Brighton live and Alert

Brighton and Sussex University Hospitals NHS Trust has gone live with its Alert electronic patient record system in one of its A&E departments.

The trust’s EPR programme manager Judith Steen told EHI the go-live went well and was a good test for future roll-outs of the system.

The implementation went ahead on 26 November at 8am in the Sussex Eye Hospital. It involved around 100 users, with a ten-strong support team who have slowly withdrawn as the department returns to ‘business as usual’.

“They are up and running now and we are looking at future improvements to help speed up the process and get people more used to it, but overall they coped very well,” Steen said.

The A&E previously used Symphony from Ascribe, which ran alongside a manual system for recording patient information.

It has gone paperless with Alert, including recording telephone triage advice on the patients.

“We are very relieved that the Sussex Eye Hospital implementation went pretty well. We’ve learnt lessons from that first step towards what I hope will be a really good EPR system for the whole trust,” Steen said.

“But this is the first step along quite a long journey. It’s challenging and hard but the trust really wants this.”

Plans are to deploy to Brighton’s three remaining A&Es on a monthly schedule in 2014. These implementations will also include electronic ordering for radiology and pathology.

“This is such a massive business change programme. There’s a balance of getting the software functionality working – getting it stable with all the fixes and things requested in there is very time consuming – and the other half is business change, making sure the people and processes are ready,” she explained.

Once A&E and order communications are deployed, the trust will go-live with clinical documentation and e-prescribing. Brighton has attracted some technology fund money to support the e-prescribing project.

Brighton’s EPR programme board minutes, released to EHI under the Freedom of Information Act, reveal that the November go-live was touch and go up until the start of the month, due to several severity one issues, described as “showstoppers to go-live”.

“Issues are progressing and being closed on a daily basis, however more issues seem to arise as others are resolved, so the overall number is not being reduced,” the October minutes say.

A number of these issues were not with the product, but owned by the trust.

“Neither party currently consider we are ready to go live. All agree the plans are in place and all are collectively working from development to complete then go live,” the minutes say.

“Alert have made a corporate decision to stop the installation of new software releases and are now only installing hotfixes with Brighton specific code.”

Steen said the challenges had generally been “run of the mill” for Alert and the deployment was helped by lessons learned at the Blackpool Teaching Hospitals NHS Foundation Trust, which went live with the system in late 2009.

She explained that because Alert is a global product, everybody gets the same upgrades which can be difficult when training and go-live test scripts are written before a change is made or functionality added. So the trust and company decided to halt all software releases and concentrate on fixes designed only for Brighton.

“We have been working with Alert really well, we benefitted from their support team at Blackpool as some were the same members of staff.”

However, the learnings probably end after A&E as Blackpool has not implemented the full EPR.

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