The innovation at Liverpool Heart and Chest Hospital NHS Foundation Trust sees a single digital system delivering a unified patient record, supporting patients’ psychological needs as they undergo treatment.


The Clinical Health Psychology team (“Psychology”) at Liverpool Heart and Chest Hospital NHS Foundation Trust (LHCH NHS FT) has extended, digitised and integrated its service into its established trust-wide EPR. This digital change is enabling a patient’s psychological care to be documented alongside medical care for a fuller record.

The innovation is releasing considerable and far-ranging benefits, such as streamlined processes, time savings, improved communication and care co-ordination, and enhanced patient safety.

Discussing the difference the system is making, Dr Alexandra Boughey, Principal Clinical Psychologist – Cystic Fibrosis Service and Operational Lead at LHCH NHS FT, said: “With our patient’s psychological notes now managed on the EPR and integrated with the patient’s full medical record, we can set up a team of specific users that have access to view the psychological notes. We’re saving so much time from being able to input our notes directly into the system and automatically sharing with the multi-disciplinary team (MDT).

Psychology set out to deliver the service using a single digital system which could manage a unified patient record, to better support the team and patient care. To be effective, they needed a flexible solution that was capable of making notes available or confidential to other members of the MDT. This was crucial functionality given the confidential nature of psychology case notes and being able to maintain a patient’s privacy wishes, if required.

The Trust decided to utilise its existing Sunrise™ EPR system provided by Altera Digital Health. In a matter of months, Psychology, Altera and the trust’s digital team worked together to configure the system to meet the unique needs of the psychology service. Today, the service is using the system to manage patient questionnaires, appointments, referrals, discharges and communicate with the MDT.

Sunrise™ is also facilitating the collection of meaningful data to monitor and report on specific psychology key performance indicators (KPIs), which differ hugely to medical KPIs.

With all patient data together in one place, in real-time, it’s providing staff with a fuller picture of a patient, supporting all members of the MDT to make more informed care decisions at the point of care.

Paula Dyce, Advanced Nurse Practitioner – CF Diabetes at LHCH NHS FT, commented: “Since being able to have Psychology on our EPR system it has helped us improve patient care and communication across professionals. It has streamlined the link between physical health and mental health appointments.”

LHCH manages a lot of critically unwell patients and nearly 130,000 patient visits every year. This makes the service that the Psychology team provides to the Intensive Therapy Unit (ITU) vital. The increased risks to patients cared for in the ITU makes an integrated system even more important, supporting the team to manage escalations and monitor patients more effectively with accessible notes and alerts for patients that require mental health support. The risk of losing paper notes and electronic files has also decreased which is contributing to enhanced patient safety.

Dr Alexandra Boughey added: “It’s been game changing, when you consider how time consuming the process was before. Previously, we would have to make notes on paper, transcribe them into word documents, file the document, and email/visit the wards to update the MDT with our recommendations.”

Prior to the Psychology digitisation, the EPR was already enabling the Trust to be 99.9 per cent paperless and complete all clinical documentation, order communications and prescribing. The integrated EPR has supported the LHCH’s digital transformation, enabling it to receive an ‘Outstanding’ CQC rating twice and achieve HIMSS EMRAM Stage 7 in its latest digital maturity assessment.

Rachael Fox, Executive Vice President, UK & EMEA at Altera Digital Health, said: “This latest digital transformation is a fantastic addition to Liverpool Heart and Chest Hospital NHS Foundation Trust’s exemplary digital journey so far. They are leading the way as digital-first trust and showcasing how it can support outstanding service delivery.”