How to Achieve Credibility in NHS Open Source IT Projects

Taunton and Somerset NHS Foundation Trust’s clinical lead for electronic patient records explains how clinical engagement has helped make EPR an open source success.

Anyone who knows me will know I am not very good with computers. Which may make me seem a curious choice to lead clinical engagement in an important IT implementation for our trust. Two years ago I took a step back from clinical practice as a consultant physician at Taunton and Somerset NHS Foundation Trust to work as chief clinical information officer and clinical lead for the implementation of an open source electronic patient record (EPR) system across the wards and departments of the trust’s Musgrove Park hospital. It is fair to say that to date it has been a success, largely due to good clinical, nursing and wider staff engagement.

It had been eight years since our previous system had been implemented, and we needed a new IT system that would support the work processes and patient flows in the NHS – the physiology of the hospital if you like. It would also need to improve the speed of access to medical records by eliminating the physical movement of paper notes. Many doctors in the hospital, like everywhere, have an instinctive distrust of IT based on a long track record of poor IT implementations in the NHS. That’s where having a clinical lead who is clinically credible, but not tech-savvy comes in. They knew that if I thought the software was clinically fit for purpose and easy to use, then it most surely would be the same for them.

Clinicians were involved from the very beginning of our procurement process when we invited shortlisted suppliers to demonstrate their systems at an event with an open invitation for as many clinicians to attend as possible. Many came to score the systems, with their input contributing to the final choice of provider. We were the first NHS trust to opt for an open source EPR from IMS Maxims, where £45m of software development is freely available and open to further development through collaboration with the healthcare community and the supplier...