As a clinician, I am passionate about improving the systems we use every day—so they work better for us, and ultimately, better for our patients.
If you’re reading this, I hope you feel the same.
Our clinical systems should amplify our strengths, compensate for our weaknesses, and help coordinate care more effectively. They should make good practice easier and safer to deliver.
With the right approach, we can rebuild our systems to be:
- Better for patients: safer and more integrated patient care
- Clinically owned: empowering users and clinical teams
- Usable and Fast: accessible, intuitive, and efficient
🧠 The Purpose of This Blog Series
This series explores how we can achieve those goals. It draws on:
- Real-world clinical cases that underscore what’s at stake
- Best practices from health informatics and industry
- Benchmark user surveys
- Lessons from leading organisations
Across this there is a common theme.
We make systems better by enhancing clinical workflow.
That means using our experience as clinicians to shape technology around how we actually work—not the other way round.
This first post introduces the key drivers and concepts behind designing workflow-centred EPR systems. While the focus is on secondary care, these principles apply across the board.
📍 The Challenge
Here’s why I care so deeply about this. It’s personal.
A Clinical Missed Opportunity
Cancer is a diagnosis no one wants to face. Thankfully, we’re getting better at detecting and treating it. Many patients now live in long-term remission—and part of my role is helping to keep them well and ensure recurrence is caught early.
Some time ago, a follow-up chest X-ray was reported by a skilled radiologist. She spotted something subtle—partially hidden behind the heart. It could have been benign, but she correctly recommended a CT scan to exclude recurrence.
A year later, the patient returned. The scan had never been done. When we performed it, we found cancer. It had grown significantly.
What could have been a minor intervention became a more intensive treatment plan. Thankfully, the patient recovered. But it could easily have been worse.
What failed? The test was done. The report written. It was filed—but never seen. The clinician had no idea it existed.
📉 A Wider Problem
This wasn’t an isolated case. The 2007 national Safer Practice Notice warned trusts to ensure clinicians are alerted to significant results. But a 2016 Royal College of Radiologists survey found that only 11 of 154 departments had a robust electronic alert system in place.
This case drove me to act. Our systems must do better—to be safer, smarter, and clinician-centred.
🩺 What Other Clinicians Are Saying
Surveys and articles reflect a similar story: clinicians are frustrated. Many EPRs fail to meet user needs.
- Some function only as passive repositories of data, disconnected from workflow
- Others impose rigid structures, asking for information that feels unnecessary
- Alerts, tasks, and forms can overload users and increase burnout
What’s missing is focus on the clinician experience:
- Relevant information is hard to find
- Communication is fragmented
- Workflow feels clunky, inflexible, or simply doesn’t track critical tasks
- Patient care can fall through the cracks
We need to move beyond “document storage” and build systems that track clinical work, support communication, and prioritise care.
🎯 The Goal
The real challenge is this:
How do we design workflow that enhances both patient care and user experience?
That’s the focus of this series. Let’s explore what benchmark surveys and best practices tell us we should do next.
Next: What does the evidence from ‘benchmark’ user surveys tell us we should do?
Reflections of a CCIO 
One thought on “EPR: A vision for enhancing clinical workflow”