St George’s University Hospitals NHS Foundation Trust will become the first in United Kingdom and Ireland to deploy Cerner in its neonatal unit.
The South West London trust has a history of firsts with the Cerner Millennium platform, but making the system work for its smallest patients has been a big leap.
Dr Sijo Francis, clinical lead for newborns, said the platform had to be shaped to handle a much wider range of patient needs than was required in other units.
The trust started planning for the deployment about two year ago, using the earlier deployment of Cerner’s critical care solution in the Paediatric Intensive Care Unit as a starting point. But Francis said it soon clear that the neonatal deployment would be more difficult.
“PICU as a group are a little more homogenous. [In the neonatal unit] We have really well babies and then we have really sick babies and then we have everything in between.”
This was further complicated by variability in baby patients’ treatment, particularly around medication and feeding, which shifted depending on just how early they were born, he said.
“It has been quite a challenge and there is a bit of anxiety that no other neonatal units had done this.”
But after months for fine tuning and training, a go-live date had been set for 2 August.
The system will cover charting, documentations, prescribing, ordering and results. It will also link up to some medical devices, including ventilators but not, at this stage, infusion pumps.
It will replace a largely paper-based system and Francis said it would require a big shift in thinking for staff.
“The paper-based system has the advantage of simplicity but it is also prone to error. Moving towards an electronic system has the advantage of safety.”
As with most EPR projects, the eventual goal is to not just collect and access data more effectively, but use it to generate insights that improve clinical care.
The project is being run without any direct support from Cerner. Matthew Barlin, who was previously employed by Cerner and moved to the trust three months ago to manager the project, has instead built up an in-house team of clinical champions to help with the transition.
Barlin said staff had not just been walked through how the new system will work, but thrown into clinical scenarios to test how they would respond.
“Projects that don’t go well lack clinical buy-in, but we have got that buy-in.”
As part of the shift, the unit has also upgraded their physical infrastructure, purchasing 12 bespoke trolley units for the ICU ward, each with a touchscreen monitor.
Other neonatal wards also had extra computer stations added to compensate for the shift away from paper. At a later stage these computers would be supplemented by tablets, which would be linked into the system through an app.
St George’s went live with Cerner Millennium back in March 2010, and the system is now used in about 45 per cent of the hospital.
Since deploying Cerner, St George’s has often been used as a pilot for new deployments.
It was both the first trust to deploy the Cerner in a PICU and to use the system for end of bed charting in critical care.