The Hospital for Tropical Diseases, part of University College London Hospital London NHS Foundation Trust, has become the first hospital in the country to go live with the Carecast Patient Administration System.
Robert Naylor, chief executive of UCLH, told E-Health Insider that the Hospital for Tropical Diseases was a small hospital that provided a microcosm for the trust on the functionality of the Carecast system.
He explained that the next really big step will be to implement the initial PAS component of Carecast across the trust by the end of April, in order for it to be ready for the opening of the brand new £422m University College Hospital on Euston Road at the end of May.
Once PAS has been implemented across the trust the next step will be to add results reporting for radiology and pathology by the end of June. Some 6,000 staff will be trained on the new system. At the same time UCLH is also continuing the roll-out of a trust-wide Picture Archiving and Communications System supplied by Agfa.
Outside NPfIT contracts
"We are now the first implementation of NPfIT even though our contract is outside of the programme"
— Robert Naylor, chief executive of University College London Hospital NHS Trust
The UCLH implementation, however, has occurred outside NPfIT contracts, due to the pressing need to have a new clinical IT system ready for the opening of University College Hospital this May.
The trust signed a ten-year £70m contract directly with IDX in September 2003, six months ahead of NPfIT awarding a contract to BT to act as Local Service Provider in London and deliver IDX’s system across the capital.
Originally IDX was to have supplied its existing Last Word Electronic Patient Record System, already in use at Chelsea and Westminster NHS Trust, but after contracts had been signed it decided to implement the new Carecast product instead.
"When IDX won the London contract they offered us Carecast and we decided to go with it as we did not want to be implementing a legacy system," said Naylor. "We are now the first implementation of NPfIT even though our contract is outside of the programme."
Naylor added: "The decision to switch systems was a big decision as it could have resulted in us not having a system in time for the opening of the new hospital." Contingency plans were developed to take existing technology to the new hospital should any problems arise with the new system.
The decision to switch also meant that the project changed from being an "implementation" to a "software development" project, due to the need to anglicise the US Carecast software for the NHS and particular needs of UCLH.
Switching systems led to a six-month delay in the project timetable. "The central issues have been getting the bugs out of the software and predictably there have been 1000s of them," explained Naylor, who stressed that he had "a high degree of confidence" the system would be ready for the opening of the new University College Hospital.
"Don’t underestimate the training requirements involved"
— Robert Naylor
Another key factor has been the fact that the trust contracted directly with IDX, with Logica CMG as sub-contractors. "For us it was software development issues that have been most important to us. A decision was made at the last minute to sign directly with IDX, looking back that was one of the most important decisions made."
He explained that this has enabled him and his team to have a very immediate relationship with IDX and the firm’s senior management, enabling the trust to get issues resolved very quickly.
Naylor said that if IDX had been a sub-contractor this would not have been as easy. "It could have led to a series of delays. What is important to a service provider is not necessarily important to a software developer and this has been a software development project rather than an implementation."
The UCLH chief executive confirmed that the version of Carecast developed for UCLH will be substantially the same as the version which is planned to be delivered across London and the South of England under NPfIT. "To some degree London and the South will follow us."
Asked for his top three tips to ensuring the success in implementing a major new IT system, Naylor said the first was that it had to be led from the top of the organisation. "I’ve chaired the project board meetings and not missed one for a year."
Clinical engagement is also vital. "You have to engage clinicians right from the beginning of the project and involve them in leadership positions."
The final point he stressed was training: "Don’t underestimate the training requirements involved." To train all its staff UCLH has invested in a 40,000 sq ft training facility and has a team of about 20 trainers.