Lorenzo teething problems at Walsall

Walsall Healthcare NHS Trust has hired 25 temporary staff to help tackle data quality, reporting and backlog issues with its newly implemented Lorenzo electronic patient record system.

Some of the main reporting problems at the trust is in relation to referral to treatment and staff struggling to ‘complete a day’s work in a day’ on the system.

The trust went live with the system from CSC in the beginning of March as part of the revised deal between the Department of Health and the company, and Maggie Craddock, the trust’s assistant director of IT business change, told EHI that the enormity of merging two PAS systems into one has been a “significant challenge.”

“The biggest impact, and where we are predominantly focussing our efforts, is on supporting our frontline and behind the scenes staff in outpatients as these clinics see high volumes of patients each and every day,” she said.

“Lorenzo relies on ‘real time’” data being entered to be an effective patient management system which is different to our original systems. 

“This is a completely new way of working and has meant we needed to make some changes to our existing resources to ensure our patient flow is recorded appropriately.”

In order to tackle the issues, the trust has hired 25 admin and clerical staff for a three month period to support permanent staff and “giving them additional help to undertake their day to day activities and providing an opportunity for them to engage in ‘task and finish’ activities to stabilise the project.”

The extra staff will support both the completion and data entry of back logged data items as well as supporting front line services in preventing a back log occurring.

A paper presented to the trust board earlier this month says that the trust has initiated eight separate projects to try and resolve issues around the system.

“A number of issues have arisen as Lorenzo moves to business as usual including backlogs, clinic restructuring and un-outcomed clinic forms,” says the paper.

“This is having an impact on staff in terms of a sense of frustration, particularly in terms of getting a day’s work completed in a day.”

It adds: “Patient experience may be compromised particularly if patients are incorrectly booked into clinics and have to be rescheduled.”

In order to tackle the issues, the trust has hired 25 admin and clerical staff for a three month period to support permanent staff and “giving them additional help to undertake their day to day activities and providing an opportunity for them to engage in ‘task and finish’ activities to stabilise the project.”

The extra staff will support both the completion and data entry of back logged data items as well as supporting front line services in preventing a back log occurring.

One of the main reporting problems at the trust is in relation to referral to treatment.

The paper also says that the trust has spoken to other trusts which have recently deployed Lorenzo and that they are also experiencing similar problems.

A spokesperson from Derby Hospitals NHS Foundation Trust which implemented Lorenzo in February this year, told EHI that the trust’s main issues have been around reporting and data migration.

“The trust has been experiencing some difficulties in reporting, most notably referral to treatment, since moving onto Lorenzo.  The problem is mainly related to migrated data and the complexity in matching and validating pathways,” said the trust spokesperson.

Neil Turnbull, head of programme delivery, information management and technology at Ipswich Hospital NHS Trust, which also went live in February, told EHI that the implementation had rather been a “catalyst for improving operational processes”.

A spokesperson from CSC said that issues are expected as the trust’s EPR implementation is part of a ‘major change programme’, designed to transform business processes and improve patient outcomes.

The company said it is supporting Walsall to work through the issues.

“With a trust led programme of this magnitude, it is to be expected that it will take time to establish new operational approaches,” said the CSC spokesperson.

“Walsall has a robust change plan in place, and CSC has been working with the trust before and since the Lorenzo ‘go-live’ to help deliver this transformation.”

The eight projects initiated by the trust to improve the Lorenzo problems include ensuring clinic structures within Lorenzo match the clinical teams expectations; ensuring all clinic outcome forms are completed correctly and entered into Lorenzo; reviewing the processes for identifying and managing two week waits/urgent pathways are robust and review activities associated with the call centre.

Ensuring referral forms are entered into the system in a timely manner, that data quality surrounding transfers ir robust, and review that the introduction of Lorenzo has not compromised the ability for staff to ‘complete a day’s work in a day’, are also part of the projects.

Walsall is the first combined acute and community trust to take Lorenzo. It previously used the legacy McKesson Star patient administration system for its acute services and CSC’s iPM PAS for its community services.