Electronic patient records rollout cocks up hospital clinics
Yet another Cerner Millennium balls-up, at North Bristol trust
Electronic patient records system led to problems including wrong patient notes being supplied and incorrect clinic lists.
The rollout of the Cerner Millenium electronic patient records system has led to a series of clinical incidents at North Bristol NHS trust.
The trust began deploying Cerner in December 2011 as a replacement for two older patient records systems.
Between the launch of the system and 17 January 2012, 16 clinical incidents were reported as a direct result of the Cerner implementation, the trust revealed in a response to a freedom of information request made by a BBC journalist.
Cerner was cited as a causal factor in all the incidents, which included problems such as wrong patient notes, lack of notes and incorrect clinic lists, according to the trust.
However, clinical safety was not compromised by the incidents, it added.
The FoI request also asked for details on how many inpatient and outpatient appointments had been delayed by the Cerner implementation. The trust said 33 inpatient appointments were re-booked for non-clinical reasons in December post-Cerner, compared to 40 in November, before the new electronic patient records system went live.
It could not provide data on inpatient appointments in January, or outpatient appointments for both December and January.
In January, the trust highlighted that outpatient clinics were the area that had experienced most disruption as a result of the Cerner rollout.
"These problems have been caused by the incorrect set up of clinic lists, which meant staff could not access the system and errors in the data migration of existing appointments. As a result, some patients may have received the wrong appointment dates, no confirmation of appointment or letters being sent out in error," a post on the trust's website said at the time.
"These issues have caused disruption and frustration for our patients and our staff and we recognise that this has not delivered the level of service that we expect, and the public expect from us," a subsequent post added.
Earlier this month, the trust said it had rebuilt and relaunched the system to clear up the earlier problems its outpatient clinics had experienced.
Oxford hospitals NHS trust also confirmed recently that it was working on fixing issues with data quality and around its patient contact centre resulting from a roll out of Cerner.
This article was originally published at Guardian Government Computing.
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If the facts are correct, there seem to have been two problems. 1. The sytem wasn't properly configured for the local setup (not greatly surprising since it's usually impossible to get sensible answers out of the client and it often needs tweaking). 2. The legacy data they were importing was a filthy mess - let me guess, a mixture of paper files and spreadsheets. I've heard of cases where if the patients age is 130 or they live in Mongolia they 've got lung cancer etc. etc. Some are known about and others are long since forgotten.
Hardly surprising if there were few problems in the migration - maybe more testing would have helped but sometimes you get to the stage where migrating beats staying with the devil (term deliberately chosen) you know, and known for biting freqently
So the actual story seems to be...
Ensuring data is correct is a pig. Data migration is a pig. Looking at the figures quoted, it seems that there was a fair amount of crufty data in the old system which caused problems. During the implementation of the new system they cleaned up the data a bit, but there is still some cruft in there.
I have a degree of sympathy for them. Cleaning data, migrating data and implementing a new system simultaneously is never fun. It seems as if they have implemented the new system and a marginal improvement in data quality - hopefully they can get on with serious data-scrubbing now.
Probably not a popular point of view so - my coat, I'll get it.
As usual, management obsession with "IT" leads to cock ups
The new Queen Elizabeth Hospital in Brum (less than a year old, and one of the biggest in Europe) has a fantastic self service system for outpatients. You go to one of 20 terminals, and either scan your barcoded appointment letter in, or just enter your surname, DOB and postcode, and the system will find your appointment, check you in, and direct you to the right area, where your name scrolls by on an airport style monitor, calling you for you appointment.
Except when I last went, the system was down, absolute chaos reigned because - get this - nobody had developed a fallback system. Each outpatient desk only holds details of appointments for their area, so patients were having to try each in turn ...