An informed specialist reports on the go-live earlier this month of a Cerner system deployed by BT at Barts and The London NHS Trust. Managers at Barts have seen the article and given their response at the end.
“Staff working at Barts & The London described the go-live as a “roller coaster ride”. The hospitals benefitted from a very high level IM&T team experience being available. Kevin Jarrold is said to have personally injected his expertise – He is now head of the London Programme for IT and was Head of IT at University College Hospital when it implemented IDX Carecast, the original American CfH choice of acute hospital system.
“Kevin Jarrold was supported during the last few months by the highly regarded Phil Jones, now Director of ICT at Barts & The London and previously in a similar post at St Mary’s Paddington.
“Patrick Brady, who successfully installed Cerner at Homerton and Newham, was Programme Manager bringing with him his unprecedented level of expertise in Cerner implementation in the UK. Nevertheless, all was not successful as The Sun points out.
“The question posed by one of the Barts & The London staff was ‘what do other trusts with less experience and expertise have to do additionally to enjoy a trouble free implementation?’
“The principal problem at Barts & The London was that despite much staff training, helped by the several delays to implementation date, the system was quite alien to the working practices of clinical and nursing staff there.
“The help desk was said to have been inundated (thousands of help desk calls were estimated to have made in first few days) with staff struggling to remember how to handle various IT activities to which they had been introduced in their limited training sessions.
“Barts & The London are said to have enjoyed one significant advantage over the southern cluster implementations which have been more problematic. Barts & The London were able to use the Cerner Command Language facility which has not been included in southern cluster implementation kits. [The Cerner Command Language is an SQL-like programming language developed by Cerner Corporation.]
“There remain significant gaps in the functionality available in the Cerner product set made available through CfH particularly in satisfying NHS-specific requirements. These gaps have to be filled by work-arounds.
“Barts & The London were able to produce local work-arounds in Cerner Command Language in software, whereas earlier implementations in the south have had to rely on manual paper- based work-arounds.
“It is also of note that the London Region Cerner software release LC0 is not identical to Cerner R0 release used in the south, but both of these are expected to be superseded later this year by new software releases based on Cerner 2008 code.”
I put this article to Barts and The London NHS Trust which provided a useful response quickly. It said:
“The new patient administration system – also known as the Care Record Service (CRS) – was installed across Barts and The London’s hospitals – Barts, The Royal London and The London Chest – last week.
“Any IT deployment of this size and complexity involves a massive amount of change for everyone involved. Contingencies have been in place to support staff as they adjust to the new system with any teething problems being quickly resolved.
“Phil Jones, Director of ICT at Barts and The London, said:
‘We are pleased that the CRS system has been successfully installed and is working correctly. However, this is an extensive and complex system and we recognise that we still have work to do in ensuring staff are using the system as intended.
‘While good staff training is essential before any go-live it is no substitute for actual hands-on use of the system. We will continue to provide significant support for our staff over the next few weeks as they familiarise themselves with the new system and refresher training will be provided on an ongoing basis.
‘We anticipated that there would be an increase in calls to our helpdesk over the first few days and had additional staff in place to field these calls.’
“Contrary to what was reported in The Sun newspaper last week, the system did not crash.”
Barnet and Chase Farm Hospitals – still a considerable number of work-arounds with Cerner go-live– September 2007