Background

The NHS is fast approaching the 20-year anniversary of the contract awarded under the original NHS National Programme for IT (NPfIT) which provides a timely point to assess where we are in regard to EPR (and indeed any technology) best practices. In the last two decades, we have seen dozens of separate initiatives, schemes, funding allocations and white papers come and go, but some fundamental issues still exist with how EPRs are procured and rolled out. Take for example this review of the implementation of the NPfIT systems:

“The implementation featured some successes with elements of the programme that were on schedule and functioning well, however it was also marked by missed deadlines, unreliable software and a lack of engagement with end-users particularly heath (sic)-professionals and patients”.

Does this sound familiar even now? How many instances of EPR deployments even in the last few years have suffered the same issues? And is there any understanding, nationally or regionally, of the missed benefits due to procurements and implementations being delayed significantly? As it stands, we are still falling into some of the same traps encountered at the turn of this millennium.

Implementation in the UK

There is no perfect best practice to procuring and deploying any technology system in healthcare but there are several instructive pointers that underpin why there are still struggles and why timelines end up being so tortuous. The following end up being at least part of the reason why deployments can take 4, 5, 6 years rather than much sooner. The most important ones we feel are system flexibility, UK experience and knowledge and the right project personnel.

System Flexibility
Every institution that is deploying an EPR will be different: different clinical workflows, workforce characteristics, local variations and pre-existing systems and levels of digital maturity. A one-size-fits-all, top-down approach is not an effective way to capture the nuances of the institution and how best to fit the technology around the users, not the other way around. Ensuring an EPR can be flexible with other systems and can be configured to local requirements and workflows is essential to quick, safe and effective rollouts.

UK Experience and Knowledge
Every vendor and deploying organisation will have standard operating procedures on how to move projects forward in a timely manner. But what if those procedures are based on cookie-cutter processes originally developed outside of the UK? Understanding and empathising with the UK and NHS-specific challenges is key to ensuring the benefits identification and realisation piece is as smooth as possible.

Project Personnel 
Any EPR implementation’s success is proportional to the experience and quality of the personnel managing it. Vendor staff must have a granular understanding of the NHS culture, policies, stakeholders and best practices and be there for the long run as EPR deployments generate benefits over years and decades not just weeks or months. If your deployment team disappears back to their country of origin or is reassigned to the next deployment in their backlog, then gaining the true benefits of any EPR will suffer.

How MAXIMS can help

At IMS MAXIMS we believe we can offer leading EPR quality and best-in-class outcomes, while at the same time offering a dynamic, flexible rollout that ensures benefits are realised much quicker than traditional, slow-moving competitors. This time to deployment is rarely mentioned in business cases but could end up with several years’ worth of extra benefits, ensuring the return on investment is much more solid. We pride ourselves in being able to take customers from initial conversations or contract signatures to initial go-lives months or even years before others. The reason we can do this stems from our corporate best practices.

UK and NHS Expertise and Focus
All of our team focused on UK project management, benefits realisation and deployments is based in the UK. We have operated in the UK market for decades now and understand all the local and national best practices and customer nuances.

A Dynamic Team
That local experience and base allows us to move much quicker when it comes to deployments. Our agile, iterative development processes allow local flexibility and variations much quicker than usual, meaning we are not beholden to US or European headquarters’ developer schedules and priorities. Our customer-facing team is there with you for the long run, ensuring no loss of efficiency due to other customer priorities, or changing project management teams – the personal connection we establish with our customers is key to this.

How does this manifest?
What these personnel, processes and knowledge sets ensure is that we can get our customers to a point of realising benefits much quicker than many others. Rather than waiting up to (or even more than) 5 years from initial conversations to deployment, we can enact full go-lives well within 18 months. The output of this is an extra 2, 3, or more years of benefits compared to other suppliers. If your business case has a 10-year horizon on it, this may mean an extra benefit haul of 20-30% with us by the same end point.

The foundation of the success of the project so far has been IMS MAXIMS ability to collaborate with Jersey’s team and to adapt to their deployment requirements as the project proceeded.

Despite only signing the contract in October 2021, IMS MAXIMS has been able to migrate over 25 million records in just over 14 months. We were also able to provide bespoke functionality that met the Jersey’s unique requirements. This speed of configuration and adaptability we believe is unmatched in the market and allowed even further tailoring of the solution to Jersey’s needs with no appreciable impact on go-live times. As the time to deployment was so rapid, Jersey will start realising benefits much sooner than traditional legacy deployments.