Morecambe Bay completes Furness pilot

Tags: A HIS iS iSoft Lorenzo Morecambe Bay Surgery

24 Jun 2009

University Hospitals of Morecambe Bay NHS Trust has completed its roll-out of Lorenzo on a final pilot ward at Furness General Hospital.

Ward Two, which went live on Monday, was the third ward to go live with the iSoft system at the early adopter site.

Steve Fairclough, the trust’s head of health informatics, told E-Health Insider that the orthopaedic ward plus three additional departments - including the patient progression unit, elective orthopaedic unit and discharge unit - went live simultaneously.

“We are taking all the departments as one even though they are scattered across the hospital because of the workflow and processes involved,” he said during an EHI visit to Furness General.

“This means that all surgery wards excluding paediatrics and day surgery are now live with Lorenzo. We are also using a system in pre-assessment clinics to support elective surgery, so we are definitely growing.

“We’ve now got the building blocks in place and all the staff trained to switch on that final component, with our key objective being that we get a critical mass across surgery on this site.”

Morecambe Bay was the first acute trust to use the Lorenzo. After significant delays, it finally went live with one ward in October 2008.

Since January, the trust has been using a ‘hard landing’ as opposed to the ‘soft landing’ approach it initially adopted, in which a paper-based procedure was run alongside the electronic documents produced by Lorenzo.

At the end of April, Fairclough told EHI that two more wards would be going live, before Lorenzo was rolled out at the Royal Lancaster Infirmary, which is also run by his trust.

The go-live at Lancaster will continue on hold until the informatics team are convinced that Lorenzo is ready to be taken to a new environment.

Fairclough continued: “We now have enough scope to show the benefits of Lorenzo in different areas. We expect to run the scope for six to eight weeks in the third ward, so we can learn lessons, possibly reengineer and decide whether the time is right to move to Lancaster.”

The roll-out at Lancaster will focus on medical wards, which Fairclough believes will be “cracked much quicker.”

He said: “At the moment it’s like having the first walky talky; it works but you haven’t got anyone to talk to. That’s especially the case in surgery, where you have built a patient record but nobody gets to look at it because patients in these wards generally don’t come back.

"With medicine there are a lot more frequent flyers so we feel we will really see the benefits of the system.”

Fairclough admitted that the team was “frustrated” by how slowly the roll-out was progressing and that it was looking into the reasons behind it.

But he said: “We are even more frustrated that the NHS has not stepped up to the plate in terms of deployment.

“There is so much action needed around deployment and frankly the NHS is wasting the taxpayers money by not stepping up. Lorenzo does what it says on the tin and people need to realise that.”

Sarah Bruce

Morecambe Bay extends use of Lorenzo (30 Apr 2009) (5)
Soft launch of Lorenzo at Morecambe Bay (06 Nov 2008) (27)

Readers Comments

Inpatients is one thing, but .....

26 Jun 09 00:47

I have every admiration for Morecambe Bay taking on the challenges of Lorenzo, but what the article doesn't say is who is using the system? Are all the surgeons electronically requesting tests and investigations? Is it live in Outpatients, where by far the greater test of electronic requesting is? I think it is a bit early to say that Lorenzo does "what is says on the tin". I for one want to see just how the order forms have been designed and how many clicks it takes to request a test or investigation. The Human Computer Interface is the most critical element there is. If the forms have too many fields, too many clicks, it will not be sustainable in Outpatients and that's a fact. Does it have duplicate checking and other interaction warning for test ordering? Does it acknowledge results and do order review? How does it support TTO/Prescribing and Discharge letters? Does it support handover reporting? Infection control alerting? Etc etc. It is a start, but a long way to go before it is doing what it says on the tin. Good luck though and well done for starting the roll-out.

Which version of Lorenzo is this?

26 Jun 09 07:44

Is this the long awaited v1.9 of Lorenzo or iPM?

Specifications

26 Jun 09 10:13

So, what exactly does it say on the tin?

slow train on track

26 Jun 09 10:51

Going for a full electronic record is a complex business, but in my experience, if doctors, and especially junior doctors, who migrate all over the site all of the time, are keen on taking up use of a good system, they will race ahead faster than we in IT can keep up.

So is it a good sign that Morecombe Bay are being very careful, or a bad one that Steve Fairclough and his team are not getting pressure from doctors and nurses on the other wards to catch up.

In my experience clinical teams will be quick to latch on if they think something will save them time, enable safer care, and do all the things we know that a good EPR should help with.

How 'live' are the two wards that seem to have been piloting for ages, and when Steve gives frustration that the NHS has not stepped up to the plate, he seems to be driving the slow train in front, which is setting the pace.

Further information to come

26 Jun 09 15:53

E-Health Insider will shortly be publishing a feature addressing some of the concerns that have been mentioned thus far, including information on the design of the interface and what the various releases at Morecambe Bay involve.

Sarah Bruce, E-Health Insider Reporter