Liverpool Women's NHS Foundation Trust

Set up onsite Day-Forward Scanning Bureau


  • Converting existing patient records into digital format for full Electronic Record Patient (EPR) solution; 
  • Reduce storage costs;
  • Obtain BS 10008 certification;
  • Full integration of PAS systems.

Client Benefits:

  • Integrated Electronic patient records (EPR) will allow the data to be shared amongst clinicians anytime and from any given site. The time spent retrieving and transporting casenotes from one location to another will be non-existent, allowing more time to be spent at patient bed sides.
  • Converting patient records into digital format will significantly reduce the amount of physical storage space needed which will save LWNFT hundreds of thousands of pounds every year.
  • Obtaining BS 10008 certification will ensure the Trusts quality of images and indexes of the electronic patient records is of the highest standard. Ensuring the correct policies and procedures are in place will provide a consistent audit trail and achieving certification will give the Trust piece of mind when destroying the original paperwork.
  • Full integration of all 27 PAS systems at LWNFT into the main PAS, Meditech, will enable all up to date patient information to be accessed by clinicians. 

In line with the government’s ‘Paperless by 2018’ initiative, LWNFT have now begun their Paperless journey. The Trust applied for the ‘Safer Hospital, Safer Wards’ technology fund back in July 2013 and have received funding for the second phase, which will go towards a fully integrated Electronic Patient Records solution. The Trust recognises the need for a scanning functionality in order to become Paper-lite, and has therefore drawn in Scandox to handle the scanning consultancy.
Catherine O’Keefe, Programme Manager at LWNFT explains where the Trust is currently at in relation to the entire EPR process and the benefits she envisages of a fully integrated electronic patient records document managed solution.

Scanning underpins everything else; if you can’t get that right, nothing will work.
— Catherine O’Keeffe, Programme Manager, Liverpool Women’s NHS Foundation Trust

Extensive Trust Knowledge is Key

Catherine highlights the importance of having extensive knowledge of how the Trust works on a day to day basis and the processes which are in place. “I have previous experience as an advanced practitioner in clinical PAS implementation and operational planning – a good basis for EPR operation”.  

“One of our main objectives is to provide the Trust with a clinical interface –one complete view of the patient record and a solution fully integrated with all 27 PAS systems. We share information across many different sites; we have midwives engaging with all the community centres in Liverpool therefore our priority is to achieve a new data warehouse with real time dashboards” says Catherine.

Guiding us in the right direction

Catherine continues to highlight the need for scanning. “We recognise the need for scanning as part of the EPR solution. “If you can’t get the scanning right, nothing else will work.” As scanning health records experts, Scandox are able to guide us in the right direction in order to achieve our goal of transforming the current Health Records Library into a Scanning Bureau.”

Like many other UK Trusts, the Health Records Library at LWNFT faces many challenges on a daily basis. Catherine says, “There are so many casenotes located both onsite and offsite of the hospital. We’ve never destroyed a single record and due to the nature of what we do, the retention period is high. (Maternity records are kept for 25 years and Genetics records are kept for 30 years). We have approximately 20 archive boxes going off-site to storage and 20 boxes coming on-site every day and it’s simply becoming unmanageable. The issue here is the high level of cost for storing the records in off-site storage units. We currently have two on-site storage facilities and although the records are structured well, are neat and tidy, the storage units are over flowing. We have opening clinics in and around the Liverpool area and more often than not, the casenote is not on the same site as the clinician or patient. Staff therefore have to physically transport them themselves, often in taxis, just to ensure the clinician has the casenote in time for appointments with patients. This not only wastes staff time, but also increases the risk of damage to the casenote.

‘What to scan’

LWNFT have opted for the Scandox Scanning Strategy Service. The service includes an in depth audit of the existing Records Library to help determine both the average size of the library and the average size of each casenote. One of the key outcomes of the audit is ‘What to scan’ therefore existing attendance data is pulled from the existing PAS. This includes pulling a variety of record types such as discharge summaries, outpatient information, correspondence and nursing notes which is then analysed. The attention to detail of this report is incredibly specific and as part of the analysis, confidence levels are generated. With this information gathered, ScanDox are then able to produce realistic recommendations for scanning including timeframes, something of which the Trust themselves may find difficult to achieve. Catherine says, “Without knowing the volumes, we wouldn’t know what to capture. We do not have the required skilled workforce or time to carry out a Library Audit so having an external, experienced workforce like ScanDox was beneficial. 

Real Recommendations

In order to make the project as effective as possible in terms of return on investment, the results of the Library Audit suggest the 45,000 patient casenotes situated onsite will be scanned before day forward scanning begins. Catherine explains they will roll out with the Genetics clinics first and hope to have the scanning bureau go live in June 2014. The Trust will be deploying the existing health records library staff to the scanning bureau. The Library Audit recommends the use of 23 staff.

Scanning Strategy Benefits

Catherine describes the Scandox Scanning Strategy to have been most useful. “We finally have a direction to go in – prior to the scanning strategy we didn’t know what that direction was. It gave us a basis of understanding for the entire EPR project plan including the approximate cost of scanning. It has given us an overall defined scope of the complete solution.”
Catherine envisages the following benefits of the wider EPR project plan:

  • One click view and accessible through one PAS system,
  • Alerts for safe guarding which are non-existent in the current PAS system,
  • True integration between systems,
  • Increase clinical safety,
  • Improve patient outcome,
  • Improve patient experience by taking the entire patient record to the bedside,
  • Eliminate storage cost and free up space throughout the hospital which can be given to clinical care.

Great Service

“We were first introduced to Scandox at the IT Health Exchange event. After Elisabeth Belisle from Scandox presented, it quickly became apparent we needed their services. Although we already had an initial project plan prior to the event, we soon realised the need for a Health Records Library Audit and BS10008 compliance consultancy.” 
“We are very happy with the service Scandox has provided. They really gave us a better understanding of what was needed in terms of scanning and the steps needed to achieve our overall EPR objectives.”
“Great service, thanks very much!” – Catherine O’Keeffe, Programme Manager, LWNFT.