Lloyd George Digitisation

Lloyd George digitisation Fully managed and secure digitisation of your Lloyd George records

Dated July 2020

Fulford Grange Micklefield Lane Rawdon, Leeds LS19 6BA

Tel: 0330 024 1269

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Contents

Clinical foreword, why choose EMIS Health.

4-7

Discover the benefits of digitising

8-11

12-15

The process and the EMIS Health difference

16- 17

How to take the first step.

This brochure introduces the benefits of digitisation. Our team here at EMIS Health are here to answer any questions and support you through the process.

A Clinician’s Introduction to EMIS Health

EMIS Health has a long history as a clinically-led business Beginning with its founding General Practitioners some 30 years ago, and continuing today with its team of incredibly experienced clinicians and clinical informaticians. All of our solutions are designed, reviewed, and developed with significant clinical oversight. This ensures that we are not only focussed on the latest technology, but on the practicalities of the user experience. When it comes to patient data you need to work with proven, trusted partners. There can be no compromise on safety and security. The challenges of delivering high-quality, safe and efficient health care are numerous, especially during this time of an unprecedented global health crisis. However, I’m confident that through our partnership and shared commitment to success, we can enable you to achieve the best: the best for your patients, the best for your staff and the best for your business, now and into the future

Dr Edward Clode-Baker Clinical Director EMIS Health General Practitioner

Started by Clinicians over 30 years ago, we’re still clinically led, with experienced clinicians working throughout our organisation and advising us on what we do.

Case study

Case study

Discover the benefits of digitising your patients' Lloyd George records

Everywhere we look, digital technologies are transforming the way we live. We manage our

lives from our smart phones, stream entertainment to our TVs and order our groceries to the front door. But the speed at which the digital revolution continues to evolve is leaving some industries scrambling to keep up.

When the NHS announced its Long Term Plan back in January 2019 there was a clear commitment to embrace technology. This was solidified by the creation of NHSX; a dedicated team focused on digital transformation. The imperative to modernise the NHS, become paperless and increase industry efficiency is recognised and supported by funding announcements. A £300 million fund has been created to help achieve the aims of the Long Term Plan, including the objective to enable “both patients and practices to benefit from the latest digital technologies”, and allow patients to “have digital access to their full records from 2020”. A dedicated £20m has also been announced to support practices to manage Subject Access Requests, a key factor of which is the digitisation of Lloyd George paper records. Practices reliant on historic paper records are presented with many challenges. Physical files take up valuable space that could be put to better use, and pose the risk of being lost, stolen or damaged. But there is a solution that can help practices save time and space when it comes to legacy patient files. The pandemic has driven new ways of working, and the need for digital access to records is now imperative to deliver safe care for patients and staff. There is no better time to get ahead and digitise.

This brochure talks about the benefits of going digital and how we can be your trusted partner to deliver this service.

Discover the benefits of digitising your patients' Lloyd George records Meeting the demand to modernise the NHS is our unique Lloyd George digitisation service. Taking paper patient records and converting them to digital files, this service eliminates time spent searching and retrieving information, and instead brings patient data together under one reliable digital record that can be viewed at the point of care. Taking your practice paperless not only builds efficiency, but frees up physical space which can be repurposed to provide much needed additional consultation rooms. Not only does digitisation help enable practices to become more efficient, but electronic records are a vital cornerstone of enabling federated care services – such as those provided by Primary Care Networks. By making patient data digital, we’re advancing toward a future of truly integrated healthcare.

▪ Making care more informed and more efficient Make better care decisions by gaining immediate, digital access to your patients’ legacy medical records that detail their broader health histories. ▪ Safer storage of your patients’ information Reduce the risk of lost, stolen or damaged records and ensure that you keep patients’ medical information safe. ▪ Free up valuable space across your practice Make better use of the room in your practice by freeing up space and removing bulky stacks of paper. ▪ Secure disposal of confidential information We’re accredited to BS EN15173 standards, giving you the assurance that the paper records of your patients’ information are securely disposed of.

How we partner to deliver digitisation

Scan

Collection

Partnered with established scanning centres:

Our process provides an unbroken chain of custody

Restore Digital Iron Mountain

Collections are delivered to local scan centres across the UK

Experienced in undertaking secure collections

Then scanned in secure accredited facilities

Using an owned and dedicated fleet of vans with background checked drivers

With a proven capacity track record of over 1.4m records scanned

Providing real-time vehicle tracking

Case study

Patient data safety is a top priority, and using encrypted digital files eliminates the risk of any physical damage or loss. Having patient data in one place also ensures quick and timely response to any Subject Access Requests.

Perhaps more importantly, digitisation has the potential to vastly reduce clinical risk. By ensuring that healthcare professionals are supported with full patient history and information, they are empowered in their decision making and choices for patient care.

Upload

Destroy

We comply with BS EN15713 secure destruction of confidential material

Notes are uploaded directly into the clinical system as clinically coded attachments They are guaranteed in the correct format and saved into the same place each time Our dedicated programme implementation team oversee the whole process to ensure no practice downtime

Provide a fully auditable process

Notes are destroyed 60 days after receipt of a signed authority to destroy

The empty Lloyd George wallets are then securely returned

Case study

The EMIS difference

Delivering safe and secure patient record handling, specifically for primary care. We are in a unique position at EMIS in that we are able to provide a service that allows both the scanning and upload of the data.

Secure Storage

Partner scan centres subject to extensive due diligence and rigorous selection process.

Meets ISO27001: standard for information security

Data Integrity

From the point of collection to the safe and secure transfer of the final scanned images.

Meets BS / EN 15713: secure destruction of confidential material

Lloyd George wallets returned

Our upload service enables the patient records to be uploaded directly into the EMIS Web clinical system. Coded attachments that are uploaded into the same place in the patient record each time make finding patient data simple

End to end tracking and traceability Provision of a detailed audit log from collection through to issues variation, scanning, acceptance and upload log.

Concludes with the issuance of a destruction certification

Registered Data handlers

ISO / BS certification and accreditation across all parts of the service. Meets NHS standards on quality management, and information security

Maintaining a paper free practice

The service is intended for practices wanting to keep their filing system free from accumulated paper records arising from inbound GP2GP transfers and other associated paperwork. The service comprises an annual contract to collect a number of boxes of Lloyd George medical records on a quarterly rota. The LGs will be packed into boxes at the practice by their staff, with each box having its own manifest list.

Once collected, boxes will be transported to a scanning centre, then checked in and any anomalies against each box manifest list highlighted to the customer.

Our commitment to you

A safe and secure end to end scan and upload service

Your Lloyd George patient records will be transported and processed to the highest quality standards and uploaded with accuracy

Service provides

Dedicated programme implementation team

Supply of Lloyd George record packing boxes and materials

Co-ordination of completing master manifest list

Schedule and collection of packed boxes

Secure tracked Lloyd George record collection and delivery

Ship USB drive securely to practice with proof of delivery

Practice review of digitised records on encrypted USB stick

Programme implementation team co-ordinate uploading of digitised records Upload of digitised records directly into EMIS Web as clinically coded attachments Records retained for 60 days

Safe destruction of Lloyd George wallet contents

Safe and secure return delivery of Lloyd George wallets

Our dedicated programme implementation team will manage the whole service, providing regular communication, and eliminating practice downtime. Your digitised records will be uploaded into the EMIS Web clinical system, providing instant access to Lloyd George notes

Scan

Upload

Scan & Upload

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How to buy

Our playbook gives a comprehensive overview on how to run a successful digitisation programme.

However, every organisation, practice and customer has different needs and we are very keen and here to support.

Should you require further support, insight to our market competitive pricing, help with pulling a business case and ROI document please contact us.

Method​

Notes​

Competitive​

Scan Only​

Upload Only​

Scan andUplo ad​

DPS Framework Coming soon​

Yes​

TBC​

TBC​

TBC​

No direct award available

Requires a copy of EMIS Web in the CCG​ Non-Framework Process. Single Tender Waiver​

IT Futures Framework​

No​

Yes​

Yes​

OJEU Notice​

Yes​

Yes​

Yes​

Yes​

Single Tender Waiver​

No​

Yes​

Yes​

Yes​

Buy Direct​

Direct​

No​

Yes​

Yes​

Yes​

For more information please contact your EMIS Health Regional Director

Contact Me

Contact Me

Contact Me

Our Digitisation process in detail.

Lloyd George Digitisation – FAQs

Is the service only for Lloyd George wallets? No. The service accommodates both Lloyd George wallet and A4 folder patient record storage mechanisms. A single Lloyd George wallet or a single A4 folder for a patient counts as 1 file. How many boxes will I need? We provide an estimate of how many boxes you’ll need based on your practice’s patient list size and an internal calculation from data collated on previous projects. These are estimates, so your own practice may need more or may need less than the estimated number. The table below includes a number of examples as an initial guide:

How much space do the unassembled boxes and lids take up? Box bundles arrive flat-packed and include lids, barcode label stickers and packets of cable ties. When stacked on top of each other, a flat-packed box bundle comprising 160 boxes is about the same height and width as an average standalone fridge freezer. How many Lloyd George wallets can fit into a box? It is difficult to provide an accurate answer to this as understandably, it depends on a number of factors. However, using previous project data as a reference, between 28 and 45 Lloyd George wallets should fit into each box.

How long does it take to pack the boxes?

It is impossible to provide an accurate answer to this for your own practice’s records as it depends on a number of variables, such as number of patients, number of staff involved in the packing, packing out of hours/weekends etc. During the initial engagement stage, EMIS Health will provide you with a number of packing process suggestions based on how other practices have completed the process previously.

When are the boxes collected?

When you have received your boxes and are packing your records, EMIS Health will be in touch regularly to see how you’re progressing which will then allow a collection date to be forecasted. You should aim to pack your boxes so that they can all be collected as one Page | 6 consignment. Under certain circumstances, it may be possible to have an interim collection if you are running out of space, but this should be avoided wherever possible

My boxes have been collected but we need access to a particular patient’s record. What do I do?

EMIS Health offer a ‘Scan on Demand’ service (or ‘SCOD’) to help when instances like this occur. Both 4 and 48 hour SLA options are available. If a request is made after 4pm, the SLA carries over to 9am the next working day. After your boxes have been collected, EMIS Health will provide full instructions on how to request a SCOD. In these instances, the required record is not returned as a hard copy, it is priority scanned and then securely emailed to the requestor. The Scan on Demand service should only be used when access to a patient’s record is required urgently.

How long will it take to process and scan my practice’s patient records?

After your boxes have been collected, EMIS Health will confirm the scanning date slot which has been allocated to your practice’s order. EMIS Health will then provide you with an estimated return date of the digitised files based on that slot. Should this change, EMIS Health will contact you to advise accordingly.

How are the digital files returned?

When your practice’s hard copy patient records have all been scanned, they will be returned to you on a fully encrypted, secure USB storage drive. When the time comes, EMIS Health will provide you with the required guidance on what to do at this stage, plus the passcode for the drive. If your practice has an interim collection, no digital files are returned until all your boxes have been collected and they have all been scanned. Also included on the USB drive is an updated version of the Master Manifest List(s) for your collection(s) which indicate any discrepancies between your original manifest list and the actual contents of all your boxes. An example may be a patient who (according to your manifest) seemingly had 1 Lloyd George wallet, but tucked inside it there was another one, so the LG count for that patient would be 2 instead of 1.

Are the empty Lloyd George wallets returned?

Yes. After you have accepted your digitisation order on the USB storage drive, the empty Lloyd George wallets will then be returned to you. These cannot be destroyed as they are Crown Property.

Can I assume that if / when practices migrate to EMIS - X that scanned/uploaded documents will continue to be available to clinicians?

Yes, in fact we are already preparing to store the records so that they will be available in EMIS-X without migration required.

Is there any National Guidance available?

NHSX who are in charge of the Digital Transformation Programme nationally have prepared a national standard, which is still in draft status pending further internal ratification.

Can Egton deliver digitalisation for non-EMIS practices?

Yes, the first digitisation service delivered was to non-EMIS practices.

Can non-EMIS digitisation providers upload records directly into EMIS patient records? If not now - are there plans for this type of interoperability? Yes, we provide an ""Upload Only"" service for practices wishing to load EMIS Web with files not scanned by EMIS. This is available to scanning operators through our Partnership programme. The scanned files and associated control list must comply with the technical requirements specification. On average a GP accesses only 1 LG paper record in a week. Retrieving a physical file is time consuming and returning the same file to its correct position also consumes a person's time. We still have a high failure percentage for GP2GP and printouts rarely arrive with records (invariably almost impossible to retrieve). Digitisation would mean we risk only receiving empty packets from other practices. What are the plans to overcome this issue? NHSX are aware of this shortcoming in the GP2GP electronic transfer mechanism and we understand they are making the resolution a priority to underpin their Digital Transformation Programme. Transferring physical records between practices can result in the record being 'in transit' for months in some cases. Common procedure for the registering practice is to create an empty LG (or A4 wallet), appropriately labelled, as a placeholder even if the physical record is not received. Do you have a feeling for how often you access a paper record?

GP2GP is not currently activated in Scotland - are there any plans for this?

Although the digitisation services are designed for NHS England, the digitisation procedures will work in Scotland too, with some enhancement for using CHI numbers (instead of NHS number).

What is the rationale behind hiding Lloyd George content from online visibility?

Current guidance states that access to the digitised version should only be provided via a Subject Access Request (SAR) which has been submitted to the practice by the patient or a patient representative. This allows the practice to check that all is in order and redact for patient viewing as appropriate. In regards to patient facing services and giving patients access to records. Will EMIS be developing their system to allow for the transfer of settings to make digital LG records private from one practice to another as the patient navigates the system? It is likely that a standard will be established and adopted nationwide for GP2GP transfers. The requirement would need to be resolved to satisfy Data Controllers' needs whilst considering any additional procedural impact on administrative staff in practice. Can you offer any suggestions about how long it might take practices to pack their own records (assuming they have been provided with the boxes)? As each practice varies in size (patient list), that question is addressed by our deployment team during pre-engagement planning so that the activity can be coordinated and scheduled. The deployment team will also be in regular contact to keep abreast of the activity progress.

Does the destruction include the Lloyd George envelope?

No, at least not under current legislation. However, NHSX are also aware of this matter and will seek a practical resolution through the appropriate channels to support the Digital Transformation Programme.

Do you recommend a certain proportion of records for practices to check before acceptance?

There is a practical approach based on BS 5750 - Quality Systems and ISO 9001 - Quality Assurance standards. This recommendation is still subject to final ratification by NHSX.

Will uploading all of the electronic Lloyd George data slow down our EMIS Web system?

Before we carry out the bulk upload we ensure the physical disk has sufficient capacity, then that the database also has capacity otherwise that would affect the users in practice. We also ensure there is no conflict with the daily system backups, releases such as for SNOMED and system patching. These checks are all needed to ensure there is no adverse impact in the practice resulting from the bulk upload. What would happen if a letter relating to another person had accidently been filed in the patient Lloyd George? Would it be picked up at the point of scanning? Due to the rate of scanning throughput, the operators do not have time to identify any historic filing mistakes. Scanning operators are not permitted to read the contents of the records, which is monitored by management on site and continuously by CCTV.

What are the challenges that have been faced in the digitisation lifecycle during the Covid-19 pandemic?

Collections from practices stopped but are now reinstated with strict engagement protocols and PPE. Likewise the throughput capacity in the operating centres has been reduced to ensure the precautionary measures and social distancing in the workplace rules are observed. There is also the option to introduce an additional shift to boost capacity should that become necessary.