Cambridge University Hospitals NHS Foundation Trust (CUH) CIO Dr Zafar Chaudry had a tough job in front of him when he joined the organisation in September 2015. CUH was at the tail end of a problematic implementation of a new electronic patient record (EPR) project known as Epic.\nStruggles to set up the system had played a big part in the Trust being put into special measures due to financial problems and being rated as "inadequate" by the Care Quality Commission (CQC).\nDr Chaudry was tasked with stabilising the project and driving adoption. He did this by optimising workflow through extensive remedial work, speaking directly with commissioners and holding their hands through system utilisation.\n"We did a massive push in terms of year on year refresher training, and training at the point of care, and that helped in the adoption, and also making sure that all the tools were in place, that there was hardware available anywhere, anytime for you to access the system," Dr Chaudry told CIO UK.\nThe project was recovered and delivered within 12 months, which helped pull the hospital out of special measures and push its CQC rating up to "good".\nCUH is the first hospital trust in the UK to adopt the system. It's\u00a0now available to 13,000 users across two hospitals and gives 4,000 clinicians concurrent access to real-time patient data.\nIt's helped cut the time taken to prepare discharge medications in half, free up 4,500 orthopaedic clinic appointments by letting clinicians view x-rays digitally, and save almost \u00a31 million annually by reducing adverse drug reactions.\nA 'paper-lite' NHS?\nCUH is one of the UK's largest healthcare Trusts. It runs the Addenbrooke's and Rosie hospitals, a biomedical research centre, and a range of specialist services across Cambridge and the southeast of England.\nThanks to Dr Chaudry's strategy, it is now also one of the country's most digital. The recovery of the Epic project helped CUH become\u00a0just the third UK Trust to obtain a\u00a0Stage 6 rating on the\u00a0Electronic Medical Records Adoption Model (EMRAM) in 2015.\nThe success\u00a0of Epic\u00a0also earned CUH a place among "Health Care's Most Wired" hospitals. It's\u00a0the first healthcare organisation outside of the US to be recognised on the\u00a0American Hospital Association's (AHA) annual list.\nEPR systems such as Epic are a key part of\u00a0the vision of a paperless NHS that politicians have promised to deliver for 25 years.\nTheir continuing failure to achieve this has come as little surprise to medtech experts, many of whom believe electronic systems should complement paper records rather than replace them.\n"I don't believe in paperless," says Dr Chaudry, who joined CUH after a three-year stint as a research director of global healthcare at Gartner. "People will still always need to print. And for business continuity, just in case the system does fail, you still need to be able to print.\n"So I've always had the strategy that I'm working towards a paper-lite environment. And we're pretty close to that. We have 750,000 out patient appointments a year, and we don't pull a single record for those out patient appointments. It's all online, and on Epic."\nCUH has also managed to reduce the number of printers at the Trust from more than 2,000 prior to implementing Epic to 438 today. Setting realistic goals that are sympathetic to staff needs has proved more powerful than grand promises.\nDigitising healthcare\nThe\u00a0digital transformation of health and social care can improve treatment, maximise staff capacity and provide more flexibility to patients. But\u00a0is ultimately an economic necessity.\n"That's how health is shifting," says Dr Chaudry. "We're not going to be building more monolithic hospitals, because we just don't have the money. So, the question is, how do you conceive healthcare differently?\n"And certainly, when we poll our patients, the millennials tend to tell us that they don't like healthcare anyway. So, they want to consume it in a different way, and that means they don't really want to come in, they just want to do it from their office."\nCUH will further support this telehealth model through its migration to\u00a0Microsoft Office 365 for Business.\nThe suite of software and services will give\u00a0staff email access on their mobile device, extensive storage space in the clouds and productivity features such as real-time document collaboration.\nIt will also support\u00a0virtual consultations with patients through platforms such as\u00a0Skype for Business.\nThe partnership CUH has developed with Microsoft provides a model for how Dr Chaudry attracts the best technology available from a variety of vendors.\n"Our conversation with Microsoft was very clear," he explains. "You put skin in the game, we put skin in the game, when we work together towards a common goal."\nCUH gave Microsoft time with nurses, doctors, and other allied health professionals to understand what they thought and wanted to ensure that Microsoft provided an appropriate service for their needs.\n"You've got to treat your vendor as a partner, but at the same time, you've got to push your vendors to bring real value," says Chaudry. "What I tend to do is say to them, 'If you think you can do it, prove it to me'. And the good ones absolutely\u00a0do that."\nCUH is also exploring how virtual reality could improve treatment in services such as physiotherapy.\n\u201cPhysiotherapists will help people exercise when their rehabbing patients," says Dr Chaudry. "And then, when the patient goes home, the patient is supposed to repeat those exercises, and come back to the hospital, and show the physiotherapist that they've been doing those exercises. But the reality is you could actually do that in a virtual world, and measure that in a virtual world."\nSecuring the future\nCyber security is of paramount importance in the NHS,\u00a0where leaks of patient information can cause major financial and reputational damage.\nCUH limits the risks through a range of tools and practices, but education remains the most crucial\u00a0component of its defences. As Dr Chaudry puts it, "your internal customer is usually your biggest culprit of losses of data".\nThe benefits of an enhanced understanding of IT extend throughout the organisation. Dr Chaudry reports directly to the medical director, who has a seat on a board that is heavily invested in digital developments at CUH.\nDr Chaudry's own experience as a medical doctor boosts their mutual understanding.\u00a0Every month he gives the board an update on the progress his team is making.\n"I think it's the CIO's responsibility - whether or not that person has a board seat - to win the hearts and minds of the board over," he says. "I spend lots of time working with board members, to keep them informed as to what we are doing within the department."\nDr Chaudry's own experience as a medical doctor boosts their mutual understanding. He uses time talking to nurses and doctors on the wards to ensure that the digital strategy is\u00a0fulfiling the needs of staff on the frontline.\n"Nurses are actually probably the best source of information any CIO can get," he says. "If you walk around the wards, and speak to the nurses, they will give you more information than you can ever get sitting in your office. They're quite vocal, and they're quite open."