The National Programme for Single Patient Record s

The National Programme for Single Patient Record s. PR Information Technology Patrick Mc. Gahon – Director of Service and Commercial Development University Hospitals of Morecambe Bay NHS Trust

Agenda l l l l l Cutover Summary Progress Since Go-Live What has gone well What has not gone well – Main Issues Service Management Performance Dual Keying Release 2 Questions

Lorenzo Care Management l UHMB went live with Lorenzo Release 1. 9 over the bank holiday weekend 29 -31 May 2010 l UHMB became the first Acute Trust in England to implement the Lorenzo Care Management functionality l Cutover activities from i. PM commenced on 24 May 2010 – approx 40, 000 data items transacted over the cutover weekend by over 100 staff l All hospital wards were transitioned to Lorenzo in a phased manner over the bank holiday weekend by 30 May 2010 l Outpatient services went live on Tuesday 01 June 2010 with Final stage of acceptance accomplished Thursday evening

Lorenzo Care Management l Big Bang deployment across 5 sites and 3500 users l The Full scope of Functionality was deployed including PDS, LRs and Arrival Booths l The Trust went live with a number of known software issues l Fixes for these issues were scheduled in conjunction with CSCA for delivery 2 weeks post go-live l During this 2 week period, the Trust mitigated the risk of not having these fixes and hence not having a ‘clean process’ by incorporating a number of temporary workarounds

Summary Week 1 & 2 l Quieter than expected during week 1 l Deliberately a 4 day week – bonus of a school holiday as well l Mainly log on and how do I do type issues with a few configuration issues l 900 + unique logons and 420 concurrent users l Week 2 – was the first working day for a significant number of staff l User frustration – they now think they know what to do l Many more configuration issues l Specific application issues raised l 850 + unique logons and 360 concurrent users l Weekend off

Summary Week 3 & 4 l l l Focus on backlog, Trust settling down Tangible progress made on issue resolution Deployment of expert teams to target areas Aggressive use of DQ dashboard 850 + unique logons and 360 concurrent users Service Pack 3 deployed at the end of week 3 contained 50 targeted fixes

Summary Week 5 & 6 l Number of System Issues reducing l Number of Data Issues Increasing l Users attempting to do more with the application as each week goes by l DQ dashboard now demonstrating that the organisation is transacting significant volumes of data

What has gone well l l Project Management Parallel runs Dry run – cutover Executive support Issue Management

Main Issues l Data Migration fall out l Trying to shoe horn i. PM into a rigid RTT structure l Performance l Users have now caught up with the system l Backlog catch-up from Referral into episode l CDS l Issues due to backlog l Inconsistencies l ‘Inconsistent’ behaviour being exhibited on occasions by Lorenzo

Service Management l End user support is now being provided via site based control rooms l Since Go-Live, the control room managers have had a team of floorwalkers at their disposal and it has been their responsibility to ensure that they provide 24/7 Lorenzo support based on the needs of each of the individual departments

Service Management

Performance CSC Team looking at 4 key areas of Performance: l Area 1: Server Side Performance - This will be done by creating an automated "dashboard" of key transactional data l Area 2: Client Side Performance - This will initially be done by CSC teams being on site working with end users to create a list of Hot Spots of poor performance. l Area 3: Business Process Performance – CSC Specialists on site to work with users to identify areas of Business process that can be reengineered or targeted for improvement l Area 4: Multi-sessions - Allow multiple login session for selected users

Communications/Project Management l Weekly Area Meetings – with key operational areas l Weekly Booking/Out-patient Meeting – Director of Service & Commercial Development with Operations l Bi-weekly Site Clinics – Staff can talk Director of Service & Commercial Development and Head of Informatics to discuss issues/progress (alternate sites/alternate weeks) l Weekly communication to staff on issues/progress

Dual Keying l l 20 staff dedicated to keying transactions into i. PM Full scope of i. PM not achievable Replicating data keyed into Lorenzo Protects organisation against technical issues with Lorenzo CDS l Trust Roll Back Option – As post ‘go-live’ period increases it takes longer to rollback

Release 2 Emergency Care: l Emergency Care supports the provision of unscheduled care within Emergency Departments (ED) and minor injuries units l Functionality supports numerous areas including registration, initial assessment, enables users to track and manage the patient’s physical and clinical journey within the department l Provisional ‘Go-live’ date of Tuesday 7 th September

Release 2 TTO/Prescribing: Scope of project includes: l Capture of Medication details on admission l Creation of an electronic discharge prescription l Automatic capture of discharge and medicines reconciliation information in the discharge summary l Go-Live Ward 2 at FGH – Expected Mid October 2010 l Following a two week period of bedding in, project based support and lessons learned, the deployment will be extended to Wards 4 and 5 l Go-Live RLI wards 20 and 22 – Expected Mid November 2010

Any Questions?