Imperial latest to face RTT issues

Data quality issues following a deployment of Cerner Millennium have affected the ability of Imperial College Healthcare NHS Trust to deliver on 18-week referral to treatment targets, according to a progress report.

The trust deployed the patient administration and maternity components of Millennium in May, following a series of delays.

The roll-out was initially meant to take place in spring 2013, but it was pushed back to August 2013, and then again to 2014.

At the time of the delay, a trust spokesperson told EHI it was “taking a rigorous approach” to ensure the system was ready to go live and staff were well prepared.

The trust deployed the first module of its Millennium project, order communications, as part of NPfIT in September 2011.

A progress report on the Millennium implementation for the trust board’s July meeting says the implementation of the PAS and maternity system was a “complex technical challenge”.

The trust needed to migrate the data in the legacy PAS and the Millennium order communications system, as well as re-numbering patient records so that each patient had a single trust number.

“Inevitably with the implementation of a complex new system, there have been some bedding-in issues as users adapt to new ways of working and teething problems with the new system are ironed out.”

The report says there have been “some challenging issues” with data quality, as users adjust to complex new workflows and become familiar with the “idiosyncrasies” of the new system.

Problems have included A&E attendances being routinely recorded at the lowest tariff, maternity pathway issues, under-recording of outpatient procedures, and issues with point of delivery classification, such as some elective patients being incorrectly recorded as non-elective admissions.

The problems have also impacted on the trust’s ability to deliver on the 18-week referral to treatment targets, the report says.

It adds that the trust’s ability to provide high-quality data to commissioners within agreed timescales has been affected by the issues.

The trust has been speaking with North West London commissioners, who have agreed to a data quality recovery plan that will give the trust flexibility by extending the freeze dates for payment.

The report says the trust is also focusing on “stabilising” its outpatient services, with consultants facing a number of challenges and patients finding it more difficult to rearrange appointments, which has led to increased ‘did not attend’ rates.

An Imperial spokesperson told EHI the trust’s focus since the go-live has been on supporting staff as they get used to the new processes and new system, while making sure it operates smoothly.

“As expected, busy outpatient departments have needed the most support. Work is continuing on day-to-day management of clinics on Cerner to provide the most efficient use of resources for patient care.”

The trust is also working to ensure that activity is accurately recorded on the system using the appropriate processes, and is correcting any errors that have been made.

“For example, in some cases planned patient admissions have been recorded as emergency admissions. This does not affect safe patient care but it changes our activity reporting.”

The spokesperson said the trust will continue planning for the implementation of clinical functionality once the PAS and maternity module reaches “stable operation”.

A Cerner spokesperson told EHI the company worked closely with Imperial, the Health and Social Care Information Centre, and BT as the local service provider for London in the run-up to the go-live and immediately afterwards.

They added that the company is continuing to provide support as requested by the trust.

“This project was complex and included the migration of data from two systems (the legacy patient administration system and the Cerner Millennium order communications solution) and the communication of patient data to 32 trust IT systems.

“We are continuing to work together in order to help the trust to a state of business as usual so that they can deploy further clinical functionality, improving the clinical, operational and financial outcomes for the trust and the benefit of the patients they serve.”