Newcastle chooses Pittsburgh for EHR

29 Apr 2008

Newcastle upon Tyne Hospitals NHS Foundation Trust has partnered with the University of Pittsburgh Medical Centre (UPMC) to deploy electronic health record technology.

Under the 14-month implementation plan, a UPMC technology team will install and adapt five electronic health record (EHR) applications at five Newcastle hospitals, including the Royal Victoria Infirmary, Freeman Hospital and Newcastle General Hospital, with a total of over 2,000 beds.

The five applications to be installed include inpatient order entry, patient administration, pharmacy management, accident and emergency services and operating room systems. Details of the applications to be used or the value of the deal were not disclosed.

UPMC and Newcastle have also formed a joint venture to provide IT services to other UK hospital trusts. “Newcastle will be an important proving ground for this partnership,” said Len Fenwick, chief executive of Newcastle Hospitals. “We are confident that others will soon see the value of what we are doing here and seek to replicate it.”

UPMC has regularly been voted one of the leading hospital groups in the US for its use of IT. Systems used by UPMC include: Epic System’s EpicCare for outpatient electronic medical records, Cerner’s PowerChart for electronic medical record management, Medical Archival Systems, Inc. for patient notes, Stentor for digital imaging, remote access tools and a physician portal.

“Our senior health care professionals are delighted with this opportunity to move forward with such enhanced IT systems. In addition, we are considering collaborations with UPMC in clinical medicine, research and development, which will be significantly strengthened by this IT improvement”, said Timothy Walls, medical director at Newcastle Hospitals.

“The Newcastle contract is the first of what we hope will be many international agreements for our information etchnology services,” said Dan Drawbaugh, chief information officer at UPMC. Donna McCormick, CIO of UPMC’s international and commercial services division will be based in London to oversee the Newcastle project and other UPMC international technology initiatives.

The Foundation trust’s decision to award a contract for EHR applications outside the NHS National Programme for IT (NPfIT) comes almost two years after it initially went out to procurement, rejecting the solution offered by the then local service provider Accenture.

In April 2006, Newcastle went out to tender outside the NHS National programme for IT, placing an advert in the Official Journal of the European Union (OJEU) for new EHR applications.

In February 2007 EHI reported that the trust was waiting to see how things develop after CSC took over from outgoing LSP Accenture.

Explaining why it has gone outside the NPfIT programme the trust said “Because of its long-standing commitment to using advanced technology to improve patient care, Newcastle sought an outside technology partner to implement elements of an electronic health record. Through a competitive bidding process, it selected UPMC as its prime contractor. The new system is expected to be fully compatible with the UK’s national programme for electronically connecting hospitals.”

Jon Hoeksma

Reader's Comments

Reading between the lines ...

29 Apr 08 17:54

"Commitment to using advanced technology to improve patient care" as the reason(s) for going outside NPfIT?

Are Newcastle suggesting that NPfIT's technical offerings are not sufficiently advanced, or that they won't deliver adequate improvements to patient care, or both?

How far does this comply with National programme?

angus.goudie@GP-A89021.nhs.uk

29 Apr 08 18:29

I was interested to hear this large procurement was 'fully compatible with the UK’s national programme for electronically connecting hospitals'. Can we assume that it will be fully compatible with the spine care record, using or exporting standard messaging in SNOMEDCT, and able to export discharge and other communications to general practice in an apporved format. Has it also bought into the NHS/Microsoft Common User Interface (CUI). Lorenzo is based on SNOMEDCT coding as a native application which should help it to be more interoperable, even if that is seen as a short/medium term goal.

When is a standard not a standard?

30 Apr 08 07:24

Angus's point is interesting but whether it matters depends on your level of confidence that NPfIT will ever deliver its systems. Newcastle's decision looks like a vote of no confidence in this!

And in what sense is SNOMED (and HL7 etc) an NHS standard? Looking at the ISB web site it seems to be some sort of technical draft waiting to be evaluated. I would have thought that for the short to medium term, compatibility with Read Coded systems (the de facto NHS standard) was more important.

IMHO Newcastle have made a sensible pragmatic decision to go with something useful now rather than pinning their hopes on "jam tomorrow".

Impact on CSC contract?

30 Apr 08 09:26

“Newcastle clearly has enormous confidence in its chosen solution. 14 months for PAS and basic departmentals and no LSP to slow things down or muck things up. Should be a cake walk. Roll on June 2009. How does this impact the CSC contract? ”

NHS Connecting for Health confirms Snomed standard position

02 May 08 16:45

SNOMED CT and HL7 are international standards that are widely adopted worldwide, and are written into key contracts. The Spine requires the use of these standards for electronic exchange of information.

The UK Terminology Centre (UKTC) is taking SNOMED CT forward for Information Standards Board (ISB) approval and assurance. The Read Codes have never been submitted for ISB approval and do not give the full range of clinical utility that SNOMED CT provides.

Excessive potential access?

briony.bowen2@nhs.net

02 May 08 16:48

Chris, I'm interested in your comment on legitimate relationships and Smartcards. As you'll be aware there are strict controls around access to patient information and accessing information without a legitimate reason is a disciplinary offence and could lead to dismissal. Can you expand on your specific concern on excessive potential access?

Tim Davis, Director of Information Governance, NHS Connecting for Health

What is a standard?

02 May 08 22:49

Doesn't this illustrate the fundemental misunderstanding being made by those advocating the standards led model of IT delivery? In reality, nobody in the NHS or DH has the authority to set and enforce IT standards. NHS organisations have proved that (unlike the university sector) they don't have the inclination to agree standards themselves.

So where does that leave us?

careless posting?

03 May 08 16:23

"Excessive potential access?

briony.bowen2@nhs.net

02 May 08 16:48

Chris, I'm interested in your comment on legitimate relationships and Smartcards. Can you expand on your specific concern on excessive potential access?

Tim Davis, Director of Information Governance, NHS Connecting for Health" Looks as though there are a couple of problems here: probably posted to the wrong address - and is Tom Davis using briony.bowen2's NHS email? (note to editor - if you remove the post referred to, could you remove this as well?)

Re:How far does this comply with National programme?

maryhawking@tigers.demon.co.uk

03 May 08 16:32

According to the North of Tyne IM&T strategy, it is intended to migrate all general practices to CSC/TPP SystmOne as a first step to Lorenzo level 4 - the fully integrated SSEPR. How does the Foundation Trust's decision affect the SHA Strategy - which, in turn (according to board papers from Yorkshire and the Humber SHA) is partly based on contractual obligations on the part of the SHA to purchase a certain volume of LSP systems? or am I missing something, and Lorenzo level 4 can/will be integrated into this system to provide the SSEPR?

Re: careless posting

04 May 08 08:09

If it is true that someone has used someone else's NHS mail account, surely that contravenes the conditions of use?

going abroad?

cpoee1@yahoo.com

08 May 08 03:54

Granger did not have good things to say about Cerner. What Newcastle is getting may be Cerner in disguise. UPMC owns millions of dollars of Cerner stock shares as posted on Cerner's legal filings in the US. Interesting deal.

about UPMC, Newcastle's new partner

cpoee1@yahoo.com

08 May 08 14:27

NEWS FLASH direct from UPMC's home city newspaper:

Charmless bracelet: UPMC should reform its patient ID system Thursday, May 08, 2008 Pittsburgh Post-Gazette Weather permitting, crews will hoist UPMC's giant letters atop the Golden Triangle's tallest structure this Saturday.

Since there seems to be no stopping this bad idea from being perched above the U.S. Steel Tower, maybe the successful medical network can atone by revamping its most common mark on Pittsburgh.

Take Social Security numbers off patient ID bracelets.

An institution with a $3 billion equity and fixed-income investment portfolio can afford to be on the cutting edge of client privacy. A hospital system that is enlightened enough to have its own vice president for privacy and information security should have a comprehensive policy that protects the identities of all patients.

The University of Pittsburgh Medical Center doesn't.

John Houston, its privacy VP, said UPMC issues unique medical record numbers to new patients, but it continues to use Social Security numbers -- plus full name, birth date and insurance policy number -- on the bracelets the hospitals put on patients who are already in the system. That's thousands upon thousands of people who come to UPMC for quality treatment.

In the digital age, there's nothing high-quality about labeling patients, who may be drugged or asleep, with enough personal data on their wrists to steal an identity.

It's time UPMC left its mark around here in more discreet ways.

Hmn, a variant on the repeated US model

08 May 08 23:03

Sounds like there are bits of the (more advanced US) Cerner solution in there, and perhaps it is best of breed.

Good for Newcastle bucking the trend, but I fear that they could follow a long list of hopefuls adopting and regretting having American billing systems. Are Pittsburg clinicians truly using this suite of systems to obviate the need for paper records ?

Can it tell left from right (I understand this is irrelevant for billing purposes in the Cerner system, as the attending surgeons generally use paper).

Buyer beware !

Re: Out of context ineptitude

11 May 08 22:41

I think he was referring to this: http://www.ehiprimarycare.com/news/over_10_nhs_security_breaches_in_last_6_months

Perhaps some of these breaches were people using someone else's email address. And to post to the wrong thread too - just goes to show you can't be too careful with data. That's why I'm opting out of having my info on the CRS. If only we had some kind of information governance to keep things secure...

Avoiding CRS?

12 May 08 15:15

I was thinking of putting all my data into the CRS database .. It'll be safe there for years as nobody can access most of it!