Lewisham works through Cerner issues

Stabilisation work at one site run by Lewisham and Greenwich NHS Trust may threaten plans to go live with Cerner Millennium at its other hospital next April, according to trust board papers.

The trust went live with the Cerner electronic patient record at Queen Elizabeth Hospital in July, after it delayed the original March go-live because of problems in transferring 18-week referral to treatment time patient data.

Following the deployment, the trust said it was postponing the Cerner deployment for its University Hospital Lewisham site from November to “early 2015” to avoid stretching its resources.

A report about the Queen Elizabeth Hospital deployment in the trust’s October board papers says there are “ongoing issues” with the use of discharge summaries, recording venous thromboembolism assessments, and access in the day care unit, as well as “a number of outstanding calls with back office."

The report also mentions ongoing issues with ensuring 18-week referral to treatment time patient data is recorded accurately, although it says RTT reporting has improved.

“The override functionality is enabling outpatient staff (especially receptionists) to schedule outside of the 18-week referral to treatment pathway.”

It says the override functionality has been removed as of the end of September, with testing being undertaken to allow users to request an appointment if they’re unable to book within 18 weeks.

Additional training and documentation to support workflows has also been provided to reduce problems caused when a specific workflow is not followed correctly.

A separate report on the planned go-live at University Hospital Lewisham for 4-6 April says the issues at Queen Elizabeth are partly responsible for the deployment being raised to the top red risk level.

This is due to concerns about the “availability of operational resources” for the University Hospital deployment due to the need to support Queen Elizabeth with its stabilisation work.

A first integration test for the site started on 2 September and was meant to finish on 3 October, but the exit criteria had not been achieved so further time was needed to run another test and fix any more problems.

“An independent review [is] being undertaken…to assess the severity of the outstanding issues, the potential impact to project activities and the go-live date,” the report says.

Work on operating procedures for the patient administration system is scheduled to be completed by the end of October, with work on theatres and clinical systems due to be completed at the end of November.

A trust spokesperson told EHI: “Moving to a new system of patient records is a major challenge, and the successful launch [at Queen Elizabeth Hospital] represents a significant achievement for all the staff involved.”

The spokesperson said the trust has implemented action plans to resolve any issues following the go-live, with ongoing work including the reinforcement of training for users and the delivery of “future enhancements”.

The trust and its partners are currently working on plans for the University Hospital Lewisham go-live, which the spokesperson said is “under constant review and management” including the assessment of how the Queen Elizabeth deployment could affect delivery dates.