University Hospitals Bristol NHS Foundation Trust has gone live with the first phase of its Global Digital Exemplar (GDE) programme.

The Trust’s GDE contract with System C includes the deployment and roll out of 20 modules which can be used across the health community over a two-year period, in addition to many complementary digital transformation projects. This is an accelerated programme and UH Bristol and its technology partner System C are planning five major go-lives this year.

In the first go-live, 500 clinicians at the Trust have gone paperless for observations, with staff on medical and surgery wards now using mobile devices to capture nursing observations and assessments digitally. The Vitals e-observations system, previously known as Vitalpac, also provides decision support at the point of care and automatically calculates National Early Warning Scores (NEWS).

As NEWS are generated, they form part of an escalation path that advises those taking the observations of the next actions, including notifying clinical teams of a deteriorating patient. Additional functionality being rolled out now includes fluid management and in-dwelling device management. Future planning will include assessments for dementia, sepsis, alcohol intake, the risk of blood clots, and acute kidney injuries.

The rollout will be extended to all inpatient wards across all UH Bristol hospitals.

This deployment follows a major system upgrade to the Trust’s core Medway EPR which now includes support for the microservices architecture and FHIR APIs required for the comprehensive integrated clinical systems due to be rolled out over the coming months. These integrated clinical capabilities include prescribing and medicines administration, clinical task management, handover, alerting, orders, results, clinical noting, clinical dashboards, secure messaging and workflow. All of these modules will be integrated into a single EPR, running on desktop, tablet and smartphone, with the mobile versions using the IOS and Android operating systems.

Sarah Beech, ward manager

Using the Vitals system has made such a difference already in the way we can respond to our patients. We can see all of the observations for our patients in one go, for example. As a nurse in charge you can see immediately who your sickest patients are.

Donna Green, nursing assistant

It’s a much more patient-friendly way of working. Because you haven’t got your hands full of paperwork, you are able to focus more on your patients.

Chris Bourdeaux, chief clinical information officer at UH Bristol

It’s been great to see how quickly staff are picking up and adopting mobile apps specifically designed for hospital use, and it really brings home the potential of the GDE programme for transforming the Trust and the way we work. We are moving at a tremendous pace and it is generating a lot of excitement.

Markus Bolton, joint chief executive of System C

It is really exciting to see all of our systems being rolled into a single Trust like this. This GDE programme has transformed delivery, projects are better resourced and the Trust is able to buy the components based on operational requirements as it needs them.

The GDE programme builds a standard delivery and benefits model that will be rolled out widely to other Trusts in order to accelerate digital maturity across the NHS. System C is already in the planning phases for fast follower deployments at Whittington Health NHS Trust and there are a number of additional Trusts in the pipeline.

The UH Bristol blueprint is a pioneering cloud-based solution, conforming with NHS Digital’s new national guidance on cloud services. It includes a full suite of System C’s integrated mobile, tablet and desktop clinical applications for use in hospital and across care communities. Functions include clinical noting, assessments, orders, results, prescribing as well as access to shared care records, multi-disciplinary care plans, patient portal, population health and remote patient management.

In addition, each of System C’s blueprint clients is taking on responsibility for developing one or two new models of care solutions, using a blueprint toolset supplied by System C. These new models of care applications transform the way services are provided, using patient portals and wearable devices to connect patients with clinicians and to help Trusts manage patients remotely.