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back to article Electronic patient records rollout cocks up hospital clinics

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 …

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Anonymous Coward

Why is this surprising?

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Who is surprised ?

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Another Nail in the coffin

for the "Paperless" office.

FFS, why is no real world testing with dummy credentials apparently performed on these so called "time saving" and "Cohesive" waste of tax-payers money for at least a year before they are deployed (Read: Deplored)

Not a week goes by without some NHS subsection pissing peoples data around like confetti.

And yet, no one EVER seems to be punished.

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FAIL

CRM

I may be totally missing something here but is there really any reason why any of the standard off the shelf CRM systems could not have been used for this stuff?

I mean Microsoft CRM is pretty damn customizable and I'll bet even it would have been cheaper than the mess they've had half-developed. Hell, would have even been a good marketing tool for MS so they'd have probs done the consultancy at a massive discount.

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Coat

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.

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Pint

Re: So the actual story seems to be...

Having been involved in migrations where you know the data is crap, some sympathy comes from me - it's a fair point Chris. Maybe they should have sorted out their data before the migration and it would have been less headachey.

And yes it seems odd no-one gets punished. Project management competency probably is partly responsible though, which is less an IT thing. I've been involved with migrations where the company has tried to cut corners for cost reasons (it was a system I didn't know much about, and would rather had the support contractor we pay for annual support pre-arranged to do it all remotely for us - so I've insisted that when we upgrade the hardware next month he is booked in to reconfigure the system and I'm just fitting boxes into a rack and getting them on the network).

Beer as after a hard day's migration a drink always helps the day seem better.

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Trollface

Mmmm-nope!

Data can be copied. Take a copy, plug it in and try it before you go live, compare against the old system, and then bring in the changed data since then until caught up, switch over. Seen it at our place, they never run the two parallel. Yes, the results were similar.

So the proper headline is "Health System too cheap to do data migration properly, cocks it up."

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N2

Years ago

I was in a meeting (yawn) when some suit got narked and stated "do you know Im responsible for implementing some new (POC) system in the NHS?"

If I were you, I'd keep quiet about that - was my reply.

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FAIL

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 ...

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Anonymous Coward

Birmingham QE

I only know it as a visitor, but I know it's more than a year old (Wikipedia says opened 2010).

Architecturally very striking but the implementation fails in a number of ways. Some of them like the one described here are software-related or operational issues and therefore fixable given time, budget, and motivation. Others (such as insufficient space to replace all the stuff that used to be at nearby Smelly Oak Hospital) are trickier to address.

The previous QE didn't have a brilliant reputation for technology either, I used to hear about the whole hospital switchboard collapsing from time to time.

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Re: Birmingham QE

well, the department I used moved there this year ...

The problem with the big bang approach is you tend to get big bangs. New systems should be run *alongside* the systems they are replacing, until you are confident they work, and any glitches are ironed out. That way, you have a fallback, and life goes on.

When our son was born, in the Birmingham Womens hospital, it had just undergone a £10,000,000 refit (1996). First appointment at the new facility, my wifes wheelchair would not go through the swing doors. In a fit of rage, I discovered they had spunked £25,000 on a "disablity consultant". They even had the cheek to suggest my wife did a tour of the new facility, but withdrew the offer when I said it would cost them £25,000 ....

And speaking of shit designs (not IT related, but I am sure we can picture the management minds that were responsible) whose idea was it to make the ONLY patient access to the refurbished Good Hope hospital a revolving door ? Try going through that in a wheelchair, or on crutches.

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Teething troubles?

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

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Anonymous Coward

Re: Teething troubles?

Indeed - every system will have issues when it's first installed. Of course in the case of Oxford the issue is that they haven't actually trained their staff in the new system before go live.

Posting anon since I know too much :)

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FAIL

16 'incidents'

Is this bad? Compared to what?

No clue is given as to whether the system is more or less accurate to the old paper system. Given that it removes large portions of human error, I'd hope that it works out as more accurate as it beds in. Teething troubles are always expected.

Unless they logged errors with the old system with the same tenacity over a similar time period, this is pretty meaningless.

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It sounds like

PEBKAC to me

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