Rotherham set to announce EPR contract

Tags: A Digital Healthcare Efficiency England EPR Foundation Trust HIS iS Lorenzo McKesson Meditech Newcastle Operating Framework PAS PAS Rotherham Solution Strategic Tender

05 Feb 2009

The Rotherham NHS Foundation Trust is set to announce the award of a contract for a new electronic patient record system that will see it spend an estimated £30-40m over the next ten years.

The move comes after the trust decided it was essential to tender outside the National Programme for IT in the NHS, and that it was unable to continue waiting for its local service provider to offer suitable software.

E-Health Insider understands the short-list of suppliers to be University of Pittsburgh Medical Centre (UPMC) and Cerner, Meditech and SystemC Healthcare.

In April 2008, Newcastle became the first foundation trust to award a contract outside the national programme, when it selected UPMC/Cerner.

The Rotherham’s decision was made despite significant pressure to wait for delayed strategic software, and the threat of potential financial penalties.

Trust chief executive Brian James said the pressure had abated recently and the trust no longer “believes” it will be liable to fines “as we’ve not been offered an interim solution by the LSP.”

“In any case, I wouldn’t be happy with an interim patient administration system,” he said. The trust’s goal is nothing less than a paperless hospital and using technology to transform the delivery of healthcare.

James says the trust is now naturally at the tail end of the latest roll-out programme for Lorenzo by CSC. “But that’s eight to nine years away. I’ll be happy to replace our new system with Lorenzo when it is a proven system, but we need something right now.”

The trust needs to replace its McKesson TotalCare PAS because: “McKesson have been clear that they will not support the system any further from 2010.”

Even if a further extension of the McKesson support contract is negotiated for the 20-odd NHS TotalCare sites - something currently being suggested – it would make no difference to The Rotherham’s pressing need for a replacement system.

“Our system is 24 years old. It’s not being updated or maintained. It’s not a live system, its dead,” James said. Board papers make it clear that any further contract extension would also require the hardware it runs on to be replaced.

Even so, James admits that he is only able to lead his trust in this direction because it is a foundation trust, with greater freedoms than a normal trust. He feels few organisations would follow the same course “unless they have an ageing legacy system with nowhere to go.”

The Rotherham chief executive adds that his clinicians and other staff need far more than a replacement patient administration system to deliver the far reaching change to safer, digital healthcare the trust is aiming for.

He also says that with just one year of the NHS’ current financial settlement left to run, and the Operating Framework for the NHS in England 2009-10 warning that “very substantial efficiency savings” will have to be made after that, the trust could be facing falling budgets. “Within two years, we need to be working in a much more efficient way,” James said.

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Waiting not an option

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Readers Comments

Congratulations Mr. James

05 Feb 09 13:56

Firstly, for recognising that the business of a healthcare in the 21st century is changing radically and needs a flexible, patient centered, responsive IT system to support it

Secondly, for recognising that NPfIT isnt going to deliver it. Even if what has been specified were to be delivered (which it has no track record of ever having done), it is a 90s solution and the problem has MOVED ON

Thirdly for having the determination to make it happen in the face of the usual threats and bullying

Congrats

06 Feb 09 08:17

Congratulations on doing a procurement, now comes the hard part...

Let's see if these alternative products really exist.

Good luck.

A done deal from the outset ?

06 Feb 09 10:06

Although there are many less risky and well proven options available from UK suppliers, my bets are on the winner being University of Pittsburgh Medical Centre implementing Cerner... After hearing the Newcastle CEO blatantly selling the solution at HISI in Dublin a couple of months ago (they get theirs free if they sell 10 apparently) it sounds a good story; “Everything integrated and from a single supplier”…Oh and not actually proven anywhere yet. Those in the know will tell you that American systems are largely inflexible, very expensive and built for an entirely different healthcare environment. I wish the people of Rotherham a very success implementation as we all hope it’s not “out of the frying pan” and more NHS money down the drain.

Cerner again ?

06 Feb 09 11:18

Interesting to note that the problematic Cerner solution (presumably Millennium) is being considered, albeit that the deployment would be via UPMC and not BT (or Fujitsu). Does that say something about a) the lack of alternatives or b) the deployment approach or maybe something else ?

Meditech or System C

06 Feb 09 17:38

I would strongly advise Rotherham to choose a fully integrated Clinical / Administrative IT system which is live, reasonably mature and fully tested in the UK.

Meditech has 3 or 4 sites and System C have at least 1 (Isle of Man).

Visit the live sites and talk to the clinicians / administrators who use the system for goodness sake.

Or perhaps the salesmen are better ...

06 Feb 09 22:59

A legacy from the NPfIT contracts seems to be the order of magnitude increase of costs. Not clear from the article if this is just the contract costs, or includes all the internal implementation, organisational development and training.

One of Cerner's great apparent strengths, curtailed by the CfH/LSP straightjacket, is supposed to be configurability. And one of the greatest weaknesses has been the inability to cope with the NHS Information model.

And as an Informatics Academy session discussed last year, the requirements of 18 week waits and pathways make it difficult for UK designed PAS systems to work efficiently.

Local control should deliver a usable product. Whether it will be a highly efficient one or a throwback, I have my doubts.

Regarding Comment 4

09 Feb 09 09:20

UoP / Cerners solution is a far more advanced system than Millenium, hence why Newcastle went for it.

The interesting thing here will be who will choose their own system next? We've had Newcastle, now Rotherham...my bets are now on of the Southern Foundation trusts...

Due Diligence

09 Feb 09 12:21

Due diligence is fundamental to selecting any product. I wonder if anyone on the current procurements (Rotherham, R Berks, Newcastle etc) has considered, for instance: 1) Where on the 'S' curve is the product? If it is on the down slope then what continuing development investment is it receiving AND is migration to its replacement included in the maintenance costs? 2) If a US application, how has the PAS been anglicised? Is it really suited to the NHS Out Patient model and dynamics, eg clinic slot volumes and casenote management? 3) Does it deliver CDS (v6) and management reporting necessary to obtaining / retaining Foundation status? 4) Is it maintained, contractually and in realiity, in line with the NHS Agenda, eg are DSCNs implemented by their effective dates? If not, how far behind might they be?

Such questions often get missed in the euphoria of nice demos and promises. Due diligence provides the very necessary sanity check. SRO's need to ensure DD is performed.

£40 million over 10 years

10 Feb 09 12:32

£40 million pounds over 10 years sounds a lot of money but our NHS Trust has an annual turnover of £500 million so £4 million per year is less than 1% of turnover.

As all Acute NHS Trusts are "expected / pressurised" into saving 3% of their allocated budget each year through CRES (Cost Releasing Efficiency Savings) then 1% sounds like small change.