Health records management – do not leap into digital before looking closely at your physical records

Stefan Chetty (pictured), Director of Public Sector Services at Restore Records Management shares the following insight with Hospital Hub…

NHS hospitals are always extremely busy places, and even more so during a pandemic. The activity figures are remarkable: in 2018-19 there were 123.4 million outpatient appointments. The number of appointments is rising and there was an increase of over 50% between 2008-09 and 2018-19, so managing patient records in the most efficient way is now more critical than ever.

Managing patient records is a vital part of the overall running of a hospital. Often an unnoticed function, a Health Records department (whether internal or outsourced) can have a significant impact on the overall efficiency of a hospital by providing timely and accurate information to clinicians and admin staff.

Over several decades, Restore records management has developed and refined its systems to ensure NHS hospital customers receive a highly responsive and efficient service providing 24/7 support for the various departments and clinics within the organisation.

When we start work on assisting an NHS hospital we are sometimes asked if we can digitise the process immediately. We advise against this for several reasons:

• Digitising large numbers of patient records can be very expensive.
• Digitising everything is usually not necessary and could result in expensive storage of unwanted or outdated data.
• Going digital should be part of the hospital’s overall records management strategy and be carefully factored into the wider picture (for example the hospital might merge with another to create a larger Trust and different record management systems will need to be coordinated and eventually merged)
• Culture change, robust supporting processes, and the appropriate technology (a platform to access and view the records) need to be bedded in within a hospital before digitisation of paper documents commences.
• Depending upon where the Trust is in their journey, digitisation of paper documents may not be required for a transition to a digital solution.

Please click the link here to see the typical journey for an NHS record that is managed by one of our specialist teams. Although it looks simple the system is designed to track and monitor at all stages of the journey and keep records moving securely and efficiently. Restore work with each Trust over time to build an optimal digital solution that is tailored to their specific requirements.

When managing records, one of our priorities is to ensure we track the record in terms of its location in the hospital. Knowing where a record sits in the organisation after the appointment is completed allows us to retrieve it quickly and to return it back to our secure record centre as soon as possible. There may be occasions when a patient may be seeing several clinicians over a short period and retention of patient files longer than necessary within clinical areas can cause issues.  Restore’s systems identify future requirements and maximise the availability of records for these appointments.

Another key priority is to ensure the record is up to date. For example, a clinician may make some loose notes which are not attached to the main file (for example a referral letter) or even open a new temporary notes file as they are unable to locate the main record. Again, our systems ensure we track these changes and consolidate the notes back into a single file.

Response times are also important for patient notes in a busy hospital which is why we operate a 24/7 service so that admin and clinical staff can order files for delivery the next day or, in some case the same day for urgent requirements. We are linked to NHS Patient Admin Systems (PAS) in the hospital and of course security and compliance are essential to everything we do.

When we start a contract with a new NHS hospital customer, we spend time to agree the service levels we will deliver, mapping out all processes, touch points and delivery locations within the hospital. While we have considerable experience of working with NHS hospitals, they will all have individual needs and their own procedures, so it is important that we fully understand the requirements of the staff and deliver accordingly.

In most instances we deliver physical files to the specific clinic or consulting area and then collect to an agreed schedule. Our specialist team make it their priority to understand the physical layout of the hospital and the detailed requirements of each clinical and admin team. We are typically seen as an integral part of the overall hospital team and in fact this was demonstrated recently during the pandemic when Restore staff helped during very busy times to give directions to visitors and ensure that people adhered to the COVID-19 guidance.

During our discussions with our existing NHS hospital customers, we find some key themes that arise consistently:

• Having a well-controlled and tailored records management system contributes significantly to the overall efficiency of the hospital.
• Our ongoing audit process provides reassurance on compliance for clinical and corporate governance.
• Our security systems and protocols for handling patient records ensure that hospitals are compliant with all necessary data protection legislation.

A key priority for the NHS is digital transformation, and, in some instances, this has started to happen.

However, our research shows that over 50% of Trusts have yet to materially commence their digital transition. It is evident there are still several physical inputs to the health records solution that need to be fully considered if this change is going to be managed effectively for those that are at the early stages of this journey.

Using our understanding of physical and digital records management practices, Restore offers free of charge consultancy services, including a gap analysis and strategic alignment, to create a clear, bespoke, phased digital transformation plan for each Trust.

For further information on how Restore can help with NHS records management call 03301 626 697 or email [email protected].