Bio: Stuart Miller serves as Managing Director for Allscripts in Europe, where he is responsible for leading the company’s operations across that regional territory. He is based in our European headquarters in Manchester, United Kingdom. Born and raised in Scotland, Mr. Miller originally trained as a registered nurse in the United Kingdom. He worked for 14 years in the National Health Service in a variety of clinical and managerial roles across a range of care settings. In 1996, Mr. Miller transitioned to work for a leading UK healthcare IT company in sales support and sales roles. He then moved to the United States with his family in July 2002 to work for Allscripts, formerly Eclipsys. During his time with the company, he has worked in progressively more complex roles in sales and business development. Since 2011, Mr. Miller has led Allscripts’ re-entry and sales activities in the UK healthcare IT space. This resulted in the addition of new clients who have deployed Allscripts solutions at Liverpool Heart and Chest Hospital Foundation Trust and Salford Royal NHS Foundation Trust.
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When Salford Royal NHS Foundation Trust, located in Salford, United Kingdom, received funding to go semi-mobile in its wards, the organization partnered with Allscripts to help bring the project to life. The effort required a very rapid development timeline, with the project beginning and launching in less than 9 months.
Salford Royal has been using an EPR for more than 10 years, and implemented Sunrise™ Acute Care (formerly known as Sunrise Clinical Manager) in June of 2013, so clinicians were familiar with the multitude of benefits that come with going paperless.
But Salford Royal needed a flexible, cutting-edge system it could tailor to meet the needs of its patients and clinicians, helping reach the organization’s goal of becoming the safest hospital in the country. Allscripts worked hand-in-hand with Salford Royal throughout the duration of the process to bring its vision to life.
Since going semi-mobile in its wards, Salford Royal has seen countless benefits. Successes include a reduction time in ward rounds, accurate timing in all entries and an increase in compliance throughout the hospital. The organization now has a better, more well-organized system, with improved auditing capabilities and the ability to review patients anytime and anywhere.
The organization has also seen substantial improvements in how it measures and manages Early Warning Scores (EWS). In the U.K., EWS help detect patients that may require intervention. The score is a composite number based off of blood pressure, heart rate, respiratory rate and body temperature, as well as other measurements.
This mobile project has digitalized a number of EWS, so hospital staff can now work in real time. The organization estimates that, when calculated on paper, 40% of the EWS are incorrect. With a computerized process, EWS are much more accurate. The new system has also provided many local enhancements – including enhanced oxygen scores and documentation of oxygen therapy – that are superior to the National EWS system.
The mobile project also uses existing Sunrise functionality, and enables clinicians to place orders that can adjust the EWS calculations. This creates a patient-specific EWS and reduces false-positive alerts for patients with known conditions.
This project succeeded because of the strong partnership between Allscripts and one of our world-class clients. Allscripts has the resources to work innovatively and rapidly with clients to provide great clinical outcomes, and to improve the health and success of an organization across the board.
If there’s a power outage to the hospital’s main server room, bad things can happen to good people. Massive disruption can ensue for IT, clinicians and ultimately patients.
To help minimise the potential effects of server disruption, Liverpool Heart and Chest Hospital NHS Foundation Trust (LHCH) (Liverpool, Merseyside, United Kingdom) recently improved its approach to disaster recovery.
Taking a new approach
LHCH is a high-achieving specialist hospital that decided to transform from paper to electronic patient records (EPRs)*. Over the course of 14 months, the organisation completed an on-time, on-budget implementation of SunriseTM from Allscripts in 2013.
LHCH quickly recognised how valuable Sunrise clinical data was to the organisation’s daily workflow and asked the question, “How do we move from disaster recovery to disaster avoidance?”
Let’s go back to that disruptive power outage for a minute. In a typical hospital server environment, the organisation will likely have a back-up set of servers in case of a “failover” event. An IT employee has to manually recognise the problem, then push the correct buttons to send tasks to a redundant class of servers. It may only take 30 minutes, but that’s a long time for a nurse at the bedside trying to capture patient vital signs and documentation.
Now with the new configuration at LHCH, a third-party software package watches for failovers. If it detects a problem, it triggers an SQL Server availability group, automatically switching to the second site. This process is nearly instant, and the nurse won’t lose any of her patient documentation.
LHCH accomplished non-disruptive disaster recovery testing, simple installation – together with automated failover, failback, recovery and testing – to deliver aggressive service levels and minimise the impact on patient care. Though a project like this might typically take six months, LHCH and Allscripts got it up and running in three.
It’s a winning combination of team members, software and automation. LHCH recently received one of five Best of VMworld Europe 2014 user awards for this virtualisation project. With a fairly limited investment in services, LHCH achieved substantial improvements.
To learn more about LHCH’s journey with Sunrise solutions, watch this video.
* Editor’s Note: Electronic Patient Record (EPR) is another term for Electronic Medical Record (EMR) or Electronic Health Record (EHR).
From the drama and grandeur of Downton Abbey, to the obsession with the Duchess of Cambridge (aka Kate Middleton), to the fantastic London 2012 Olympic Games, the US has great affinity and affection for all things British.
And that feeling is reciprocal when it comes to healthcare. Yes, I’ll admit, there’s the odd little difference in the way healthcare is structured, provided and paid for, but England’s National Health Service (NHS) often looks across the Atlantic when looking for solutions to the very similar challenges they face in providing 21st Century healthcare:
Pressures on healthcare funding in a predominantly state-funded delivery system … consolidation of the management of healthcare delivery across the continuum of care for improved disease management … the ongoing drive to embrace and systematize evidence based care to improve outcomes … and the ever present and ongoing need for clinical analytics to aid clinical and operational decision making.
Sound familiar? Yes, we have much in common with the Brits but here are some things you may not know about the NHS.
All secondary care doctors working in the NHS are actually employees of the hospital they work within. That means that much of their outpatient (ambulatory) work takes place in clinic settings owned by and typically situated within the hospital. The often very extensive case notes (charts) are longitudinal not encounter- or episodic-based, and incorporate all. The patient also has only one set of records no matter how many specialists they might see at the facility, so doctors are accustomed to having access to a full history. When a patient is discharged from an inpatient (acute) visit, they are discharged with a 10-14 day supply of medication from the hospital pharmacy, not a prescription they have to take to an outside pharmacy.
All these differences create challenges for American health IT companies as we look to adapt to the unique workflows, structures and practices of healthcare in the United Kingdom. Fortunately, Allscripts solutions and our people are extremely flexible, enabling us to be successful over and over again. Allscripts has long experience with Sunrise in global markets. Canada, Italy (yes, we have a customer in Palermo, Sicily), Singapore, Malaysia, Australia and now the United Kingdom all have major Sunrise installations.
In the past two successive quarters we have added leading UK NHS hospitals to the Allscripts family with multi-year contracts to deploy Sunrise Clinical Manager and Allscripts Patient Flow. I’ve had the privilige of working with the leadership at both Salford Royal NHS Trust in the Greater Manchester area, and Liverpool Heart and Chest Hospital NHS Trust – and they are world-class healthcare organizations that will make great use of the Allscripts technologies we are providing them.
Situated just 26 miles apart in the North West of England, the hospitals are home to two of the greatest football (er, soccer) teams in the world, Liverpool FC and the mighty Manchester United. And, more to the point, they have wonderful clinical and IT staff who are excited to be working with us.
Working with us again in the case of Salford Royal … but, that’s a story for another time.
Right now, it’s time for those of us at Allscripts to embrace Cool Britannia! Even if that does mean having to learn what a TTO is, add a few vowels, and come to love an altogether different kind of football.