Cerner success at Kingston Hospital?

Kingston Hospital reports that its implementation of the Cerner Care Records Service  has been more successful than at other trusts – but the local paper, the Surrey Comet, isn’t convinced.

Meanwhile the hospital’s Chief Executive reports that “ongoing operational issues are being prioritised”.

In 2009/10 the Trust received extra money – through NHS London and NHS Connecting for Health – to support its Care Records Service go live and to help develop a scaleable national implementation model. But it needs extra funding because “ongoing resource requirements are much greater than those originally expected”.

The Trust says: “Due to increased development of the reporting systems to ensure they are sophisticated enough to deliver a timely, accurate reporting solution, the Trust is currently seeking additional funds to ensure successful delivery.”

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After learning the lessons from NPfIT go-live failures at various hospitals, Kingston Hospital went live with the Cerner Millennium Care Records Service on 30 November 2009.

E-health insider reported that trust switched from its iSoft CliniCom Patient Administration System to Cerner.

KatieGrimes Kingston’s chief executive, said at the time: “The escalationprocess, with the different layers of support, seems to be working. OurCRS [Care Records Service] Command Centre is a hive of activity withthe teams there solving minor technical glitches with the transfer ofdata between our old PAS and CRS.

“Many of the issues are simplythe nerves of the first few hours of using the system, which is exactlywhat we predicted and planned for.”

An NPfIT CRS success?

Now it transpires that Kingston is encountering teething problems. It has put in place a remedial plan to “ensure that accurateinformation could be obtained on key targets such as the 18 week wait”.

The Trust says it met the 18 week target for December 2009 but”it waspossible that the target might be missed in January 2010″ – whichraises the question of whether any patients who were not seenwithin 18 weeks have ended up as possible victims of Kingston’s CRSsuccess.

TheTrust has conceded that outpatient DNAs [did not attend] increased inDecember and January “due to post CRS implementation issues”.

Kingston spends £800,000 on “floorwalkers”

Along-established media group in Surrey, the Surrey Comet, reports thatthe trust has “been forced to spend £800,000 for IT support’floorwalkers’ as NHSstaff struggle to come to grips with a troubled computerised recordssystem”.

The trust says the implementation has been a success. The chairman of the hospital, ChristopherSmallwood, told the Surrey Comet,

“Although there have been some rough edges, this hasbeen the most successful introduction of CRS.”

And Grimes said:

“I think we have got allthe key issues on to the table. More clinicians are beginning to seethe benefits of deployment of the system.”

Some other parts of the Surrey Comet article:

“Delays in implementing the £12.7bn national Care Records Service (CRS)cost Kingston £500,000 last summer in contractors and staff kept on thepayroll in readiness for its introduction.

“The overall cost of teething problems in the new system so far is morethan £1.2m, although the trust said it had made some of the money back.

“Floorwalkers roam around providing IT support for frustrated workers trying to input information into the system.

 “The number of calls to the help desk has dropped to about 50-a-day, with training for staff who have problems using it.”

Kingston’s February 2010 board minutes

Below’s excerpts from Kingston’s board minutes will be proof to some of the success of the implementation.

Othersmay see the minutes as defensive of Cerner, which is the chosensoftware of BT, the local service provider for London, and NHSConnecting for Health, which runs parts of the NPfIT.

Defensive of Cerner?

Minutesat Barts and The London were defensive of Cerner: when there were CRSproblems Barts pointed out they had little or nothing to do withCerner; and Kingston says: “A number of the issues related to culturaland process changesrequired within the organisation rather than issues directly related tothe performance of CRS.”

Excerpts from Kingston’s February minutes:
 
CRS

“TheCRS implementation had been more successful than at other Trusts.However, a number of data migration issues had emerged which had hadoperational implications, particularly in outpatients.

“Astructured programme was being put into place to address outstandingissues. Those issues that had a direct impact on patients were beingprioritised.

“A number of the issues related to cultural andprocess changes required within the organisation rather than issuesdirectly related to the performance of CRS.

“As yet it was unclear whether the Trust would be able to address all of these issues by the end of February 2010.

“Aremedial plan had been put in place to ensure that accurate informationcould be obtained on key targets such as the 18 week wait. The Trusthad met the 18 week target for December 2009 but it was possible thatthe target might be missed in January 2010.”

TheBoard congratulated the IT director and “all the Trust staff who hadbeen involved in the implementation of CRS, particularly those inoperations and IT”.

The stabilisation of CRS at Kingston continues

The Hospital’s Chief Executive reports:

“The stabilisation of CRS continues with a refocused programme of work.

“Ongoingoperational issues are being prioritised within relevant workstreamsand being actioned accordingly. A dedicated email address and telephoneand fax line have been set up for GPs who are experiencing CRS relatedissues to enable speedier resolution.”

Key financial risks are CRS and data challenges
 
Separately in its February papers the Trust reports:

“Theyear-end forecast remains a surplus of £1.9m before impairment with themain risk still being CRS implementation and data challenges…”

“TheTrust successfully deployed a new patient administration system in late2009 – the Cerner Millennium Care Records Service (CRS) as part of theNational Programme for IT.

A CRS benefit: real-time bed management

“As CRS beds in, it will bepossible to reduce the complement of additional staff that have beenrequired to enable go live and to seek further operational synergies -for example through real time bed management.

“Little recognition of the potential savings has been made in the plans to date as this is still considered premature.”

Comment:

TheCerner implementation at Kingston appears to have gone better than thego-lives at some other hospitals.. But it’s early days – and it seemsthat some patients might have noticed the disruption, however diligentwere the attempts to minimise it. 

Links:

Hospital spends £800k on IT troubleshooters – Surrey Comet

Minister to sew up new NPfIT deals ahead of general election? – IT Projects Blog

O’Brien claims govt may lock-in NPfIT – E-Health Insider

Kingston goes live – NHS London – London Programme for IT

Tories uncomfortable on what they’ll do about the NPfIT – IT Projects Blog

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