Weston says Millennium benefits mixed

One of the first NHS trusts to take Cerner Millennium says it has achieved only some of the expected clinical benefits from upgrading to the latest version.

Weston Area Health NHS Trust first went live with Cerner Millennium in 2007, as part of the National Programme for IT in the NHS.

It was one of seven sites in the South of England to be upgraded to the LC01 version by BT last year.

However, a benefits analysis obtained by eHealth insider under the Freedom of Information Act shows benefits have been mixed.

The November 2011 report says that of 12 key anticipated benefits, four have not yet been achieved, while others have been only partially achieved.

It also suggests that the benefits it has seen since have come in areas “where improved functionality has automatically generated benefit."

The trust appears to be struggling to deliver in areas that require significant changes in working practices.

For example, the report says that before the LC01 upgrade there was no recording of ED investigations and discharged disposition because the coding database was not working.

ED coding is now being done automatically in FirstNet and had reached 80% by November, although it had not hit the100% target that had been set for July 2011.

The trust says it has saved three to four staff days per month by using Millennium for coding.

It has also seen a reduction in the number of uncodable notes from 3% pre-LC01 to nil, securing payment for an additional 156 patients per year.

Before the upgrade, just 20% of patients were receiving a follow-up appointment before leaving the hospital, but this had increased to 80%.

The trust does 2,750 follow-up appointments every week. More than one minute is saved per appointment due to this more streamlined process, saving more than 36 hours of administration time a week.

The report also says there has been an improvement in data quality, as users can no longer accidentally select the wrong encounter.

However, the creation of electronic discharge summaries via the system is described as “patchy”.

The report says “the content of summaries is generally poor, and [they] are not routinely sent to GPs.”

The trust was expecting some issues to be resolved in a forthcoming maintenance release; although the report says the quality of data will still need to be improved.

The report says three of the four “not achieved” targets are due to “lack of change resource/operational management of the implementation of the change required.”

Another of the targeted benefits that was not being achieved in November was to have 40% of elective procedures requested via Millennium, rather than “To Come In” forms within 12 months of go-live.

The report says there has been “no progress with redesign and implementation of the process” and as of November, only three consultants were undertaking electronic requests for procedures.

Another target was to standardise and improve death notification to GPs, on which no progress had been made.

Two targets related to safer care for adult patients, involving 100% completion of the Falls Assessment and the Waterlow Assessment, were on hold for review.

Following the problems reported at North Bristol and Oxford University Hospitals NHS trusts after they went live with Millennium recently, EHI has been contacting trusts in the South that have been live with the system for four or five years.

EHI has submitted FoI requests to those trusts, like Weston, that declined to respond or give interviews about the benefits they have realised.

A number of benefits identified in the Project Initiation Document are not mentioned in the November 2011 update released under FoI.

These include the automatic production of theatre lists and availability of theatre utilisation information, more accurate activity reporting and improved infection control.

In a statement to EHI the trust said: “Weston Area Health NHS Trust was an early adopter of Cerner Millennium and met a key milestone in February 2011 with the completion of the LC1 deployment.”

The trust described the February 2011 deployment as “significant” and said it had been “satisfied with the outcome, following the resolution of some initial operational issues.”

The statement continued: “We have realised some key benefits and continue to review our realisation programme to extract maximum impact.”

It concluded: “The trust is now planning ahead considering options for the end of the national contract in 2015.”