IM&T Strategy – Replacement of EPR, Data Warehouse and Development of Clinical Portal


In 2016, the RMH Trust Board approved the IM&T Strategy that recognised the issues associated with the continued provision of ‘homegrown’ IT solutions to meet the Trust’s current and future needs. The IM&T Strategy set out an ambitious programme of IT upgrade and replacement.

The Trust needed to identify the most effective, efficient and economic order of delivering the key components of the IM&T strategy for the following:

  • Replacement Electronic Patient Record (EPR) – to provide enhanced functionality including full e-prescribing and order communications
  • Replacement Data Warehouse – to support enhanced reporting capabilities and to capture and analyse research information
  • Development of a Patient, Research and Clinical Portal – to support new models of care
  • Provision of resilient and robust infrastructure – to support new IT platforms maximising availability of core systems, including Mobile working

The Trust then needed to complete preparation for the procurement and delivery of these programmes through development of requirements and approval of Outline Business Cases


Nautilus was engaged to lead the programme initially for three workpackages (Roadmap, Options Appraisal and Requirements), which was extended to include the development of a set of OBCs for TrustBoard approval. Nautilus deployed a team of subject matter experts for each solution area, under the leadership of a Directorlevel consultant providing overall vision and senior engagement.


Nautilus prepared a high level roadmap which addressed the challenges and opportunities facing RMH as a world-leading specialist Trust. This was achieved by our knowledge of a broad cross-section of potential solutions (including understanding of functional scope, supplier costs, Trust resource requirements, delivery timescales) and identification of the technical solution and clinical inter-dependencies. The high level roadmap considered
interim states which would continue to support the operation of the Trust. In reviewing the four components, the roadmap identified high
priority requirements for Clinical Services (Pathology and Radiology) and Research, and downgraded the priority of a separate portal
solution (based on maturity of requirements and available solutions).

Options Appraisal

Building on the Roadmap, for each component, Nautilus identified:

  • Solution options and associated costs (including options for collaboration)
  • Resource impacts for implementation
  • Existing solution cost savings, and potential benefits
  • Risks and dependencies
  • Procurement routes
  • A proposed method and order of delivery

Nautilus worked with key stakeholders from across the Trust to assess the options and confirmed a preferred option for each.


Nautilus SMEs worked with RMH staff through a series of workshops to develop comprehensive output-based specifications for EPR,
Pathology, Data Warehouse and Infrastructure. These were based on existing collateral and enhanced to reflect the specialist needs of the
Trust, balanced with understanding of the structure and functionality available in existing COTS solutions.

Outline Business Case

Nautilus drew upon the work completed in the preceding workpackages to develop a set of consistent and clear 5-case model business cases for presentation to the Trust Board. These collectively made the case for the overall IT Strategy delivery programme, including detailed impact assessment on Trust resource requirements as well as overall costs and benefits.

Nautilus provided a team of subject matter experts covering the broad spectrum of RMH requirements. We led production of all key outputs (Roadmap, Options, Requirements and OBCs) and supported the Trust team in their progress through key Trust governance groups.

Nautilus provided additional specialist expertise where necessary, and sub-contracted further work (e.g. network audits) where necessary to provide rapid and detailed further evaluation was needed.

Nautilus engaged broadly across clinical, IT and operational staff across the Trust (and Sphere, the Trust’s outsourced IT infrastructure partner) to ensure wide engagement, input and validation of all key outputs.


Nautilus delivered:

  • high level delivery roadmap for the IM&T strategy
  • Option Appraisal, OBS and OBC (including viable cost models, risks and benefits) for:
    • EPR
    • Pathology
    • Data warehouse
    • Infrastructure

As a result, the Trust is now progressing with procurement and Full Business Cases for the delivery of its IT Strategy Programme.

download the full casestudy