Electronic Patient Record (EPR)

Introducing the only low cost integrated EPR solution that has been specifically engineered for the UK Ambulance services.

The Doc-works EPR app has been designed with ambulance crews in mind and models the layout of existing paper patient records that crews are familiar with.

Crews can be provided with the most appropriate sized devices depending on their carrying capacity. So they can choose to use anything from a pocket sized smartphone up to a 10” tablet.

To keep the recording of the patient record as simple as possible, sections that are not required are hidden once the nature of the incident has been recorded – this keeps navigation of the record simple and easy to use and can even be operated one handed.

Once uploaded, the EPR records can co-exist with any scanned paper records held in a secure EPR WebCabinets system that allows fast retrieval and reporting. Having only one place to look for records makes locating and reporting on records a much simpler task.

The EPR WebCabinets system enjoys all of the major features of the standard system but is normally hosted on Trust provided servers where patient records are to be stored.

  • Affordable solution tailored for all responders
  • Range of devices to suit crew requirements & budgets
  • Automated forwarding to external services (GP, Social, Falls, Police)
  • Immediate upload of patient record
  • Increase patient safety by reducing or correcting errors
  • Option to capture continuation forms and other form types
  • Over 10 years experience with patient records management

Benefits for your business

An affordable solution that can be tailored for all responders

Many current EPR solutions are too costly to allow all responders to have access to a device, this leads to secondary costs to the trusts to handle the paper forms that must be used in these cases.

Our solution addresses this issue by allowing Trusts and providers to use their own hardware and as an extra benefit, migrating to EPR devices will further reduce risk from physical deliveries of paper forms.

Efficient, accurate transferability of Private Provider records

Where NHS trusts need to work with private providers, the current unavailability of suitable EPR solutions makes a 100% EPR target unattainable.

Enabling private providers with our EPR solution will provide a secure integration path that will help to eliminate paper records and all of the inherent issues with transportation, scanning and data entry / validation of the paper records.

Immediate upload of patient records

Once a network connection can be provided to the device the form can be uploaded straightaway, so even if the device does not make it back to the station, the EPR will.

High accuracy of data entry

By recording data directly to the app, important details of the incident can be captured without the need to employ expensive data capture and validation staff.

Range of devices to suit crew requirements & budgets

The app runs on a range of android devices, so if it's important for the device to fit in a pocket a Smartphone is fine. Where the flexibility of a larger display is required an 8” or 10” tablet can be used. Trusts and ambulance providers can source their own hardware and choose the tradeoffs between price and ruggedisation.

Automated forwarding to external services (GP, Social, Falls, Police)

As soon as an EPR is uploaded to the central database, it can be converted to a user friendly PDF document and forwarded to external services such as GP and Social services via the NHS.NET email system.

Increase patient safety by reducing or correcting errors

Before marking a section as complete, the app will prompt the crews to ensure they have completed all mandatory fields.

Where patients have taken their own medications, are unable to respond or have refused care, the EPR app allows crews to record "Patients Own", "Unable" or "Refused" as appropriate. This ensures a complete record can be taken.

Option to capture continuation forms and other form types

Whilst we know that a paperless solution is the holy grail for patient records, the reality is that there are still occasions where diagrams need to be drawn, pictures need to be taken and pre-printed forms need to be signed.

To enable this we have built in capture capabilities for camera equipped devices. By using unique barcodes on pre-printed forms its also possible to link physical and electronic forms so that the incident details recorded can be matched to the images when the paper forms are scanned.

Frequently Asked Questions

Q
How do I Manage Complex Approvals?
The system can be configured to handle complex approval paths, where any number of people can be involved in the approval process (multiple approvals required before the invoice is deemed to be approved). The complexity and route any invoice takes is determined by rules on price, GL Code, Project Code, Site/Cost Centre, Supplier and so on. Where invoices require special treatment then approvers can redirect to seek further information or additional approval from users not in the normal approval path.
Q
Future proof solution

Docworks is committed to developing the system and will continue to work with Trusts to ensure the best possible system is provided.  In the future we expect to provide database lookup services and wireless connectivity to medical devices.

Q
Why Doc-works?

Doc-works has been working with the storage and management of patient records for South Central Ambulance Service and the Isle of Wight PCT for over 10 years. Until recently these records were paper based and required scanning and intelligent data capture/validation.

We believe it is critical to provide a system that can hold all of the patient records – regardless of their source. We now provide the ability to import electronic EPR records into the system but with a user friendly PDF form that allows them to be viewed alongside paper records and continuation forms.

In addition to the digitisation and data capture processes, we have provided enterprise scale document storage and reporting systems to provide secure access to the images and to enable bespoke reporting functions such as those required for national CPI reporting.

Q
How is the system accessed ?

All access to the system is via Web browsers.  Documents can be viewed, either as PDF or in their native format such as Word or Excel.

Q
Can a Supplier Email an Invoice?

If required a supplier can email a specific email address and the invoices attached wil be automatically uploaded to their account for processing and approval.

Q
Where is the system hosted?

The system is hosted on the latest HP servers which are housed in data centres that boast fully resilient power,  multiple Tier 1 network connectivity  and ISO 27001 and 9001 accreditations.

Q
Ingestion

For customers who already have their invoices scanned by a third party, these can be ingested (with associated index data) by the systems automatic uploader.

Q
How are the documents filed / indexed?

The options are endless for how we do this,  we can segregate different document types into separate cabinets.  Each of which can have its own set of indexes.  Alternatively we can group documents together - for example electronically generated invoices with proof of delivery documents scanned from paper.

Q
How are restrictions enforced to provide appropriate levels of control?

The top level of access is the list of cabinets that a user is allowed to see.  This is the simplest level and restricted documents such as HR documents for Executives can then be placed there.

The next level is to enforce a filter on the documents in the cabinets.  This can be a single entry such as employee number (e.g. for payslips)  or could be a combination of fields such as department and document type.  Groups can be setup to allow easy enforcements of ranges of valid entries.  So for example if sites were in regions we could create multiple groups for each one with a list for each one that defines the sites in each region.

Q
Adding Documents : Outsourced Scanning:

It is expected that the majority of paper based documents will be forwarded to a scanning bureau and they will be responsible for digitising and indexing these documents. We will require a valid set of indexes for each image and these will be used by the search function to locate the documents.

Q
Adding Documents : Outsourced Indexing:

Where documents are scanned, either in bulk or on an ad-hoc basis,  we have a data entry partner who can take on the task of providing the essential indexes to make documents locatable.

Q
Adding Documents : Outsourced Print:

In addition to paper based documents, it is possible to take electronically generated document streams such as invoices or payroll documents.  Generally this would be output as PDF and we would normally want some form of index for these. Where it is possible to extract the index criteria from the  PDF we do not need an extra index.  Where pre-print is used and a layer needs adding to the images we can handle this on the fly.

Q
Adding Documents : Via email:

Records can also be scanned in using multi function devices  and emailed to an email address. This can also include emails with attachments,  ideally there will be a subject line or note in the email to identify the employee or property the documents relate to.

Q
Adding Documents : Upload function:

There is also a facility for authorised users to upload to the site using drag and drop.  The screen will require the operator to enter the employee ID/property Id and document type.  This function will allow multiple documents and document types to be uploaded from the users desktop.

Q
How Big can the files be?

There is a limit on the size of the files that can be uploaded but its pretty big (10Mb each). We have some examples that run to thousands of pages,  the bigger the document the longer it takes to upload and download.  If you have a fast internet connection these will not be a problem.

Q
We have an existing backlog – can these be accommodated?

Absolutely,  if there is an index for these files we can use that, if the documents are in subfolders we can use that too. We can also do some processing on the file names so that documents can be searched and retrieved quickly  ( we like to add indexes to the database where we can so if part of the name needs to be searched its much better to extract this to a field so we can apply a db.index).

Q
Auto Recognising Document Types

We are looking into the application of barcodes within documents that are uploaded so that we can reduce the overhead of indexing.  For example, with HR documents, such as an "Employee Absence Form"  where a document is printed and signed then uploaded,  if we can extract a barcode that tells us what we need to know then we can make that part of the upload process .  There are also possibilities if the document has been OCR'd.  However, this will need to be considered on an individual basis.

Q
Is the system resilient?

We operate from two distinct hosting sites, which are more than 35 miles apart.  Data is constantly copied over from the main site to the secondary site.   All servers utilise raid and have a 'mirror' server at the secondary site.

For most customers we provide the second site as a warm standby so that it can be brought online in case of a business continuity situation. If required we can provide a "Live-Live" environment so that either site can be accessed at all times.

Q
What happens if we only want this as a mid-term solution?

Although we would like to continue hosting for indefinite periods, we recognise that some clients needs change and in-house integrated solutions mean the data has to be brought in house.  This is not a problem and we will endeavour to provide the data in the most useful format. There may be a time & materials charge for the work done if there is a need to output the data in a bespoke format but we always consider the images belong to the client and we do not believe it is ethical to charge punitive amounts for clients to get their data back.

Q
What if we want to host this on our own servers?

At present we would need to take this on a case by case basis, for a normal client it is not cost effective to purchase hardware, software, firewalls and all of the administration tasks that go with running the system, for larger clients that wish to provide departmental or divisional services this is an option and we would be happy to investigate options.