Birmingham Women's Trust to go live this weekend with key NPfIT system

Birmingham Women’s NHS Foundation Trust is due to go live this weekend with a milestone “Lorenzo 1.9” electronic records implementation under the National Programme for IT [NPfIT]. The go-live is further evidence that the NPfIT...

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Birmingham Women’s NHS Foundation Trust is due to go live this weekend with a milestone “Lorenzo 1.9” electronic records implementation under the National Programme for IT [NPfIT].

The go-live is further evidence that the NPfIT is far from dead - although the Department of NPfIT minister Simon Burns has implied that it is. 

Announcing the future of the NPfIT Burns said last month: “Improving IT is essential to delivering a patient-centred NHS. But the nationally imposed system is neither necessary nor appropriate to deliver this.”

The go-live of iSoft’s Lorenzo 1.9 at Birmingham Women’s is important to CSC, the NPfIT local service provider that has £3bn worth of contracts under the national programme.  

Last month Christine Connelly, CIO at the Department of Health, said the successful deployment of Lorenzo 1.9 at Birmingham Women’s, and at other 1.9 early adopter sites including NHS Bury, University Hospitals of Morecambe Bay NHS Foundation Trust, and Pennine Care, was an essential milestone for CSC. Meeting the milestone will trigger payments to CSC. 

Birmingham Women’s decision to go-live came as another Lorenzo 1.9 “early adopter” site, University Hospitals of Morecambe Bay NHS Foundation Trust, revealed that it went live with Lorenzo in June this year when the system was unstable and unready. 

We've learned lessons from other NHS sites

But Steve Peak, Chief Executive of Birmingham Women’s, told Computerworld UK yesterday that the Lorenzo project is “subject to all the necessary criteria around technical capability and clinical safety measures”.  
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He added that the Trust Board has been briefed throughout the project on the state of readiness for this project.  

“Our own project plan has included a detailed review of lessons learnt at previous deployments and we have made a number of changes to our plans both pre and post go-live as a result," he said. 

The Trust said that go-live of Lorenzo was planned for this weekend, though Peak said the go-live remains “subject to all the necessary project milestones being met”.

I take full responsibility says Trust CEO

I asked Peak who would take responsibility if the implementation went seriously awry and adversely affected patients as it had at Nuffield Orthopaedic Centre, Royal Free Hampstead, Weston Area Health Trust and Barnet and Chase Farm. He said: 

“As the Trust project sponsors for the deployment I take ultimate responsibility for the implementation of the system.”

This week Sydney Schneidman, the clinical lead for health informatics at Morecambe Bay Trust, told a conference that his Trust went live with Lorenzo 1.9 when the system was “really not ready for release and it was really unstable,” according to E-Health Insider.

It appears that Lorenzo 1.9 has yet to prove stable at either Morecambe Bay or NHS Bury. Pennine Care NHS Foundation Trust was due to be the first mental health trust to install Lorenzo 1.9 but it’s reported by E-Health Insider to be thinking twice about implementing the system.

Time to rethink monolithic e-record go-lives?

Birmingham Women’s was originally due to go live with the Lorenzo Care Management in May this year. Several go-live dates have since been postponed. 

Some in the NHS say it is time to rethink “monolithic” electronic health record implementations that require large-scale and complex data migrations and “big-bang” go-lives. They suggest integrating modular new systems with existing data and technology.

Relative to Morecambe Bay, though, Birmingham Women’s is a small trust. It’s unlikely that any failure will have as serious effect on patients as the problems that followed an NPfIT Cerner-based Care Records Service implementation at Barts and the London.

DH and Connecting for Health -  no comment

I asked NHS Connecting for Health and the Department of Health whether the go-lives at Morecambe Bay and Birmingham Women's had been centrally authorised. They have made no comment.  

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