iSoft has announced that the initial roll-out of its iCM electronic patient record (EPR) system at Derby Hospitals NHS Foundation Trust is nearing completion on the trust’s surgical and urology departments.

Following this initial pilot of the order communications component of iCM – enabling clinicians to electronically order and receive test results – is now being rolled out across the trust speciality by speciality. The system is due to be fully operational across the trust’s two main sites – Derbyshire Royal Infirmary and the new Derby City General Hospital – within 10-12 months.

At the new City General Hospital the trust has also successfully moved to fully digital x-rays with the implementation of a GE Picture Archiving and Communications System (PACS) and HSS Radiology Information System (RIS), both delivered by iSoft.

In October 2003 the trust signed a £14.9m, eight-year managed service contract with iSoft to upgrade IT systems, in advance of the NHS National Programme for IT. The trust placed the contract to ensure that it would have an electronic system in place when it opened the new City General Hospital.

The trust decided at an early stage that its IT programme must not begin by simply replacing its existing patient administration system (PAS), but instead focus on adding new clinical functionality and tools that would add benefit to clinicians and their patients. Based on this decision the trust elected to kept its existing McKesson TotalCare PAS onto which iSoft’s iCM clinical software and other departmental systems have been integrated.

With several of NPfIT’s local service providers struggling to deliver next generation integrated solutions before the end of the decade the option of building on existing PAS systems has obvious attractions. And the approach taken by Derby is being closely watched.

David Pearson, head of IM&T projects and services at the trust told E-Health Insider: “We do have a contract for delivery of an iSoft PAS if we so wish, or we can keep the McKesson PAS, or we can take the NPfIT system if we want. But we are not letting it distract us from our desire to get on with clinical systems.”

He added that it was all too easy to get “distracted” with non-clinical projects such as Choose and Book, and it was essential to retain a clear clinical focus.

He said that implementation of order communications focused initially on all the outpatient areas, day cases and one of the wards. “We’ve now just taken another three wards live over the past couple of weeks.” Roll-out will continue over the next year.

As well as beginning work on iCM the trust has also installed iSoft’s ORMIS software for theatres and EDIS for A&E – all have been integrated with Derby’s existing McKesson PAS which has a one-way connection to the NHS data spine to enable it to link with the national Choose and Book system.

The EPR project was scheduled to coincide with completion of the new 1,159-bed Derby City General Hospital, being built under a £333m Private Finance Initiative (PFI) scheme. The first phase of the hospital opened in March.

Pearson said pilot system has already had a big impact. “Clinical staff are extremely enthusiastic about the system as it helps them do their jobs better and more efficiently.”

He added. “Faster turnaround of test and x-ray results improves patient care naturally, but will also speed up discharges and will help to free beds earlier. The system is also eliminating duplicate tests so saves money and wasted time.”

Once the implementation of iCM has been completed work is due to begin on installing a new pathology system, followed by systems to enable electronic prescribing, drugs administration and clinical documentation.

Pearson added: “Throughout the project iSoft has worked with Skanska, the firm building the new hospital, and with the network provider in carefully planning installations of conventional and wireless networks especially for the ‘network-hungry’ PACS.”

So far Derby remains outside the national programme, but Person says the Foundation Trust plans to keep its options open: “We will assess the benefits and costs once an alternative strategic option is in place,” said Pearson. “We have a contract with iSOFT until 2011 with the option to extend this for three years, so there is no immediate pressure.”

He added: “What we do as a trust is measure progress against what is happening elsewhere in the country.” He said that stepping outside the national programme to ensure the new hospital would open with an EPR system had been a big decision, “but it feels that we’ve made the right one”.

iSoft says that Derby’s EPR solution fits with the national programme’s principle for sharing patient information as patient details are entered once and updated from any of the applications.