Aneurin Bevan Health Board’s implementation of Wales’ national patient administration system, Myrddin, has caused significant disruption to normal service and needs to be urgently stablised.
The health board, which covers Gwent, was the sixth Welsh health board to go live with the PAS last November.
However, since the system’s installation, the health board has experienced difficulties with service resilience and reliability, particularly to outpatient services, board papers say.
The national PAS replaced the Aneurin Bevan’s iSoft PAS, iExpress. After a successful pre-implementation stage, more than 1,000 users switched over to using the new system.
However, the board papers describe the implementation as of “poor quality” and say that the confidence of many staff has been damaged “in relation to using IT for their core business."
Aneurin Bevan’s “did not attend” rate has increased as the system has created problems with the board’s “appointment letter production processes”, which have been hampered by the lack of understanding from users and printer reliability.
The largest impact of the implementation has been on the clinical staff that rely on using the board’s clinical workstation to underpin their workflow.
The performance of the workstation is reliant on the interface with Myrddin, and on “many occasions this has failed resulting in severe disruption.”
Jon Holmes, head of health informatics at Aneurin Bevan, told eHealth Insider that the health board had encountered a number of “technical issues” with the system.
“Our patient administration system is underpinned by a number of workflows and it’s taking a little longer than we thought it would but we are getting there.”
To minimise disruption, Aneurin Bevan is using the back-up Myrddin server as well as the primary server to share users, ensuring that when a performance drop occurs, only 50% of users are affected.
To counter these problems, the board is to implement “key changes to service configuration” and software upgrades are set to take place during the next month, which it hopes will improve the system’s performance.
Expert consultants were also engaged in April to assist with the board’s analysis of Myrddin, which has still not reached a settled phase and a review of the recommended sizing of the system is underway.
Myrddin is already live at Cwm Taf, Powys, Betsi Cadwaladr, Hywel Dda and Abertawe Bro Morgannwg University health boards. Cardiff and Vale University Health Board is the only organisation not to have implemented the system.
The PAS was specifically developed for Wales by the NHS Wales Informatics Service and its predecessor bodies and was intended to integrate with the Welsh clinical portal and enterprise master patient index projects currently underway.
However, clinicians and senior managers at Aneurin Bevan have already expressed concerns that the functionality of the portal “may not match the existing clinical work station portal currently in use."
The board also states that the single common portal, which aims to connect all NHS Wales staff to patient data from multiple systems, might not be implemented, as the “confidence level in major clinical support system replacements with national products is very low.”