NHS trust to sideline £21m e-records implementation

Rotherham NHS Foundation Trust plans best-of-breed patient records system after Meditech 'failures'

Rotherham NHS Foundation Trust is abandoning an electronic patient records (EPR) system that it has spent more than £21m implementing, and which only went live in 2012, after what its board describes as a "catalogue of failure".

The Meditech 6.0 system, produced by US-based Medical Information Technology, was procured in August 2009, while services supplier Perot Systems was appointed to do the implementation.

The Trust was one of the first to abandon the National Programme for IT (NPfIT) electronic patient records system back in 2009 and to adopt its own system instead in a bid to save money, as the NPfIT floundered.

However, the implementation only went live in June 2012, two years later than planned, and resulted in difficulties with booking patient appointments, among its glitches. Furthermore, a lack of consultation with clinical staff meant that the system was never accepted and staff quickly reverted to the previous EPR, Ascribe's Symphony, shortly after it was switched on.

They also complained about the level of data input required and the workflows that had been built into the system.

The Trust admitted in February 2013 "persistent serious issues" with the Meditech EPR and stopped further roll-out until an external US consultant, Larry Blevins, had reviewed the system and its implementation. He was paid £25,000 per month to help resolve the issues.

Up until February, the Trust had spent an estimated £21.5m on the system, according to specialist magazine eHealth Insider. That included "more than £8m on implementation and ongoing support costs against a budget of £6.5m, mostly due to a £1.2m over-spend on trainers".

The Trust's £6m-£7.5m deficit for 2012-13 could largely be ascribed to the costs of the botched EPR implementation, claimed Monitor, the regulator set up to oversee foundation hospitals.

A draft "informatics strategy report" released last week was also scathing. "Clinicians weren't involved in the testing and so, at go-live, the full impact of EPR use on clinical efficiency and throughput added to the problems. Lack of clinical engagement during the implementation process has left a significant legacy of distrust and negativity towards ‘the product' as opposed to ‘the vision'," it stated.

In its place, the Trust is planning to implement an alternative best-of-breed approach, which will retain Meditech in a number of departments, while reducing the level of usage of the Meditech software originally planned.

Early reports over the implementation had been positive: "...the implementation of the first phase across Rotherham Hospital over the Diamond Jubilee weekend went 'smoothly'; with the implementation set to continue over the coming weeks," reported the specialist website Healthcare Today.

It continued: "Phase one incorporated real-time bed management including admissions, transfers and discharges, order communications and results, outpatient letters to GPs, discharge summaries. Subsequent phases will be rolled out over the next 18 months, with the trust eventually aiming to move to a paperless operation."

Following the problems at Rotherham, City Hospitals Sunderland Foundation Trust also delayed the deployment of Meditech 6.0, despite using the software in its various versions since 1992. It blamed data migration problems for the delay.