Great Ormond Street Hospital
Leading pediatric hospital streamlines clinical workflows and improves the patient experience by digitizing consent forms and signature capture.
Great Ormond Street Hospital (GOSH) is one of the world’s leading children’s hospitals. With research partner UCL Great Ormond Street Institute of Child Health, GOSH hosts the United Kingdom’s only pediatric National Institute for Health Research Biomedical Research Centre.
GOSH receives more than 240,000 outpatient visits and 42,000 inpatient visits per year. Most patients are referred from other hospitals throughout the U.K. and overseas. GOSH provides the U.K.’s widest range of specialist health services for children at one site, with more than 60 different clinical specialties.
The challenge
GOSH needed to upgrade its out-of-date digital infrastructure, since some systems were at the end of their effective lives. The electronic patient record (EPR) and imaging systems were at the heart of its strategy.
“You don’t have a complete EPR unless it includes medical images of the patient,” said Dr. Shankar Sridharan, chief clinical information officer at GOSH. “We wanted to ensure our EPR provided access to pictures from both visible light and DICOM sources. Our main motivation was quality of clinical care.”
The solution
GOSH utilizes Hyland’s OnBase platform, integrated tightly with its Epic EPR. The Hyland solution seemed to be the obvious choice, in part because Hyland integrates with more than 30 Epic modules.
“We wanted more than just a document store,” said Christopher Jephson, a consultant pediatric ENT surgeon at GOSH. “We also looked at additional capabilities such as form writing, which we wanted to use to develop an e-consent system.”
In a children’s hospital, a consent form may require many signatures, including those from the patient, parents, a social worker and a language interpreter.
GOSH had some prior experience with medical image management, having installed a VNA.
“The VNA provided us with added control over most diagnostic images, but we soon realized that adding document images and clinical photographs to the mix was also necessary to truly complete the patient picture,” said Simon Hadley, head of clinical digital content at GOSH. “At the time, few vendors handled both.”
OnBase has been beyond fabulous, though 90% of hospital staff have no idea that OnBase is being used. They think it is all in our EPR.
— Dr. Shankar Sridharan, Chief Clinical Information Officer, GOSH
The difference
Improvements across the board: The imaging systems were incorporated into the EPR project. Since the hospital went live with this consolidated content management, imaging and EPR solution, staff have noticed a significant reduction in the time doctors spend looking for notes and other information. The increased access has produced improvements in the quality of care and productivity, as less time is wasted.
“OnBase has been beyond fabulous, though 90% of hospital staff have no idea that OnBase is being used,” Dr. Sridharan said. “They think it is all in our EPR.”
Complete workflows: The implementation strategy was to “go an inch deep and a mile wide,” quickly enabling as many departments as possible to begin using the system. The strategy was designed to create complete workflows that could then be deepened as the enterprise collectively gained experience and understanding of the systems’ capabilities. GOSH also believed it was the best way to avoid simply recreating yesterday’s workflows for tomorrow.
The most precious commodity — time: Saving time has been a consistent theme.
“The most valuable resource in a hospital like ours is the clinician’s time,” Jephson said. “Time not spent looking for information is time we can spend with patients.”
Customized solution streamlines access: GOSH furthered its collaboration with Hyland by creating Mind Palace, a customized solution that expanded its Hyland Healthcare product suite. The solution is designed to capture and manage clinical guidelines, policies and procedures that integrate with OnBase.
Mind Palace provides real-time access to documents in GOSH’s large digital footprint. The solution features faceted navigation, conversational search, natural language support and other intuitive elements that enhance clinical productivity and patient outcomes.
Mind Palace pairs the capabilities of OnBase with Enterprise Search to increase search flexibility, reduce search times, and support compliance and government requirements.
“At GOSH, we care for children and young people with the most complex and serious health conditions, and their care can span across many specialty areas,” Dr. Sridharan said. “For our staff to deliver gold-standard care, we need secure, easy and rapid access to information within vast clinical guidelines. The Mind Palace knowledge base acts as a complementary force to our electronic health record and will enable us to deliver better care.”