Wirral goes live with Cerner

Wirral University Teaching Hospital NHS Foundation Trust has become the latest English NHS trust to go live with Cerner Millennium.

The organisation, which has a reputation as an NHS IT leader, has contracted directly with Cerner outside the National Programme for IT in the NHS. The only NHS trust to do so.

In a change from recent big-bang installs, it began with the A&E departmental module, which went live on 31 May. Wirral has also taken Cerner’s PowerTrials clinical trials management system, the first NHS hospital to use the system.

“Big bangs are pretty scary, and can have a lot of problems so we’ve taken a different approach,” Luke Readman, Wirral’s information director told E-Health Insider. He explained that the existing PAS has a lot of development which it didn’t make sense to try and replace all at once.

So the new A&E module initially connects to the trust’s ageing but “functionally rich” TDS 7000 hospital information system, now almost 20 years old. The A&E module includes full orders for all pathology and radiology tests which will synch with both the old and new systems.

The trust says it will be the first in the UK to have full synchronisation between a legacy patient administration system and Millennium.

“Our existing PAS has full orders and results and clinical rules and patient pathways, which we couldn’t disrupt,” explained Readman. The trust is using interfacing technology to instead gradually transition to the new Cerner PAS.

The next phase will go-live later this year, when both clinical and clerical staff start using Millennium for a variety of purposes, including outpatient appointment bookings, patient correspondence, management of medical records, and statutory reporting.

“The next milestone will then come in November with meds and inpatients, that’s when we think we’ll switch off the old system, said Readman. He described the implementation is described as part of “a 10-year change management programme”.

Readman praised the team involved, “The team of staff that has made this happen has been outstanding.” He said they had ensured disruption in A&E was minimal

He told EHI that there were now about 400 users of the system in A&E, plus another 200 users outside A&E with access. In addition there are 20-30 people using the clinical trials system, for two clinical trials, a number that will be increased to 60 separate trials.

"I would like to extend my personal thanks to staff from the A&E and other hospital departments, Wirral Health Informatics Service and Support Team, and staff from Cerner; all of whom have put in huge effort to make this possible,” said Readman.

He said benefits are already being seen. “Staff find it much easier to visually understand where people are in their treatment and have tools that enable them to reduce the paper they have. “

Readman said: “Changing our IT system is a major task and there are bound to be difficulties while staff familiarise themselves with the new system. The success of this first phase in minimising difficulties has been a real boost to the organisation.”

He added: “This is only the first stage of a large joint programme that will give us a range of benefits beyond those offered by our current system."

Wirral will eventually use Millennium to automate core care processes, providing an integrated medical record and enabling the sharing of information across different departments within the trust’s hospitals.

Staff will be able to securely access electronic patient records anywhere within the trust. Patients should benefit from electronic pathways for most conditions.

The trust is also planning to integrate historical clinical results for both radiology and laboratory tests, fully automate electronic discharge summaries and GP letters, and integrate reporting functionality through Cerner’s Power Insight solution.

Alan Fowles, Cerner’s vice president and general manager for the UK and Ireland, said: “I am delighted that Wirral University Teaching Hospital NHS Foundation Trust’s ‘go-live’ has been such a success; this is the first stage within a significant change management programme."

Wirral has long been one of the most digitised NHS hospitals. It is widely regarded as the most successful of the three HIS reference sites and a national leader on hospital e-prescribing. It will now be a key reference site for future Cerner direct sales.

The trust falls within the North, Midlands and East region of England, for which CSC in the local service provider under the national programme. As a result, it has faced a long and tortuous route over almost a decade to get Cerner.

Initially earmarked to get iSoft Lorenzo, the chosen system for the NME, the trust first had to make the case that its needs were different.

It was then meant to take Cerner through Southern LSP Fujitsu, as an ‘out of cluster’ site. The plan had to be dropped after the Japanese firm left the programme in 2008.

The terms of the trust’s direct deal with Cerner have not been made public, but are understood to provide the trust with access to the full Millennium product catalogue.

Newcastle upon Tyne Hospitals NHS Foundation Trust has gone live with Millennium in a deal led by University of Pittsburgh Medical Centre (UPMC). A similar model is being used at Royal Berkshire NHS Foundation Trust.