Worthing says PAS teething problems over

07 Nov 2007

Worthing and Southlands Hospital NHS Trust says it has resolved initial teething problems of its new Cerner Millennium patient administration system, provided by local service provider Fujitsu.

The go-live has described by sources close to the trust as the best implementation of Cerner Millennium under the NHS IT project to date, but one which still requires extensive work-arounds.

“The trust is very happy with the way the transition to the new Cerner Millennium system went. As would be expected with any project of this size and complexity, we have experienced some initial difficulties. However, we also have in place robust support processes that are enabling us to address these as quickly as possible,” a spokesperson told E-Health Insider.

Stephen Cass, chief executive of Worthing and Southlands Hospitals said: “Implementing a programme of this size and scale is complex. The extensive planning that has gone into ‘Go Live’ has proved to be very effective, but it is the dedication, hard work and support of all the staff that has helped to achieve the transition.”

The upbeat view comes in response to enquiries by E-Health Insider over the past two weeks about how staff are getting to grips with the new system; questions prompted by frustrated users who say they are struggling to make an unwieldly system work for them and their patients.

One anonymous professional told EHI: “People are fighting hard to make it work because they care about patients and because we know that we cannot go back - but nearly everything is long winded, hard to remember and inferior to what we had before.”

A frequent criticism of the Millennium implementations in the South has been that they require a significant number of “work-arounds” to meet NHS requirements.

The source spoke of being exasperated the relentlessly positive internal gloss being put on a functional but frustrating to use system. “I worry for all the other Trusts that may still go live, believing that it is plain sailing.... it is not.”

Another source close to the project said: "The deployment activity is now much better but there remain underlying problems that have not been fixed. The solution still requires an extensive work around list."

Most tellingly the PAS system installed is so far said to not match the functionality of the Sema-Helix PAS it replaces.

Other feedback has been more positive though, particularly for the coding used by Millennium, “The coding bit is, however, brilliant and quick”.

Two weeks after EHI submitted questions the trust, after conferring with Fujitsu, said that staff are pleased with the system and says it will undertake an audit review to analyse staff opinions on the system once the initial bedding-in period of 45 days has passed.

“Trust staff have worked extremely hard to adapt to the new system and they recognise that there will inevitably be a period of adjustment while it beds in. We have commissioned an internal audit to gain feedback from users, which will enable us to make future improvements to our processes,” a spokesperson told EHI.

The Millennium system went live on 29 September and the first patient was booked on the system on Wednesday 3 October following initial problems on the external network over a 48 hour period, which hit performance of the system.

However, since then, the trust has been fully operational on the system, including modules in A&E, maternity and theatre.

The trust has not yet begun using the order communications functionality, contained but not yet enabled in the Millennium software, and say they have experienced only one problem since go-live, unrelated to the system itself.

A trust spokesperson told E-Health Insider: “In the month following go-live we have had only one planned reversion – during the clock change from BST to GMT – and three unplanned reversions, due respectively to a BT network problem, a power outage and a DNS issue, none of which was Cerner-related.”

In order to minimise problems with appointment bookings, the trust worked on a phased deployment basis: “Outpatient booking functionality was rolled out in phases to ensure the transfer of new and future appointments was achieved as smoothly as possible. Some issues did arise during the roll-out but we have in place a dedicated team for identifying and resolving these to keep any disruption to a minimum,” a trust spokesperson said.

Reader's Comments

to sum up...

07 Nov 07 17:15

It seems to have taken months of effort to install a system that gave 48 hours of downtime on go-live, that delivers less functionality than before, that is more difficult and long-winded to use, that has clinically useful functionality turned off, and which then fell over when the clocks went back. Have i missed anything?

and how many extra staff ?

08 Nov 07 11:57

The article did not cover what additional staff and operating costs have this backward leap caused.

And the coding bit (working well) is an external program.

Teething problems? "Over?"

09 Nov 07 09:17

"Over?"

Its over a year since Mid and South Bucks went live and the 'teething problems' still exist.

The first problem to be solved is admitting you have a problem in the first place

Comfort Zone

09 Nov 07 09:25

I have worked as a PAS Support engineer for a national PAS since 1992 and more recently as an IT manager that has implemented Millennium PAS. I still remember the complaints about the old PAS whenever it changed significantly. Once staff are taken out of their 'comfort zone' then they turn on the new delivery. Regular complaints were made about old PAS systems being 'unfit for purpose' but they evolved with the direction and help of the users. We must not lose sight of the fact that this is the initial release of this product with other major releases planned. At the Cerner User Group Conference at the end of October David Sides, MD of Cerner UK, acknowledged a number of userbility issues and promised that they had been recognised and were being worked on. Lets all get with the program and attend user groups to apply pressure and influence the progression of the product. Don't forget a number of old PAS systems were rapidly heading to being unsupported. The NHS has to move forwards and occasionally this includes a sideways step.

May still need a heart and brain transplant

11 Nov 07 13:44

Teething problems may be over, however may well still need a brain and heart transplant. Feeding is only one function of a baby, and this baby has serious health problems! You readers of e-health-insider can read between the lines of the report above, and the between the lines bits may well be the truth!

Comfort Zone - or wrong train !

12 Nov 07 13:47

I too have worked for a significant period implementing clincal and admin systems in the NHS.

What is so frustrating about the LSP systems is the lack of knowledge that the LSPs bring, the enormity of the backward (not sideways) step, and the feeling that it will be almost impossible to achieve the sort of fixes we have worked into our existing systems. Rather the game seems to be to make the NHS stand on its head to hide the inadequacies of the system, and save the supplier cutting code.

I've heard that one hospital in the South has had to double their Outpatients clerks to cope with the poor workflow in NCRS. Benefits realisation has a very hollow ring.

I'd prefer to stick with a train that has wheels and is moving in the right direction. And not have the NHS pay for something which has apparently proved itself incapable to enhance UK practice.