Duplicate records created after Manchester iPM upgrade

A problem in a software upgrade provided to trusts using the iSoft iPM patient administration systems in the Greater Manchester region last month has led to almost 400 duplicate patient records being created every day, requiring records to later be de-duplicated.

The problem affected upgrades to the iPM system provided by Computer Sciences Corporation under the NHS IT programme. The trust most disrupted was University Hospital South Manchester Foundation Trust.

After trusts received the Maintenance Release 1 upgrade for the iPM system, incoming Choose and Book appointment requests were being allocated to newly-created blank patient records, without the system checking if a patient already had an existing record.

A trust spokesperson told E-Health Insider that the recent upgrade had "provided significant benefits" to the organisation but acknowledged it had caused problems as well: "Unfortunately, there have been a small number of issues with the software, but these have not caused any operational inconvenience for the trust. These issues are being resolved by CSC."

A CSC spokesperson told EHI: “A scheduled upgrade to the latest version of the iPM Patient Administration System was undertaken for all organisations in Greater Manchester using the iPM system solution during the weekend of 21-22 April. This includes University Hospital South Manchester Foundation Trust and PCT Clinical Assessment Centres which all currently make extensive use of the Choose and Book system to refer patients to clinical assessment services and outpatient clinics.

“In this particular upgrade a problem has subsequently occurred with the integration of this patient administration system and the Choose and Book system for users in Greater Manchester, which has led to some duplicate patient records being created. We estimate that around 400 duplicate patient records might have been created each day.”

CSC said the duplicate records being created were being carefully identified and deleted: “The system is being continually monitored throughout each day and where a duplicate is identified data is being merged to form one single record for each patient.”

The LSP to the North-west and West Midlands, North-east and Eastern clusters say they have now identified the root cause of the problem and are developing a solution to the software problem. The CfH prime contractor stressed that it processes "almost 1.3m messages across all PAS systems a day in Greater Manchester".

CSC said: “The fix will be applied to all users in Greater Manchester who received the recent upgrade as soon as it is available in the next 2-3 weeks. Prior to the application of the permanent fix, an interim solution has been put in place to identify the duplicate records and correct them. This has now been put in place with the full agreement of those organisations affected and will have minimal impact on the users of the system and no impact on the delivery of patient care.”

The trust has now formed teams to prevent patient data being lost, but board papers reveal that merging records is ‘creating significant extra work’, which ‘may later need to be unscrambled’ to ensure data integrity.

The news of the problems come as CSC prepare to give evidence to the Health Select Committee hearing on the electronic patient record and its use on Thursday.

In January 2006, EHI reported that under certain circumstances the iPM patient administration system was found to both incorrectly display patient referral data, and to also record a patient’s referral data against the wrong electronic patient record in the same region.  With this earlier problem, records affected by the issue were picked up by CSC running overnight scripts that identified the corrupted records.

According to a report in Computer Weekly on South Manchester problem the problems at the trust are not isolated with 200 "major incidents" resulting from Connecting for Health provided systems at NHS hospitals in the four months to the end of January 2007. The magazine reports that dozens are in the highest "severity one" classification and some have affected NHS sites across England. 

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Patient data errors created by iSoft’s iPM system