Barts and the London NHS trust ended up in “The Sun” newspaper yesterday [9 April 2008] after going live with a basic version of Cerner’s “Millennium” Care Records Service under the NHS’s London Programme for IT.
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The newspaper claimed that “two top hospitals descended into chaos last night as a multimillion pound computer scheme crashed on launch day” . It said the system should hold all patient records and bookings of operations, but it “failed, forcing doctors at the Royal London and Barts hospitals in East London to write notes on slips of paper.”
Responding to story, Barts and The London NHS Trust issued a statement which denied the system had crashed but made no comment on The Sun’s claim that doctors had resorted to writing notes on slips of paper.
The trust’s statement gave the impression of minor problems only, saying the “majority” of issues had been resolved within 24 hours. It apologised to patients for a “slight delay” while staff familiarised themselves with the systems.
This was the statement:
“The new patient administration system – also known as the Care Record Service (CRS) – installed at Barts and The London NHS Trust this week did not crash, contrary to what was reported in today’s Sun newspaper.
“A period of adjustment was anticipated with contingencies in place to support staff who experienced any problems, with the majority of issues being resolved within 24 hours.
“Some patients may have experienced slight delays during clinics while staff familiarise themselves with the new system. We apologise for that, but it is important to note that patient’s [sic] clinical care is not being compromised.”
Three weeks ago, shortly before the go-live, the trust’s Chief Executive Julian Nettel told his board that the go-live would represent the “biggest change in the way patient information is handled within the Trust for 30 years and is a major milestone towards the introduction of electronic healthcare records for patients”.
He added: “The CRS [Care Records Service] represents a major investment in technology for the future and the Trust is committed to launching a robust and effective system that will bring major improvements to the speed, safety and quality of patient care and treatment.”
In preparation for the go-live about 340 members of staff agreed to become CRS “Local Experts” to help colleagues in their team or work area with any queries. There were also about 90 “floorwalkers” on hand to help staff get used to the new system – as well as the trust’s ICT helpdesk.
Last month the trust categorised as a moderate risk a possibility that the trust would fail to manage effectively the initial implementation of the Care Records Service, which could impact adversely on clinical care and business operations.
The trust also listed under the heading “gaps in control” an “uncertainty on timing of resolution for all critical issues, including issues arising from the results of testing” and the “complexity of relationship with BT/Cerner given basis of contractual arrangement”.
To minimise the risks, the trust has:
– adopted a “comprehensive test strategy that tests all operational processes and infrastructure”.
– put in place training to include ‘refresher’ training – in part because earlier go-lives had been postponed.
– given daily updates on outstanding issues to executives
– participated in the development of LC2 release [a London-wide modification of the Cerner system that’s being deployed in the South of England]
. learnt lessons from ‘dress rehearsals’ including those on business continuity and ‘downtime’ arrangements.
Barts and the London NHS Trust has gone live with release LC0 of the Care Records Service. Its executives are due to implement the next version, LC1, this summer. BT and the NHS in London have “de-coupled” their implementations of Cerner’s “Millennium” system from the version of the software being deployed by Fujitsu at trusts in the south of England. The London system is based on Cerner implementations in 2004 at Homerton and Newham.