A confidential review of the two Local Service Provider versions of iSoft’s iPM patient administration system carried out by Sheffield Teaching Hospitals NHS Foundation Trust concluded the system was not, in its team’s opinion, “fit for purpose” and created “clinical risks”, due to a series of performance issues.
The team looked at versions of the initial Care Records Service (CRS) software implemented by CSC in Birmingham and by Accenture in Scarborough. The Sheffield trust is in the North-eastern cluster being managed by Accenture.
The confidential review, carried out by a project review team, led the trust to conclude that it would abandon plans to implement iPM and instead meet the extra cost of implementing an alternative non-CfH PAS system, as exclusively reported by E-Health Insider on 16 August.
The review states that three key pre-requisites for restarting a CRS P1R1 project, which has already been stopped twice, have not been met. Sheffield had originally been due to go live with CRS P1R1 in November 2004, a date that got repeatedly delayed due to problems with the software.
The confidential trust board review concludes: “It is the conclusion of the STH [Sheffield Teaching Hospitals] Project Team that the iSoft iPM PAS product as currently presented is ‘not fit for purpose’ and that it can’t be deployed at WPH [Weston Park Hospital] without implications for operational services and clinical/financial risk.”
The decision not to take iPM was partly based on visits to Scarborough Hospital NHS Trust in May and University Hospital Birmingham NHS Foundation Trust (UBHT) in July – two acute trusts that had already installed the CfH system. The review paints a stark picture of the problems experienced by a complex hospital trusts running the versions of iPM supplied by CSC and Accenture.
Referring to a 5 July visit to UBHT the review says. “The visit confirmed the trust’s [Sheffield’s] view that, as currently presented, the iPM product is ‘not fit for purpose’.”
The review also notes that an earlier May visit to Scarborough “gave the trust a full appreciation of the impact of performance issues and functional deficiencies on operational processes, resulting in additional resource implications and clinical risk.”
Specific problems identified include problems with the printing, that at Scarborough resulted in lost letters. The Sheffield report also says that it is “not confident that performance issues identified at Scarborough have been resolved and will not be replicated at WPH.”
The report says that an upgrade to Scarborough’s version of the iPM system – CRS version 908 patch 3 hot-fix 3 – which was to have resolved their top ten problems, including performance problems, had been delayed from mid-July to mid-September.
Accenture and CfH had offered Sheffield assurances that “high-impact functional issues” would be resolved by February 2007.
Following the May visit to Scarborough Sheffield decided on 22 May, to ‘defer go-live’ to enable the impact of issues at Scarborough to be assessed. The confidential July review seen by EHI, including the visit to UBHT, was carried out to determine whether the project should be restarted.
However, in a statement to E-Health Insider last month Sheffield flatly denied that the two visits had influenced its decision not to take the Accenture iPM product. “The site visits did not have any material impact on the decision made by the trust but they informed our formation of the pre ‘go-live’ requirements.”
On 6 July, one day after the Sheffield team visited UBHT, Chris Linacre, deputy chief executive of Sheffield Teaching Hospitals NHS Foundation Trust, wrote to Claire Pacey, regional implementation director for the North-east cluster, setting out its concerns and outlining “the trust’s lack of confidence in the iSoft iPM product…” based on the visits to Scarborough and then Birmingham.
Linacre says the lack of confidence in the iPM CRS product had been “further reinforced following a visit this week to Birmingham, where operational problems caused by functional deficiencies in iPM similar to those being experienced by Scarborough were also impacting on the effective delivery of patient services.”
Linacre goes on to state: “The iSoft iPM product, in our view, is not fit for purpose and we have no confidence that a resolution to functional issues will be delivered in a timetable to enable a successful deployment of CRS P1R1 into WPH this year.”
Asked about the specific details of the CRS review document the trust declined to answer any further questions from E-Health Insider.
A spokesperson for iSoft told EHI: “We can not comment on the specific reasons why this trust has decided against iPM P1R1 as configured by Accenture.
“Clearly, iPM is used extensively throughout the NHS and by some of the country’s largest teaching hospitals and foundation trusts as well as internationally.”
The internal Sheffield review notes. “There is only one secondary care deployment of CRS in an acute setting within the North East/Eastern cluster and there are only a small number within the North West/West Midlands cluster.”
It observes that as a result of delays to the implementation of CRS in secondary care. iSoft’s profits have been hit “leading to instability in the company”. The report says that Accenture are reported to be reviewing their secondary supplier options and “have currently suspended the approval of any secondary care projects that include iSoft as a supplier”.
As a result the report concludes. “The future of iSoft as a key supplier to the North-east cluster is therefore a risk to the trust’s goal of a single strategic PAS for the trust.”
Sheffield, which currently operates three different PAS systems, is now understood to be exploring options to extend its use of McKesson’s TotalCare product to Weston Park Hospital.
Since Sheffield decided not to implement theAccenture version of iPM iSoft has signed a new deal with CSC that provides a framework for CSC to potentially implement the iPM in other clusters. It also gives CSC the ability to directly take over the management of iSoft’s software development.
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