A flaw has been identified in the iSoft iPM patient administration system being provided as the standard solution to NHS trusts in the North West and West Midlands that can corrupt patient data creating suspected clinical risks to patients.
Under certain circumstances the iPM patient administration system has been found to both incorrectly display patient referral data, and to also record a patient’s referral data against the wrong electronic patient record.
NHS Connecting for Health correspondence seen by E-Health Insider states that problem has "suspected clinical risk implications", and urges trusts not to try and recreate the circumstances under which the problem occurs.
The iPM patient administration system is being supplied by Computer Science Corporation Alliance (CSCA) to NHS trust’s across the North West and West Midlands (NWWM) cluster under the £6.2 billion NHS National Programme for IT (NPfIT). CSCA is the prime contractor responsible for delivering new IT systems to NHS organisations across the region under a £973 million contract.
The problem, which was first identified by NHS organisations in Greater Manchester on 16 December, appears to exist in all iPM implementations carried out in the region. An iSoft spokesperson told EHI that a fix had provided within two days of the problem being identified.
Mis-recording referral data to the wrong patient record has so far been identified in 40 patient records, out of 220,000 patient records examined. According to iSoft it has so far been "unable to replicate the problem outside of the cluster" and has "not had any issues logged oustide the NWWM cluster".
A version of the same iSoft PAS product is also being offered by Accenture, NPfIT’s prime contractor in the North East and Eastern regions.
As of the end of December approximately 36 NHS sites in NWWM were understood to be at various stages of implementing the iPM patient administration system. CSCA, iSoft and NHS CfH declined to identify the specific sites affected by the problem.
A 20 December e-mail from the NPfIT regional implementation director Paul Charnley stated that following investigations, carried out after the problem was first identified: "It now appears that there may have been a risk with this piece of functionality since the first sites went live with iPM."
Charnley’s e-mail goes on to tell health authority chief information officers that "iSoft and CSCA are working on a fix", and that overnight "scripts are being run to identify any further records that might become affected".
In its initial investigation of 220,000 patient records CSCA identified 40 potential incorrect patient referrals. According to Charnley’s email all 40 instances known to be affected have been identified and the referral information for the patients concerned passed onto the local trusts concerned for verification.
As a work around specially written scripts are currently being run every night by CSCA, to identify errors and then notify the NHS trust concerned so they can take corrective action. Trusts notified of potential problems are urged to carry out checks that should involve "both electronic and patient records"
The documents state that patient data may be incorrectly displayed and recorded to the patient’s record if what should be routine functions are used – either clicking the Referral View icon or Referral View option from the Context Screen of iPM.
"All testing to date suggests that not using either the Referral View icon or the Referral View option from the Context menu is the single most important step to take in avoiding this problem," states the NHS CfH correspondence seen by EHI. "We believe that the necessary functionality can be accessed in other ways, notably by right mouse click from the Patient View."
CSCA NHS CfH declined to confirm how many sites had ben affected or by when a full fix to iPM would be implemented. The NHS CfH email correspondence on the issue stresses the need to keep quiet on the problem. "We would also ask you to keep this information as confidential as possible."
A joint CSCA, iSoft and NHS CfH statement said: "On Friday 16th December, users in Greater Manchester identified an issue in the LSP reference solution which has resulted in a small number of referrals being associated with the wrong patients. The issue only manifests itself when the solution is used in a specific sequence.
"The CSC Alliance has investigated all such potential incorrect referrals and has identified a total of 40 out of over 220,000 records. Each of these 40 referrals is being investigated to ensure the correct information is associated with the individual patient concerned. The level of clinical risk has been assessed as low since all 40 instances known to be affected have been identified and referral information for patients is being verified in conjunction with local Trusts."
The joint statement concluded: "The CSC Alliance has identified a fix for the issue and the method of full deployment is currently being finalised. Scripts to identify any incorrect referrals will be run on a daily basis until the fix is fully deployed."