Addenbrooke's Hospital £200m IT system proves an Epic fail

Cambridge University Hospitals NHS Foundation Trust is put into special measures, in part thanks to a new online patient records system

Cambridge University Hospitals NHS Foundation Trust has been put into "special measures" by health regulator Monitor, after over-spending an average of £1.2m a week, in part due to its new online patient-record system, which has been fraught with problems.

Monitor found that the Trust lacked adequate financial controls, and that it had failed to deliver necessary savings and has not submitted a credible plan to address a rapidly growing deficit - forecast to hit at least £64m this year.

Some of the issues at Addenbrooke's and Rosie hospitals in Cambridge, which are part of the Trust, have stemmed from over-spending on an online patient records system, dubbed e-Hospital system, provided by US firm Epic. Reports suggest that the organisation has spent as much as £200m on it.

The system went live on 26 October 2014 and was intended to enable medical staff to access patient records on handheld devices instead of waiting for notes. But instead of improving performance, a report in November last year by the county's clinical commissioning group (CCG) found a 20 per cent drop in A&E performance, along with other problems.

Some of the issues have reportedly been eradicated - but Monitor today specifically mentioned the e-Hospital system as one of the reasons why the Trust was put into special measures.

"The Trust underestimated the scale and challenges of implementing its new electronic patient record system, e-Hospital, and the impact this would have on its provision of healthcare for its patients. These issues led to significant cost increases and a failure to realise the benefits the system could provide," Monitor said.

A Care Quality Commission (CQC) report published today found that the implementation of the Epic system had caused confusion among staff. Staff didn't know how to deal with remaining paper records, which could not be stored in Epic.

Implementing the new system also meant that it was harder for the Trust to find locum cover, as it was difficult for new locums who were not familiar with the Trust's systems to use it.

The CQC investigation found that Epic had also been producing inaccurate discharge information, leading to a risk that patients would not receive appropriate follow-up care. There were also issues with timely access to information to provide patients and other healthcare professionals with up-to-date information because of the introduction of the new system.

Since the implementation of Epic, the Trust has seen a serious decline in its 18-week referral to treatment performance. At the time of CQC's inspection, 14 out of 18 specialities were not meeting the required target of 92 per cent of patients waiting no more than 18 weeks from referral.

The new IT system had a detrimental effect on staff too; three members of staff told CQC that they "felt bullied after raising concerns about patient safety following the implementation of Epic".

Two members of the administration and clerical staff, meanwhile, told CQC that they had been made to feel "incompetent" in their role and had feelings of being "ashamed" of the quality of work they were able to produce through Epic.

The Epic system implementation has all of the hallmarks of yet another public-sector IT disaster. Computing documented its 10 worst-ever government IT projects last month.