A History of Healthcare Computing and Advances in Clinical Information Productivity in Southampton, 1980 -2024: Essay 7: The Challenges of Acquisition and Integration of an Enterprise Document Management System in Southampton, 2013-2024

In 2010, in recognition of the continuing failings and overruns of government directed IT programmes, which included the NHS National Programme for Information Technology (NPfIT), the Government Digital Service was created to bring coherence to IT strategy in Government Departments and to its internet projection. This initiative created Gov.UK around a series of 25 exemplar projects, and a series of powerful design principles which focussed upon in house development, agile and iterative development, and a relentless focus and testing of the actual needs of the true end users of any system. This would make any such a system “Digital by Default” meaning so good that the user would choose no alternative way of working. In 2013, the then Secretary of State for Health Jeremy Hunt followed NPfIT with the “Go Paperless” strategy for the NHS, which was still heavily dependent upon paper records with their resulting costs and inefficiencies. The “Go paperless” mandate prompted an urgent plan at University Hospital Southampton (UHS) to undertake two major projects in parallel: the digitisation of archival paper records, and the acquisition of a commercial enterprise grade Electronic Document Management System (EDMS). The EDMS in turn was intended to serve as the primary EDMS for the Trust, and to replace the locally developed UHS Electronic Patient Record (EPR). This project proved to be more complex than intended, with modified outcomes. Old lessons were relearned about the evolution of complex digital software projects which are mandated by political imperatives rather than operational needs and technical maturity. In the previous essay in this series, I described the digital scanning programme at UHS from 2013 – 2018 and the attempts to create a workable classification scheme for the diverse documentation that comprises a typical medical record. In this essay, I describe and reflect upon the lessons and outcomes of the acquisition and implementation programme for the Hyland OnBase EDMS at UHS between 2014 and 2024.