University Hospitals of Morecambe Bay NHS Trust has announced a “soft launch” of Lorenzo. The trust has the electronic patient record running in one ward at Furness General Hospital in Barrow in Furness.
A small number of users on ward five – a surgical ward – are using the system to record alerts, allergies, problems and procedures, to place requests with the trust’s radiology information system and to pick up results, and to create discharge summaries. The trust is installing a new pathology system that will interface with Lorenzo once it has bedded in.
Paper forms and cards are being used on the ward alongside the new system. Eventually, there will be a “hard launch”, after which paper orders will be discontinued. A second soft launch on a medical ward at the Royal Lancaster Infirmary will take place shortly.
The trust seems determined to avoid the problems that have arisen in London and the South with “big bang” deployments of strategic systems. “We have taken a very robust attitude as a board that we will only do this when we are happy with it,” said Patrick McGahon, director of service and commercial development.
University Hospitals of Morecambe Bay NHS Trust has been working on the Lorenzo deployment – the first at an acute trust in England – for a year.
It has had a team of 20 IT staff working on the project, with NHS Connecting for Health, the agency that runs the National Programme for IT in the NHS, and CSC, the local service provider, contributing a further 100 staff each in support.
Steve Fairclough, the trust’s head of informatics, said IT and clinical staff had run multiple end to end tests of the system to iron out bugs and other issues.
The trust has also done a considerable amount of customisation; for example building in its own colour schemes for requests and other actions and writing its own on-screen guides for users. “We were very clear about what we wanted to get out of this,” Fairclough said.
The Cumbria trust covers an area of more than 1,000 square miles. It already has a community of interest network linking its hospitals, GPs and other healthcare facilities, which is robust enough to handle large files such as PACS images.
Managers involved in the Lorenzo project say its attraction is that it promises to deliver an electronic patient record that can work across the whole health community – and that this could not be achieved using other solutions.
“We have investigated putting EPRs into this kind of set up and it is very difficult and very expensive,” said Fairclough. “When the national programme came along, we felt that for the first time people were listening to what we wanted, because being able to transfer records around Morecambe Bay is massive for us.”
Dr Sydney Schneidman, a consultant in emergency medicine and the trust’s clinical lead for health informatics, also said that Lorenzo was the “fourth or fifth” EPR that he had seen in his career, and “it is the best one I have seen.”
He said that while the trust had taken some “pain” during the deployment project “we are willing to take the pain because it allows us to engineer change, and ultimately patients will benefit.”
A go-live at the trust has been much anticipated. Earlier in the year, health IT minister Ben Bradshaw indicated this would happen by the end of the summer – a deadline that appeared to come and go – with CfH able to say only that it would happen when the trust was confident in the system.
In a statement, the agency said: "We welcome the implementation of Lorenzo at University Hospitals of Morecambe Bay NHS Trust.
"The roll-out of the electronic patient record system will bring a huge improvement to the safety and quality of patient care. The experience of adopting Lorenzo at Morecambe Bay will be invaluable for informing further roll-outs of the system."