Powering Digital Health Transformation: Alder Hey’s EPR Go Live Story

Transforming healthcare delivery for 4,000 users whilst maintaining uninterrupted patient care

The Client

Alder Hey Children’s NHS Foundation Trust is one of Europe’s biggest and busiest children’s hospitals. It is one of the UK’s leading specialist paediatric hospitals, serving children and families across the North West and beyond.

With 4,000 end users relying on their systems daily, any technology change carries enormous responsibility for patient safety and care continuity.

The Challenge

Alder Hey faced a critical system transformation: migrating from their existing Electronic Patient Record (EPR) MEDITECH v6.08 to MEDITECH EXPANSE v2.1 as part of their AlderC@re initiative. This wasn’t just a simple upgrade—it was a complete overhaul that would introduce new functionalities, including:

• A new scheduling module supporting their “Brilliant Booking” initiative
• Enhanced theatres module for operational improvements
• Patient portal enabling electronic communication with families
• Web-based software for mobile work on tablets
• Improved user interface replicating traditional patient notes
• Quality and Surveillance (QRM) module for enhanced patient safety

 

The Critical Issues

Fragmented Planning The project suffered from siloed working, with over 10 different workstreams progressing at different paces. Communication wasn’t fluid, and there was no integrated view between IT and clinical/operational teams.

Data Migration Uncertainty: Four months before go-live, fundamental questions remained unanswered:

• “How long does the data migration take?” “Don’t know, a couple of hours”
• “How long does each step take?” “Don’t know”
• “Do you track timing for each step?” “No, nobody asked for that before”

This uncertainty had direct implications for the planned downtime period, a critical factor when patient care depends on system availability.

The 40-Hour Surprise. The most concerning was the EPMA (Electronic Prescribing and Medicines Administration) data initialisation. The Meditech team assured us it would take 5 hours based on recent data cycles. We planned the entire cutover weekend around this timing, including:

• Go-live schedule
• Pharmacy testing release
• Contingency planning for paper prescriptions
• Staff mobilisation for data catch-up

The reality? It took 40 hours = Eight times longer than expected.

This wasn’t a technical failure; it was a knowledge gap. The team had confused a full data load in an existing environment with data initialisation in a brand-new environment… A fundamental difference they’d forgotten since the original setup about two years earlier.

High-Stakes Environment Adding pressure was Alder Hey’s connection to Liverpool Women’s Hospital. Any extended downtime, particularly affecting laboratory systems, would impact patients across both hospitals.

Our Solution

Strategic Approach

We implemented our proven Cutover Framework combined with a Hybrid Waterfall-Agile methodology:

Foundation Building (Weeks 1-3)

• One-to-one meetings with all stakeholders
• Stakeholder mapping and cutover kick-off documentation
• Set up the Cross-workstream workshops to break down silos for the next 5 months

Structured Communication We established a comprehensive meeting cadence:

• Weekly workstream-specific calls
• Weekly joint sessions with all workstreams and senior leadership
• Weekly clinical-focused sessions
• Bi-weekly “Drop In” sessions 1.5 months before go-live—open forums where any staff member could ask questions directly to the C-Suite and programme team

Data Migration Enhancement

Visibility and Control

• Added detailed logging to all data flows
• Conducted “like-for-like” end-to-end dress rehearsals
• Tested parallel sequencing to identify dependencies and optimise timelines

Comprehensive Rehearsals Since we couldn’t access an integrated pre-production environment, we broke down the dress rehearsal into manageable components:

• Downtime procedures
• Data migration processes
• Data catch-up procedures
• Functional testing workflows

The “One Document” Approach

We created a single source of truth—one comprehensive cutover plan that served all stakeholders but was tailored for different audiences:

• Senior Leadership: High-level milestones and risk overview
• Clinical Teams: Patient safety processes and clinical handover procedures
• EPR Champions: Detailed technical workflows
• Technical Teams: Granular implementation steps
• Floorwalkers: User support procedures

This eliminated confusion and ensured everyone worked from the same playbook whilst receiving information appropriate to their role.

Collaborative Leadership

Global Cutover Manager Role: As the central coordinator, we ensured seamless communication between teams, working closely with:

• Change managers for trust-wide communication
• Clinical leads for patient safety processes
• Workstream leads for proactive updates and task completion

The Results

Measurable Outcomes

Stakeholder Alignment

• 100% of workstreams aligned to a single cutover plan
• Clear communication channels have been established across all levels
• Reduced decision-making time through streamlined reporting

Risk Mitigation

• Eliminated data migration timing uncertainty
• Established robust contingency procedures
• Created comprehensive dress rehearsal protocols

Operational Excellence

• Smooth system transition with minimal disruption
• Maintained patient care continuity throughout
• Successful deployment to 4,000 end users

Business Impact

Enhanced Patient Care The new system delivered on its promise of improved patient care through:

• Streamlined booking processes
• Better clinical handover capabilities
• Enhanced patient and family communication
• Improved quality monitoring and safety alerts

Operational Efficiency

• Reduced manual processes
• Improved clinical workflow efficiency
• Better resource utilisation across the hospital

Future-Proofing

• Mobile-enabled workforce
• Scalable platform for future enhancements
• Integrated approach supporting hospital-wide initiatives

 

Key Lessons Learned

 

• Never assume knowledge exists—always verify timing and processes, especially for infrequent activities

• A single source of truth is essential when managing complex multi-workstream projects

• Stakeholder engagement at all levels prevents communication breakdowns

• Dress rehearsals must be realistic to identify genuine issues before go-live

• Flexibility within the structure allows for necessary adjustments whilst maintaining overall direction

The success of Alder Hey’s Meditech Expanse deployment demonstrates that even the most complex healthcare transformations can be delivered smoothly when proper planning, communication, and risk management are in place. The result? A world-class children’s hospital equipped with modern technology to deliver exceptional patient care for years to come.