iSoft system leaves North Staffs unable to bill

University Hospital of North Staffordshire NHS Trust, one of the most indebted trusts in the country, is facing a potential £16m risk due to severe problems with a new electronic patient record system from iSoft, which have left it unable to code activity and recover income.

The new system has left the trust, which already has a deficit of £15m and is shedding 1,000 staff, incapable of produce the activity reports required for billing. The trust puts the potential financial risk for the full year between £4.5m to £16.2m.

In the first quarter of the year the lack of activity data cost the trust £450,000 of income – though this has since been recovered.

The problems have arisen from a project to install versions of iPM and iCM, the two key software systems currently being offered by iSoft to the NHS IT programme. After extensive delays the project went live this July.

The project which has occurred outside the NHS National Programme for IT was signed between the trust and iSoft in 2003 and originally due to have gone live in March 2004.

According to the trust board papers the problem stems from the new data warehouse associated with the EPR. Activity reports needed for billing have been impossible to generate due to “the failure so far of the system to collate appropriate identifiers to the work”, and the “high level of coding backlog” that has as a result built up.

The October board paper states: “While significant effort is being put into resolving these issues little meaningful progress has yet been made. These issues must be resolved as a matter of urgency if the trust is not to suffer a major loss of income, impacting materially on the 2006/7 out-turn.”

A trust spokesperson told EHI: “Since the publication of that particular paper, the first quarter issue has been resolved and the £450,000 has been recovered in full. The trust is continuing to work with iSoft on issues surrounding billing for the remaining three quarters of the year.”

The spokesperson added that progress has been made and the trust was confident the problem would be resolved. “This particular problem is not about the functionality of the EPR system but about data management within the data warehouse. The quality of the data itself is not in question.”

A contradictory view was offered by iSoft. A company spokesperson said that the problem was historic and associated with the 15-years of historic data that had to be migrated. “There were also issues of data quality,” the spokesperson told EHI. "The two year delay has been due to the quality of the data.  There are still some problems with translating data from iPM and iCM to the data warehouse."

In addition to the problems with reports and billing, the trust is also experiencing severe problems with core clinical functionality of the iSoft software. Last week it had to advise staff that the ability to order patient tests – a key feature of iCM – had been switched off. “Due to technical difficulties, trust department/wards will be unable to view results via iCM until further notice.”

The spokesperson confirmed that the trust “had experienced a problem with the package that had left staff unable to use iCM”. They stressed that back-up arrangements were in place.

“I think it’s fair to say that this is a big IT system and very complex, and it’s taking longer than hoped to get it working properly.”

The problems with the joint iSoft iCM/iPM solution will be of particular concern to other trusts as it is the software being offered by Computer Sciences Corporation (CSC) to 60% of NHS trusts under the £12bn NHS IT programme. CSC is currently being forced to offer the older software as versions of iSoft’s new Lorenzo system, originally due in 2004, are now not expected until 2008 at the earliest.

Link

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North Staffs prepares for big bang