Established practice

Your EPR project has been on the agenda for two years and still hasn't moved

Stalled digital transformation in independent hospitals is rarely a technology problem. Misaligned clinical, operational, and commercial requirements keep projects in committee while the cost of delay compounds quietly.

steps: 6; steps
to start: 1 week; to start

The short answer

EPR projects in independent hospitals usually stall on people and process, not software. Before you buy or restart, write down how your clinical, operational and billing workflows should run, get consultants and nurses to sign them off, and make one named person accountable for adoption. Then test suppliers against your workflows, not their demo.

6 steps

Do it yourself: step by step

0 of 6 done

List what is live, what is half-used and where staff use paper or workarounds. Walk one patient journey from enquiry to invoice and note every re-keying point
Time
1 week
Typical cost
Internal time
Who does it
Head of IT with outpatients, theatres and billing leads
Done when: You have a one-page map of the current patient journey with workarounds marked
Describe each workflow in plain language: booking, pre-assessment, consent, theatre, ward, discharge, results, coding, billing, insurer pre-authorisation. Include consultant needs such as remote access to letters and results
Time
2 to 4 weeks
Typical cost
Internal time, or £5,000 to £20,000 if a consultant supports (Solvable estimate)
Who does it
Project lead with clinical and finance leads
Done when: A requirements document signed off by the medical director, matron and finance director
Name an executive sponsor, a full-time project lead and a clinical safety officer. The clinical safety officer manages risk under DCB0160 (the deploying organisation standard). Recruit clinical champions on each ward and in theatres
Time
2 to 6 weeks
Typical cost
Backfill costs for champions
Who does it
Hospital director
Done when: Names, time allocation and responsibilities are written down and agreed

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EPR readiness checklist

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Checklist

EPR readiness checklist

Tick each before you sign a contract or restart a stalled project.

Governance

Executive sponsor named: [Name]
Full-time project lead named: [Name]
Clinical safety officer appointed and trained (DCB0160)
Supplier has a DCB0129 clinical safety case report
Data protection impact assessment completed with your DPO
Board has agreed budget including training and backfill

Requirements

Current patient journey mapped, workarounds marked
Workflow requirements written for booking, pre-assessment, consent, theatre, ward, discharge, results, coding and billing
Consultant needs captured (remote access, letters, results, e-prescribing)
Insurer pre-authorisation and billing workflow included
Requirements signed off by medical director, matron and finance director

People

Clinical champions on each ward and in theatres
MAC briefed and consultant representative on project board
Training plan with time allowed for every user
Floor-walkers booked for go-live

Supplier

Live scenario test completed on 3 real workflows
Two UK independent sector reference calls made
Interfaces to PAS, labs, imaging and billing confirmed in writing
Data migration plan and test load agreed

Go-live

Go-live date avoids Fridays, bank holidays and peak theatre weeks
Downtime procedure tested
Adoption measures agreed and baseline taken

Avoid these

Common mistakes

Choosing a system from the demo before writing down your own workflows.
Giving the project to IT alone with no clinical lead.
Cutting training budget to save money, then paying for it in workarounds.
Forgetting consultants, who then keep their own paper notes and letters.
Declaring success at go-live instead of measuring adoption for three months.

Free personal check

Done by Paul Robinson, not software

Answer eight quick questions and I'll show you why your EPR project is stalling

What I need from you

Eight tap answers about your EPR project
Your current system and stage

What you get

Where your project stands against those that go live well
The three blockers to clear first
What to ask suppliers next

Within 2 working days

No sign-in, no sales call. I read every request myself and reply on WhatsApp.

Free tools

Check where you stand

Your illustrative estimate

£139,000

Solvable estimate. Rounded to the nearest £500. Updates as you type.

Staff hours lost per week

Starting figure 60 (midpoint of 40 to 80). Change it to match your practice.

Hourly cost

Starting figure £25 (midpoint of £20 to £30). Change it to match your practice.

Unbilled or late episodes per year

Starting figure 100 (midpoint of 50 to 150). Change it to match your practice.

Average episode value

Starting figure £2,000. Change it to match your practice.

Share recoverable once the system is adopted

Starting figure 50% (from 50% (all Solvable estimates)). Change it to match your practice.

Formula

Annual recoverable cost of a stalled EPR = [staff hours lost to re-keying and workarounds x hourly cost + unbilled or late-billed episodes x average value] x share recoverable

Variables and defaults

staff hours lost per week: 40 to 80
hourly cost: £20 to £30
unbilled or late episodes per year: 50 to 150
average episode value: £2,000
share recoverable once the system is adopted: 50% (all Solvable estimates)

Defaults only. Change them in the calculator to use your own numbers.

Assumptions and defaults

staff hours lost per week = 40 to 80
hourly cost = £20 to £30
unbilled or late episodes per year = 50 to 150
average episode value = £2,000
share recoverable once the system is adopted = 50% (all Solvable estimates)

Counts only time and billing leakage, not clinical risk. Total leakage is roughly £140,000 to £425,000 a year (40 x 52 x £20 + 50 x £2,000 = £141,600; 80 x 52 x £30 + 150 x £2,000 = £424,800), shown as context. At 50% recoverable, about £70,000 to £210,000 a year.

Benchmarks

Training and backfill often 10% to 20% of total project cost
Commonly under-budgeted part of EPR projects (Solvable estimate: every user needs training time, plus backfill and floor-walkers at go-live)
Solvable estimate

Every supplier I know who solves this. No one pays to be listed. Where I've worked with them, I say so.

The DPO Centre
Data protection
Outsourced data protection officers, NHS DSPT support and Caldicott Guardian services, including for healthcare organisations.
Outsourced DPO and GDPR support with healthcare clients. Useful if nobody in the clinic owns data protection.
Best for: Clinics and hospitals needing an outsourced DPO
Price on request
No commercial relationship

Know a supplier I have missed? Tell me Suggest yourself

EPR and digital transformation projects in independent hospitals fail most often because of change management, not technology. The clinical, operational, and commercial requirements are rarely aligned before procurement begins.

The primary root causes stem from a lack of integrated strategic planning where clinical, operational, and commercial needs are not holistically defined and aligned before procurement.
This often leads to selecting systems that are technically capable but ill-suited to the organisation's unique workflows and patient pathways.
Furthermore, insufficient investment in change management and staff training, coupled with a failure to secure genuine clinical buy-in, results in poor adoption and suboptimal utilisation of the new system, undermining its intended benefits.

NHS trusts in England could spend more than £13.5 million in 2026 on correcting data problems that emerge after electronic patient record (Digital Health Intelligence Ltd, 2026)

Increased administrative burden and staff burnout
Inefficient patient flow and longer waiting times
Significant cost overruns on implementation and ongoing maintenance
Missed opportunities for efficiency gains and revenue optimisation
Increased risk of medication errors and adverse events
Delayed or inaccurate diagnoses due to incomplete patient information
Negative patient experience and reduced patient satisfaction scores
Damage to the hospital's brand and competitive standing

What it looks like in practice

Clinicians reverting to paper-based processes or workarounds
Significant delays in patient registration and appointment scheduling
Inaccurate or incomplete patient records leading to clinical inefficiencies
Frustration among staff due to clunky interfaces and poor system integration

Paul Robinson

14 years in UK private healthcare

I solve this one for hospitals

Want a hand? I'll look at your situation and tell you the three things I'd tackle first.

A few quick questions, about two minutes. I read every one myself and usually reply the same day.

No sales call unless you ask for one. Just a straight answer from me.

I reply personally, usually the same day.

Questions

Frequently asked questions

Do we need a clinical safety officer?

Yes. DCB0160 is the NHS information standard for organisations deploying health IT in England (current version 3.2, from 2018). It applies to organisations providing NHS-funded care and is sound practice for private work. The clinical safety officer should be a registered clinician with appropriate training. NHS England is reviewing DCB0129 and DCB0160, so check for updates.

How long does an EPR implementation take?

For a single independent hospital, plan on 12 to 24 months from contract to stable use, longer if you are replacing several systems (Solvable estimate).

Can we restart a stalled project without changing supplier?

Often yes. Most stalls come from unclear requirements, no clinical ownership or too little training. Solve those first and re-test before switching.

How do we get consultants to use it?

Involve them early, give them remote access to what they need, and make the system faster than the paper alternative for their top three tasks.

What should we measure after go-live?

Paper usage, login rates, discharge letter times, coding completeness and billing turnaround.

Last reviewed: 30 October 2026

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The short answer

Do it yourself: step by step

1Diagnose where you are1 week · Internal time

2Write the requirements by workflow2 to 4 weeks · Internal time, or £5,000 to £20,000 if a consultant supports (Solvable estimate)

3Appoint the right people2 to 6 weeks · Backfill costs for champions

4Test suppliers on your workflows4 to 8 weeks · Internal time

5Plan training and go-live properly3 to 6 months of planning · Training backfill often 10% to 20% of project cost (Solvable estimate)

6Measure adoption, not just go-liveWeekly for 12 weeks · Internal time

EPR readiness checklist

Common mistakes

Answer eight quick questions and I'll show you why your EPR project is stalling

What I need from you

What you get

Check where you stand

What's this costing you?Optional: work it out with your own numbers

How we worked this outMethod, formula and assumptions

Suppliers who solve this1 supplier. No one pays to be listed

Why this keeps happening

What it leads to

Evidence

Want a hand? I'll look at your situation and tell you the three things I'd tackle first.

Frequently asked questions

Do we need a clinical safety officer?

How long does an EPR implementation take?

Can we restart a stalled project without changing supplier?

How do we get consultants to use it?

What should we measure after go-live?

You're not the only one with this problem.