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Hospital creates new EPR with open source



Taunton and Somerset NHS Foundation Trust has customised openMaxims software for an electronic patient record that could be reused by other organisations

A west country hospital has begun to use an electronic patient record (EPR) based on open source software that could be more widely reused in the NHS.

The 600 bed Musgrove Park Hospital, part of Taunton and Somerset NHS Foundation Trust, went live with the solution – based on openMaxims software – at the beginning of last week, with initial implementation in A&E, outpatients and the 30 inpatient wards.

Senior hospital staff said the next step will be to develop an e-prescriptions function, and that the EPR is now available for other trusts to use and adapt to their own requirements.

The trust has won the support of Richard Jefferson, head of programme commissioning at NHS England, who said: “We are delighted to see the first deployment of openMaxims going live in an NHS hospital. This represents a landmark moment in the use of open software in the NHS and validates the idea that open source can play a significant role alongside proprietary offerings.”

Deal clincher

IT director Malcolm Senior told UKAuthority that the trust was initially interested in the product from IMSMaxims before it was made open source, but the company’s decision to open up the code was the clincher in its decision.

He said it has provided a large cost saving for the trust, which has had to pay the company for its implementation support and ongoing maintenance but been free of licence fees. Also, “it has given us control in how we manage the software, and we’ve developed the skills we’ve been able to do more with it”.

“In past implementations I’ve worked on we’ve had a token member of the operational staff on the project,” he added. “But in this case we’ve switched that around, so if anything IT has been supporting the mainstream leads.”

Chris Swinburn, the trust’s clinical lead in the implementation, said the IT team had worked with doctors and nurses in developing the EPR “right down to a local departmental configuration”.

“Users like it because it very flexible yet structured,” he said. “If we’ve wanted to make changes we haven’t had to make a request but been able to do it ourselves.”

Hospital staff contributed to the design of a number of features, including a wards organiser, an organiser for outpatient clinics and the workflow for the patient journey. Swinburn said this was important in preventing a repeat of the experience of the trust’s legacy system, which staff often had to work around.

“With this system they’ve all informed us of the way they’ve wished to work and the software has been built to support that,” he said. “When they come to use it it’s not only clever but useful.”

Launch support

The launch was preceded by a training programme for 2,500 staff, and a command centre with members from the IT team and the supplier was set up to provide support.

Although the EPR has been in use for only a few days, Senior said there are already signs of it providing benefits for patient care in that clinicians are able to enter more real time data. This is giving them a clearer, up-to-date view of what has been done for a patient and reduced clinical risk.

“This is a real clinical win for the software,” he said. “We make the hospital ever safer and ever more efficient.”

He was also confident that there will be sufficient support from the open source community in the future development and maintenance of the software, claiming there is plenty of enthusiasm around the NHS for open source solutions. Relevant communities have emerged with the Code4Health programme, in which healthcare professionals are being encouraged to learn how to write software.

Senior added that there has already been interest from other trusts in using the EPR.

Image from IMSMaxims



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