Friday, July 22, 2016
Talk About A Long Goodbye! The UK NPfIT Finally Wraps it Up.
Digital Health.net (http://www.digitalhealth.net/) has written two articles which somehow seem to be a long obituary for one of the largest Health IT initiatives ever!
First we have the reporting:
11 July 2016
The National Programme for IT has finally come to an end, although the bill for the enormously expensive and controversial project will continue to be paid for years to come.
The deadline to exit NPfIT national contracts in the North, Midlands and East passed on 7 July, marking the end of the final chapter of the £12.7 billion attempt to bring the NHS into the digital age.
Trusts in these regions should have now signed new local contracts but most have opted to simply stick with those services that were deployed under the national contracts with United States-based company CSC.
In a final move before the July deadline, four additional trusts have also applied, and will likely receive, extra Department of Health funding to deploy Lorenzo, the electronic record CSC planned to roll-out across the NME before running into development and deployment troubles.
That means 15 trusts will now receive additional central funding to deploy Lorenzo for years to come, with some of these contracts stretching out until 2022.
Health and Social Care Health Information Centre figures show that of the 782 systems deployed across 223 organisations under the NPfIT in the NME, 64 % were being retained under new local contracts.
In acute trusts this was mostly mix of older iSoft systems originally deployed as “interim” measures, such as the i.PM patient administration system, the i.CM clinical suite and related products such as the Ormis theatre system.
Lots more here:
Then we have the obit.
The National Programme for IT in the NHS came to an end in the North, Midlands and East last week. Its flagship electronic patient record was Lorenzo. After ten years trying, and millions of pounds of investment, how are recent deployments going, and what legacy will it leave? Ben Heather reports.
Peruse the board papers of Norfolk and Suffolk NHS Foundation Trust and it soon becomes clear that it’s been a rough year on the IT front.
The trust deployed CSC’s Lorenzo as its electronic patient record on 20 May last year. It was hoped the new system would turbocharge Norfolk and Suffolk into the digital age, replacing paper and ageing, clunky software with a slick, adaptive platform. It hasn’t quite worked out that way, at least not yet.
In October last year, the Care Quality Commission warned the trust it needed to get Lorenzo in order, but as recently as June the trust’s board was still being told “performance issues” with the EPR were an “outstanding risk”.
Board papers reveal that 554 incidents relating to Lorenzo were reported on Datix between go-live and May 2016. Many of these issues were local; but others related to national “outages” that affected all trusts using Lorenzo.
Between November last year and April there were 11 such outages, and CSC, at least initially, struggled to get to the bottom of them. “Although reliability has improved, system outages have not been eliminated,” the board papers note. “Key actions are outside the control of NSFT [the trust] and so [there is] no timescale for remedy.”
It all started with the National Programme for IT
After Accenture quit the National Programme for IT in the NHS back in 2006, CSC became the sole local service provider for the North, Midlands and East of England – three fifths of the NHS.
It was due to roll-out Lorenzo to healthcare communities across these regions, but ran into repeated development delays and deployment issues. Eventually, CSC bought iSoft, which had developed Lorenzo, and with it a suite of older patient administration and clinical systems.
CSC offered these systems – primarily iPM, iCM, and the theatre system Ormis – to trusts as ‘interim’ solutions. And, despite their age, they have proved popular. Offered a chance to tender for alternatives as their national contracts ran out, most trusts chose to stick with them.
Figures released to Digital Health News last week showed that of the 782 systems deployed across 223 organisations under the NPfIT in the NME, 64 % were being retained under new local contracts.
However, the number of trusts deploying Lorenzo remained small and mostly confined to ‘exemplars’ like University Hospitals of Morecambe Bay NHS Foundation Trust, which exerted a huge effort to make Lorenzo work.
In response, the Department of Health and CSC negotiated a contract reset in 2012 that removed the company’s right to be the sole supplier of systems to the NME, while making central money available to trusts that still wanted to adopt Lorenzo.
The Health and Social Care Information Centre confirmed last week that 11 trusts took up the offer; with a further four still in the pipeline.
Vastly more here:
This is a story well worth reading all the way through. I find it amusing that the older iSoft products seem to have been so successful in use – showing once again how sad it was that we lost the company from Australia – much more for commercial rather than technical reasons in my view.
Overall the program ran for close to 20 years and cost billions. It will be interesting to read the book when it is finally written.
Posted by Dr David G More MB PhD at Friday, July 22, 2016