Managing the expectation versus the reality of an EPR rollout

Last year, NHS England met its target for 90% of trusts adopting electronic patient records (EPRs) in hospitals. The level of adoption varies considerably across the NHS. Some have opted for a big bang rollout across the whole organisation, others have rolled out functionality just for adult inpatients, some may have achieved electronic prescribing and medicines administration (EPMA) with electronic discharge notification (EDN), while others may still be planning for this.

Common pitfalls

Although no two projects are the same there is always commonality between implementations. Unsurprisingly, we have observed that the level of success achieved in rolling out a brand new, game-changing EPR is always influenced by the expertise and experience of the teams involved. Cloud21 has applied its proven know-how to many EPR implementations and, on several occasions, we have been brought in during the later stages of the programme to work with organisations to get them back on track.

However, these pitfalls experienced are happening all over the country, and generally fall under key categories:

  • Organisational readiness
  • Technical readiness
  • Staff engagement

Few are directly the fault of the teams involved. Trust EPR programme teams work exceptionally hard, building business cases, going through procurement processes, planning the programme of work, through design, testing, implementation, go-live and then, eventually, business as usual - but hopefully in a new and far more effective way.

Every EPR rollout is unique

There is no one handbook that explains how an EPR rollout should be implemented. Every single organisation has its own operational nuances, different organisational structures, and varying levels of digital maturity and legacy contractual tie-in. Then there are the products - with different operational and implementation styles of different vendors making it impossible to define standard approach or method. Also, crucially, the teams who are implementing this complex EPR are also busy tackling funding, operational and clinical pressures every day, rarely able to devote enough time to the needs of the EPR programme. The staff working through this on the front line are the ones who will be using the new EPR and expected to get the most out of it. Getting them on board can be the biggest challenge for EPR programme teams.

With the majority of trusts working to either exploit their existing EPR or, in some cases, upgrade or change within the next few years, the remaining trusts will be expected to have a new EPR in place by the end of March 2026. If you are one of the organizations yet to complete your EPR adventure, how can you manage expectations and avoid common pitfalls to ensure a successful outcome?

We know how to get it right

Many Cloud21 colleagues have lived experience of working in the NHS. We understand the competing pressures, we know how it works (and when it doesn't), we've witnessed what happens when things go wrong, and we're practised in getting it right.

We have delivered and supported successful rollout as a partner to organisations implementing EPRs, by both making sure the foundations, and expectations, are right from the start, or by getting stalling programmes back on track and over the line.

The Cloud21 team has created a series of blogs around the common expectations that people often hold at the outset of an EPR programme. They discuss the realities that are often experienced but too rarely planned for during this process, so that those just embarking on their EPR journey can plan more confidently for success.