomplete,
— There can be multiple sets of notes for a patient e.g. main file,
maternity file, physiotherapy file - and some patients even have multiple
main files,
— Staff – including nurses - are duplicating effort (and records) in an
effort to compensate for the problems. This also adds risk as there is no
single ‘version of the truth’,
— It is extremely difficult for anybody to find all information about a
patient with information held on multiple clinical systems,
— Paper notes can only be seen by the person holding them, requiring notes
to be copied for MDTs,
— The end result is a complexity that also contributes to poor data
quality with no ownership,
— The direct cost of managing and administering the paper record is high.
An EDMS solution will enable the Trust to convert paper health records to
an electronic scanned image and then provide networked PC based access to
the information contained in these records across the hospital.
In summary the key business drivers are:
— Poor security of paper health record,
— Cost of maintaining paper files – filing, retrieving, delivering,
culling and destroying,
— Paper files susceptible to fire and flood,
— Storage facilities over-loaded leading to handling problems,
— Pressure on storage space,
— Cost of transporting paper files between sites,
— Duplication and fragmentation of files in several locations,
— Lost and missing files - unavailability of Health Record for
appointments,
— Need to access to stored files when needed - time delays in accessing
paper file,
— Inability to share information over different sites or for multiple
clinic appointments,
— ePR alignment and strategic fit.
CPV: 48613000, 72310000, 79999100, 48329000, 48311100, 48318000.