Imperial College Healthcare NHS Trust has upgraded its desktop environment in preparation for the roll-out of Cerner Millennium clinical functionality later in the year.

The trust has recently completed migration of 7,500 desktops from Windows XP to Windows 7, with the help of AppSense solutions. It has also significantly reduced its number of applications and created personalised user profiles for staff, greatly improving the performance of its PCs.

Imperial’s deputy chief information officer Kathy Lanceley told Digital Health News that before its work with AppSense, the trust’s “shockingly poor” desktop performance meant it could not ask clinical staff to move off paper to a digital environment.

In preparation for going live with the Millennium patient administration and maternity system a year ago, it replaced 5,600 15-17 inch PCs with 23-inch models. 

Lanceley explained that Millennium is an incredibly busy system and needs a 23-inch screen to view it. “Before going live we had to have much better performing desktops to give clinicians and staff confidence in using the new system,” she said.

The trust received Millennium from BT under the National Programme for IT and will move out of the BT data centre into the Cerner data centre in September, before the national contract expires in October.

Under a new individual contract with the company, the trust plans to implement clinical documents and e-prescribing modules across all wards and outpatient clinics over the following months, to be completed by March next year.

Lanceley said the trust managed to take away the problem of slow log-in times and user corruption before it became a problem for clinicians.

“The frustration on our clinical side is that we can’t do it faster. We have to move data centres before we do clinical roll-out in earnest, then we will do it throughout the hospital as fast as possible so everybody is very enthusiastic about that.”

She said the project to upgrade the trust's desktops started with the merger of Imperial with St Mary’s and Hammersmith Hospitals in 2008, saying the two IT infrastructures “couldn’t have been more different”.

Combined, the hospitals had close to 3,000 applications sitting on work desktops. This has been reduced to around 900 which have been packaged and virutalised using AppSense.

The large number of policies on desktops was also slowing them down, so the trust worked with AppSense to reduce these from 180 to 20, with personalised user profiles for members of staff.

These changes mean that nothing but the operating system sits of the drive, with everything else sitting on the server.

Imperial’s IT team set itself a “30 second challenge”, which meant that everything it did must ensure a user could get from a cold start into an application within 30 seconds.

Lanceley said the faster power-up and restart times meant the trust could start enforcing patching which increased from 67% to 98%. Calls to the IT help desk have also reduced by 60%.

“The thing we were keen to do is to make sure that whatever we did on the desktop would take us into a mobile world. By packing up the applications environment into a virtualised environment and putting user profiles in a central environment we are ready for mobility,” she said.

The trust is piloting a ‘bring your own device’ policy which gives the desktop experience on both Apple iOS and Windows tablets. It will go-live across the trust in July, ahead of the roll-out of the full Cerner electronic patient record.

“AppSense has made an enormous difference. When we first saw the product we were looking for something to make the user profiles mobile and we were quite cynical about whether it could do everything we wanted, but it did that and more, it was a wow moment.

“The amazing thing was that the whole project cost a shade under £3.5 million and we came in before deadline for getting rid of XP. It was pretty great,” she said.