Ipswich struggles with iSoft order communications glitches

Ipswich Hospital NHS Trust, has experienced persistent problems getting its new Computer Sciences Corporation (CSC)-provided iSoft iPM patient administration system and iCM clinical software to communicate with clinical requests sent from iCM not being picked up by iPM.

The trust went live with the new systems, provided by CSC under the NHS IT programme, over the weekend of 22-23 April and has been struggling with the intermittent iCM/iPM messaging problem for the past two weeks.

Sources indicate that the problems last week resulted in clinical messages becoming extremely slow and in some instances handled manually. The teething problems are particularly embarrassing as Ipswich is the first site to get the iCM clinical ordering system under the £12bn NHS IT programme.

Documents seen by E-Health Insider show that the iPM patient administration system and iCM clinical system have been experiencing problems communicating with each other, with electronic clinical messages not being sent between the two iSoft systems. 

The problem was considered serious enough to receive a severity 1 category rating from NHS Connecting for Health, after a series of earlier incident reports had rated it severity 2.

A CFH severity 1 service incident update from 11 May stated the problem: "Intermittently iCM clinical manager messaging is not transferring to iPM". It explained: "This prevents clinical requests from being transferred between iPM and iCM".

By last Friday CSC had a team working at the trust trying to resolve the problem with clinical messages from iCM not being transferred to the iPM PAS system. The company stressed that a huge amount of work had been done by CSC and trust.

In response to questions from E-Health Insider CSC, CfH, iSoft and the trust issued a joint statement, which confirmed the existence of a messaging problem which it said were being "constantly" monitored.

The joint statement said: "CSC can refute that there was ever an issue of patient information being compromised when there was a delay with messaging, resulting in data being held in a queue. The delay did cause some operational difficulties which were quickly addressed by CSC and the Trust who ensured there were robust procedures implemented that meant patient care was not compromised. This included constant monitoring of the delivery time of messages, with appropriate immediate response as necessary, whilst the Root Cause Analysis was thoroughly investigated."

The joint statement said that clinical messaging "is now restored to acceptable timings".

A trust spokesperson told EHI: "We have had minor problems associated with the implementation of a very major system. My understanding is that all the issues are being addressed and all the people involved are working very hard on it."

Ipswich is a flagship site for CSC as it is the first hospital site to receive both iSoft’s iPM patient administration system (PAS) and a version of its iCM clinical manager product under the NHS IT programme, providing order communication allowing doctors to electronically order diagnostic tests.

CSC plans to install the version of iPM and iCM installed at Ipswich to a number of other hospital trusts ahead of iSoft’s Lorenzo product becoming available. The two products were previously known as the ‘Plymouth option’ based on the versions of the two systems installed by iSoft at Plymouth and Derriford Hospital.

The clinical messaging problem follows an earlier ‘severity 2’ problem at Ipswich in the days immediately after go-live that left users being unable to book appointments.

Connecting for Health service incident notifications from the end of April reported that users of the system of the iPM system "are experiencing errors while trying to book appointments".