The first hospital in England to install a smartcard-based
Cerner system under the health service’s £12.7bn IT modernisation
scheme faces indefinite, multiple problems, according to an
internal NHS
document.
It discloses that since the
Royal Free Hospital, Hampstead, installed systems in June 2008,
under the national Care Records Service scheme, there have been
risks to patients, breaches of security through smartcard sharing,
long log-in times which discourage staff from using the system, and
information having to be written on paper – making parts of the new
technology redundant.
There have also been system crashes, sometimes twice or three
times a week, and extra staff needed, in part to "minimise clinical
risk".
The paper "Lessons learnt from the Royal Free Hospital Emergency
Department" was disclosed by an NHS employee and has been obtained
by Computer Weekly. It gives an insight into how difficult it will
be for suppliers and the NHS to maintain the smooth running of
hospitals while installing standardized national systems into
complex hospitals across London and south of England, all of which
have different ways of working.
A spokeswoman for the Royal Free said that some problems with
the system "will take some time to sort out".
If similar problems arise from
other implementations in the south and London, NHS staff may
find that it takes longer to do what they did before, which could
mean they care for and treat fewer patients. Some patients may be
put at risk if they are lost in the system or their condition is
under-estimated through mistakes on the system or a lack of
information. The paper also highlights the risk of clinical time
being wasted dealing with system work-arounds – or the IT going
unused because of the difficulties.
The paper says the implementation of the
Care Records
Service at the Royal Free was "particularly difficult for the
emergency department".
A spokeswoman for the Royal Free said: "Our new Care Records
Service was installed in June this year. Although the
implementation initially went better than we expected, there are
some problems with the system which will still take some time to
sort out. This is being pursued vigorously with the local service
provider, BT, the London Programme for Information Technology and
the system supplier,
Cerner UK.
"The longest period of downtime we have experienced was
overnight 17/18 September when an error occurred during a data
back-up exercise at the BT data centre.
"This led to the trust's computer system being unavailable from
midnight on Wednesday 17 September for 11 hours. BT worked through
the night to restore the service. During the downtime paper systems
were used, which is the standard business continuity procedure.
"There are bound to be issues when installing a system of this
complexity and these are being worked through. Some have required
software or other solutions from BT/Cerner, while others have
required the trust to find improved administrative processes.
"We expect that we will continue to experience issues from time
to time in what are still early days for a change on this scale.
Staff are particularly vigilant during any periods of disruption to
ensure that patient safety is not compromised."
A spokesman for
BT, the NPfIT local service provider to London, said: "We
recognise that there have been problems at the Royal Free Hampstead
NHS Trust, the first trust in London to implement the LC1 release
of Cerner Millennium.
"There has been some downtime and we have worked in conjunction
with the trust to keep this to a minimum. All parties -
BT,
the London Programme for IT and Cerner UK - are fully committed to
working with the Royal Free Hampstead NHS Trust to resolve the
remaining issues. BT and Cerner are working with the Trust and are
taking a systematic and staged approach to dealing with the issues
the Trust is experiencing. Service enhancements are being planned
and will be implemented incrementally over the coming weeks.
What the
internal NHS paper says – Computer Weekly’s IT Projects blog
>>
See also:
Pioneering London hospital - Royal Free Hampstead - hit by crashes
and delays >>
Barts still struggling with Cerner CRS (E-health insider)
>>