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Case studies

NHS Greater Glasgow

NHS Greater Glasgow and Clyde use Rhapsody® Integration Engine to create a near-paperless hospital environment

Located in west central Scotland, the publically-funded NHS Greater Glasgow and Clyde Health Board was formed in 2006 through the merger of NHS Greater Glasgow and part of NHS Argyll and Clyde. Now the largest health board in the United Kingdom, it delivers services through 35 major hospitals, 10 specialised units and 50 health centers and clinics. General practitioners, dentists, pharmacies, physiotherapists and other health care providers work through these facilities. In all, about 44,000 staff, 1,000 consultants and an additional 1,000 general practitioners care for the health board’s patients.

With the merger, the new board embarked on a series of major building projects to move services from cramped Victorian era buildings into modern hospitals that could better support 21st-Century medicine. As NHS Scotland’s largest and most ambitious health care modernization program, Greater Glasgow and Clyde plans to spend £750 million on modernization over the next six years.

A large part of this modernization venture included the implementation of a solution that provided a single unified view of information retrieved from an existing clinical data repository, a scanned paper case notes store and an encounter repository. Rhapsody was implemented to feed clinic letters and other documents into the various repositories in order to provide clinicians with a richer patient data set. The health board also began to redesign health care services to better care for this large patient population.

Improving access to patient medical records

One of the first projects the health board wished to undertake was to make it easier for its tens of thousands of providers across these dozens of facilities to access patient medical records. It wanted to implement an Electronic Health Record (EHR) system that incorporated a portal with an intuitive user interface that could provide all clinicians with access to a unified patient medical record regardless of where the patient lived or where the clinician was located.

The portal needed to access the health board’s Scottish Care Information (SCI Store) system, a Central Data Repository (CDR) that stores patient data for nearly two million people. Implemented in every NHS health board in Scotland, SCI Store includes patient demographics, test results, referrals and clinical documentation. Before the EHR could deliver a broad set of data about each patient to clinicians, it was imperative to make as much patient information as possible available in an electronic format. The health board began to improve the organisation of patient information by creating the “Top 64” project, a method to determine which clinical documents were the most important in the health region in order to standardise data collection for the SCI Store records.

It then found ways to collect information it had previously gathered on paper in an electronic format. For example, the health board implemented the “E-forms” project to convert or create electronic forms for use in clinical contacts. A scanning project was undertaken to generate electronic notes from paper case notes to provide the historical information in each patient’s electronic record. The board also created a digital dictation solution to move away from cumbersome analogue tapes. At the same time, the board also expanded its network capability to provide the infrastructure for everything to work seamlessly.

Training and use

Greater Glasgow and Clyde began training staff on
system use at the end of 2008. As new hospitals open,
all staff members are being given user accounts on the
system. Scott Hendry, Greater Glasgow and Clyde’s
portal project manager has observed widespread
acceptance of this massive IT project. “People see the
benefit in moving away from paper,” Mr. Hendry said.

However, Mr. Hendry noted that clinical staff have relied
on paper for so long that they are reluctant to access
SCI Store until it is perfect. “That’s where we have the
challenge,” Mr. Hendry said. “People are willing to pick up
the portal and run with it, but it needs to be as effective
as the paper-based system. Luckily, the Orion Health
Hospital solution is very intuitive, which will play a critical
part in encouraging acceptance by the clinical staff.”


Although the health board is still in the implementation
phase of the project in many facilities, the Rhapsody Integration Engine is already delivering a paperlite hospital
environment at the NHS Health Board’s two new
Ambulatory Care and Diagnostic Centers. The health
board also has significant plans to scale the EHR system
to reach all other acute sites. GPs and community
workers, as well as other partner organisations, such as
social workers, will ultimately be given access.

Rhapsody Integration Engine is making healthcare information in NHS Greater Glasgow more readily accessible, helping them
provide a fast, efficient healthcare service.

“The solution is very intuitive, which will play a
critical part in encouraging acceptance by the clinical staff”

Scott Hendry, Portal Project Manager, NHS Greater Glasgow and Clyde

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