Royal Devon still assessing Epic costs

Royal Devon and Exeter NHS Foundation Trust is undertaking further work to assess the potential costs of implementing the Epic electronic patient record, after making a £19 million funding bid to NHS England’s technology fund.

The trust selected the American supplier as its preferred bidder last May, from a shortlist understood to include Cerner, CSC, Cambio and IMS Maxims.

The trust was due to present a full business case on Epic in November last year, but is undertaking further analysis before signing a final contract.

Minutes from the trust’s board meeting last September show that it has made a substantial bid to the Integrated Digital Care Technology Fund – or tech fund 2’ – to support the EPR project.

Tracey Cottam, the trust’s director of transformation and organisational development, said the trust had applied for a grant of £18 million to £19 million from the fund to help with the capital funding of the project.

In response to questions from another board member, Cottam said the figure had been “led by the fund’s own guidance”, as well as the fact that the trust had to match any funding given and £19 million was the maximum it could bid for.

Cottam also discussed the trust’s site visit to the United States, where staff visited Epic’s offices and a hospital within the Sentara Healthcare organisation to “see a different pathway supported by a very different IT platform.”

“The staff discussed what worked well, the pitfalls and the benefit profile of using the Epic EPR system.”

The board decided at the September meeting that a comparison of the benefits achieved by Sentara would be included within a full business case on Epic, due to be presented to the board in November.

However, a trust spokesperson told EHI that while the due diligence phase has been “largely completed”, further work is required in the remainder of the 2014-15 financial year “to ensure a viable business case can be supported by both trust executives and [foundation trust regulator] Monitor”.

“The trust remains committed to progressing to a full contract award with [Epic]… we expect to conclude this final stage in April and move to full contract award as soon as possible after this date.”

Cottam told EHI further analysis by the EPR programme team is required to take into account how the EPR can assist the trust in delivering clinical benefits while fitting with its business model.

“Any investment in a new EPR system will be a significant one and it is important we take the necessary time to get it right within the context of our strategic direction and five-year plan,” she said.

When Royal Devon announced it had chosen Epic last May, one industry source told EHI that affordability would be a “huge issue” for the trust.

They added: “The greatest challenge to Devon, or any other trust, is being honest about the reality of achieving benefits.  You can’t leave this to the supplier; you have to be fully engaged as a customer if you are going to realise the clinical and business benefits.”

Cambridge University Hospitals NHS Foundation Trust, the first NHS trust to implement Epic, encountered a range of problems after going live in October.

However, the trust’s chief clinical information officer, Dr Afzal Chaudhry, told EHI that most of these had been encountered in the first days after go-live.

Progress reports on the trust website indicate that it is still taking action on some issues, such as making sure that discharge letters go out with sufficient information on them.

The trust is one of a number around the country to declare a ‘major incident’ because of pressure on its A&E department, which has forced it to cancel a number of emergency admissions, even though it has opened 105 contingency beds.

EHI is running a survey to determine the effect of the delay to the announcement of winning bids to tech fund 2.

Please complete the survey if the delay is affecting your trust or healthcare community; it asks for no identifying information, and will take less than five minutes to complete. The results will be published on EHI next week.