Doctors go public with Millennium concerns

21 Feb 2008

Two doctors using the Cerner Millennium went public last night to voice serious concerns about the system.

One of them, independent A&E specialist, Chris Taylor, said she believed the system put patients at risk.

Interviewed on Channel 4 News, Dr Taylor expressed the view that in its present incarnation Millennium’s benefits were non-existent and that the costs and risks were considerable.

She drew attention to the problems of printing labels for blood samples as an example of risk.

“ I was walking around the department with a handful of blood samples in my hand afraid of putting them down because I didn't want to get them mixed up with the samples that others had in their hands which were equally unlabelled because the system couldn't cope,” she said.

“So if you are asking me whether it puts patients at risk? Yes, it does, because sometimes you must not delay treatment.”

Cerner told Channel 4 News: “The Cerner Millennium solution has passed all...testing and assurance requirements.” They added they had conducted performance tests on speed with satisfactory results.

Dr Simon Eccles, Connecting for Health’s national clinical director for acute care and a London hospital A&E consultant himself, said the problem needed to be investigated but pointed out that there was an escalation procedure for dealing with such issues.

"We do have a very clear escalation policy for any issue that offers risk to patients. It is unacceptable to leave patients at risk and we don't do so,” he said.

The second consultant unhappy with the newly-installed system was Dr Patrick Carr of Worthing Hospital who said it had been abandoned in the hospital’s A&E department. “Every process we used to do by hand seemed to take longer using the Cerner solution,” he said.

Dr Eccles said that in two years’ time he expected most hospitals to have the system working reasonably well.

It was also alleged that the system was costing trusts more than they had expected. Dr Carr said that at Worthing hundreds of thousands of pounds had had to be spent to make it work.

Channel 4 reported: “In just three of the 13 trusts with it - Taunton, Worthing, and Winchester - extra staff and other costs add up to around £1m.”

Link

Channel 4 – NHS multimillion pound IT: the risks

Reader's Comments

Lack of testing

21 Feb 08 15:10

I understand that a more rigorous testing phase, using live systems and data, was never fully implemented. Such a phase of testing may well have highlighted isues that are now coming to the fore. This is allegedly due to cost cutting by the DoH nationally.

Dr Eccles's 2 year prognosis ....

colin@clinformation.com

21 Feb 08 17:11

"Expected to be working reasonably well in most hospitals."

All a bit vague isn't it?

Wandering around the ward with unlabelled samples!

21 Feb 08 21:27

This clinician has obviously never heard of best practice and positve patient identification. One of the benefits of barcoded specimen labels is to perform PPid with the labels you have just printed at the label the samples at the bed side straight after collection!

Perhaps more training for the consultants and locum consultants will reduce their fear of the "new fangled" IT systems. They could always leave the ordering to IT savvy junoir doctors who take to it like ducks to water.

Finally, shame on Channel 4 for presenting such an shoddy peice of journalism to the general public. The dumbing down of the news by creating inaccurate soundbites is very sad. Perhaps they had to wait till RG had gone to sneak it in?

Between a rock and a hard place?

22 Feb 08 00:35

It seems that we can either accept large systems designed by central Government/LSPs with insufficient clinical engagement or buy small systems, designed in conjunction with frontline users that cannot easily share data. The latter appear more desirable but an EHR is needed to realise the value of their data yet the House of Commons Health Committee opines that this is a long way off. It seems that the patients and staff of the NHS will have to cope with the unknown dangers of a relatively untested new technology, that has none of the safeguards or monitoring that - for example - a new drug might have, whilst being faced with the unpalatable possibility that their investment in IT may prove to be valueless.

A preview might help..

22 Feb 08 08:38

The big problem in implementation of Millennium is that you don't get to see the system early enough to test planned processes in the software. ROPs and screen shots cannot substitute for walking through the process in a complete environment. So you end up with clinicians wasting time on impractical processes that could be done safer and faster by reordering the sequence slightly, eg "print label, bleed patient" not "bleed then print"

Emergencies

22 Feb 08 09:29

It seems perfectly sensible to print the label before taking the blood but this may not be possible for acute emergencies.

If a patient is admitted collapsed, the priority is to get in a line and start treatment. Normally blood is taken as the line is inserted.

At this point the patient may not be on the system so it will not be possible to print out the label in advance.

Salute those who spoke out

23 Feb 08 22:57

I know most "go-live" Trusts have had similar problems to Worthing, and probably similar costs to "no benefit" ratios. I know the journalists involved met an army of frightened doctors unwilling to speak out for fear of losing their jobs - well done to Drs Carr and Taylor - they have the support of the Consultants in Worthing Hospital.

The comment about printing out bar codes is a farce - if this system even could printout front sheets with GP phone numbers we would all be astounded and grateful - batr codes - fantasy land!

The version installed in Worthing is ineffective, inefficient and hugely costly to no advantage in any clinical or operational functionality.

The money spent just to match our previous PAS would have bought so much clinical nursing time, or ward clerks ..... I am an IT advocate, and fully support the aims of NPfIT, but this software as installed in Worthing will not "do it" in 1, 2 or 5 years.

(Post edited by EHI)

Was Milton Keynes protest evr acted on?

25 Feb 08 09:24

Milton keynes famously declared the Millennium r) as not fit for purpose.

Were they acknoledged? Did further action result?

NOthe same version was deployed in the next sites with no modifications.

Even BT who claimed they would use an unbundled version supported by cerner directly instead of the middle man Fujitsu regagaed and deployed the same R0 at Enfield.

Clinicians -speak louder -because due to an administartion cockup, the batteries for the DoH hearing aids were delivered to somewhere else, some other time and filed under round shiny things.