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Lorenzo - slow progress at Morecambe Bay

Tags: A   Connelly   CSC   iSoft   Lorenzo   Morecambe Bay   NPfIT  

19 Jan 2010

University Hospitals of Morecambe Bay NHS Trust is yet to go-live with Lorenzo Release 1 at the Lancaster Royal Infirmary, more than a year after it originally planned to do so.

The trust is still working on the deployment of Lorenzo R1 at Furness General Hospital. However, it says that all surgical services are now live with the electronic patient record system from iSoft, which is being implemented by CSC under the National Programme for IT in the NHS.

In a statement, Steve Fairclough, head of informatics at the trust told E-Health Insider: “We’re making steady progress with Lorenzo and have been through a period of consolidation and expansion.

“Lorenzo now extends to all surgical services at Furness General Hospital and includes the ability to produce an operation notes that can be references as part of the discharge process.”

Morecambe Bay gave Lorenzo R1 a ‘soft landing’ on a medical ward at Furness General in November 2008, after a series of delays. At the time, the trust said it was planning to extend the implementation to a surgical ward at The Royal Lancaster Infirmary.

The trust then decided to start the surgical ward implementation at Furness General instead. In June last year, it said it would extend to Lancaster when two more surgical wards were up and running.

At the time, Fairclough said: “We now have enough scope to show the benefits of Lorenzo in different areas. We expect to run the scope for six to eight weeks in the third ward, so we can learn lessons, possibly re-engineer and decide whether the time is right to move to Lancaster.”

According to the trust, the project was then discussed with consultants and CSC. Rather than rolling out Lorenzo to another site, a decision was made to extend its scope to cover, for example, the provision of operating notes directly from theatres.

In April 2009, Department of Health chief information officer Christine Connelly set deadlines for the national programme’s local service providers, CSC and BT, to make ‘significant progress’ with getting Lorenzo and Cerner Millennium into acute trusts.

She said that Lorenzo Release 1.9 would need to be live in “any care setting” by November 2009 and “on track for implementation at an acute trust by March 2010.” NHS Bury went live with R 1.9 in November. The acute trust mentioned is believed to be Morecambe Bay.

In a statement provided to EHI, George Nasmyth, a consultant at the trust who has been using Lorenzo to write operation notes, said: “Not only can the results of all investigations be accessed through a common IT portal, but all clinical notes are available and can be used to develop discharge communications.”

He added: “Clearly, with any new system there will be a need to modify and improve the configuration to meet specific end-user demands. Whilst the ‘off the shelf package’ is not perfect, we are very privileged to have the opportunity to be leading the primary development of these systems and configuring them for general use.”

Morecambe Bay said it is now in the process of finalising the deployment plan for the rest of the trust.

Links: iSoft

CSC

Sarah Bruce

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© 2009 E-HEALTH-MEDIA LTD. ALL RIGHTS RESERVED.

Readers Comments
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Readers Comments

1

Late delivery?

19 Jan 10 13:23

Six years late and still counting.  What happened to those severe penalities for late delivery?  By now CSC should be paying the Health Department for the prividledge of delivering Lorenzo.


2

Off the shelf

19 Jan 10 14:04

The Consultant who use the term "off the shelf" needs some education.

Off the shelf would normally mean some software you buy down at PC world for a few quid. Not something thats taken 5 years and £m's of quid to design and deliver. iSOFT and CSC have had hundreds of experts toiling over requirements, writing use cases, developing code, testing, re-testing, and then deploying. How upsetting then that after all that work it gets labelled as "off the shelf"!

And why isn't it perfect for Mr Naysmyth after all this time. I'd expect bells on it at this stage of the game.

Perhaps we should go an look at some off the shelf stuff if thats how its going to be percieved. As Apple says "we got an app for that". Perhaps they have. I'll go and look for one now.


3

Off the shelf

21 Jan 10 08:47

I understand his point, the entire point of this program was a standardised suite of applications that would be deployed almost production line fashion to the NHS meeting it's needs.

Sounds almost off the shelf to me, just because you know the reality to be different doesn't mean the customers have seen beyond the sales pitch.

Don't blame users for false promises.

PS quite a few of the Apps at PC World have spent years in design and development and have the money spent on them so a non specialist can pic it up and install it on their machine.

 

 


4

Health Info Systems are hard

21 Jan 10 09:46

Developing health care information systems is hard. There have been almost no large-scale, successful deployments anywhere in the world and where there has been success, the scope has been limited and the costs have outweighed the benefits.

When NPfIT started, the OBS was written in vague non-specific terms, useless as a guide to software development. Also the LSP/supplier relationship was mired in software development techniques, appropriate to the creation of solutions for extremely well understood problems, which is the exact opposite of the situation in health care.

Agreeing standards for inter-operability would have been a better solution initially, but in the end, it is necessary to tackle ignorance. Without an investment in research, another £12.7 billion will be wasted and no-one will be any nearer understanding what a successful healthcare IS should do and how it should integrate with clinical and non-clinical work in health care providers.


5

All politics is local...

21 Jan 10 13:05

Just like politics all system implementations are local.  No matter what the functionality available, and its clear that there are severe limits with Lorenzo, systems need to be flexible enough to account for local i.e. individual consultant/nurse, practices.  It's not that the problems or work processes are that different, it's that the human beings think they are or are wedded to their way of doing them.

The blend of flexibility and configurability of the software and a fine balance between standardization across the organization and reflecting important local needs is the 'art' of succesful system deployment in any business area, but especially so in healthcare.

The thought that anybody could take a single software systems with a single configuration approach and 'cookie cutter' plop it into multiple NHS hospitals, and think that would be warmly received by the natives, is deluded and shows lack of experience.

I would hope that lesson could be recognised and accepted now as we enter an era where more local choice and say seems to be appearing.  The fear is that individual Trusts vision of what is possible from any given software solutions could do for them is cramped by the desire from the center to stick with the approach chosen and overly controlling standards.

There are plenty of reporting standard demanded by the Department of Health. There is also plenty of work going on it other places around industry interoperability standards, not parochial NHS system standards.  Reporting and interopearability should be the standardisation required by the NHS, not whether this systems has blue buttons in the right place rather than pink ones and the text has particular fonts of a given size and placement.

Call me a libertarian (your wiki word of the day!), but I think more choice devolved, just like with the Foundation Trusts, would be a damned good thing, assuming that standards are appropriately targeted and enforced.

 


6

OBS - stupid, yes; vague, no

22 Jan 10 00:02

 

"the"OBS was written in vague non-specific terms, useless as a guide to software development."

i can only assume the poster has never seen the obs/works for an LSP.  The OBS was technically, commercially, and managerially stupid, but was certainly not vague

easy to solve - just ask to see it

freely available

 

 

 

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