Integrating Centralized Medical Content Management Systems in the NHS: A Time and Motion Study

OBJECTIVES: USBs, printing images, and other non-encrypted communication methods are often used to transfer clinical images and videos to patients' electronic patient records (EPRs). This manual process by nurses is time-consuming, error-prone, and limits real-time information utilization.

This research aims to assess the impact of integrating a medical video recorder and a centralized medical content management system connected to EPRs in a hospital on nurses' time and experience.

METHODS: A single-center, direct observational time and predetermined motion time system analysis was conducted over two, separate one-week periods in the ear, nose, and throat (ENT) outpatient department of Royal Devon University Healthcare NHS Foundation Trust located in Devon, UK. In addition, a survey was conducted to measure nurses' experience during the transition from traditional (manual) to digital processes.

RESULTS: Traditionally, nurses used two methods to upload clinical images and videos to EPRs. Digitization resulted in efficiency gains of 10% and 33%, respectively, saving 43 seconds and 3 minutes and 8 seconds per endoscopy compared to Process 1 (nurses print, attach, scan, and digitize images offsite to EPRs) and Process 2 (urgent content recorded on iPad, transferred to EPRs), respectively. For the ENT outpatient department, digitizing could save nurses 26 working days annually in non-patient-facing tasks. Additionally, 63% of nurses strongly agreed that digitizing increased confidence in the accuracy of patient details, and 75% of nurses reported significantly improved morale. All paper processes were eliminated.

CONCLUSIONS: A centralized medical content management system has the potential to improve nurses' workflow by reducing time spent on non-patient-facing tasks and documentation, providing timely access to clear images and videos which can speed up clinical decision-making. This may result in higher quality of care and patient satisfaction, as well as helping to maintain positive staff morale. It also is environmentally friendly through the reduction of paper-based processes.