Cerner sites to report benefits

A series of 2011 benefits analysis reports for Cerner Millennium implementations at Southern trusts have been submitted to the Department of Health.

The reports will feed into an updated statement of benefits for the National Programme for IT in the NHS, and the £2.7 billion that it has spent on care records systems so far.

The DH was supposed to submit the update to the Commons’ public accounts committee by September last year.

Its failure to do so was criticised by the PAC, when it held hearings on the National Audit Office's third report on the programme last summer.

EHealth Insider has a Benefits Position report, dated June 2011, produced by a benefits realisation sub-group of the CRS Live Sites Executive – a voluntary group with members drawn from each of the Southern trusts live with Millennium.

The report says the sub-group was created to “maximise the benefits to be gained from the CRS Upgrade (LC1 enhanced) for the seven live sites in the Southern programme” – and implies that some trusts had seen few, if any, benefits by then.

“With competing priorities, and where reduced levels of transformation/business change have been applied or are scarce, there is a marked reduction in benefit realisation,” it says. “The group are sharing optimisation processes and additional benefit realisation plans.”

The report says the group was due to deliver a unified submission to the DH outlining the benefits position for 2011.

EHI understands individual trusts have been sending reports to the DH since late last year, but despite submitting many requests to the DH, Southern Programme for IT, and individual trusts, EHI has not been given access to them.

The first eight trusts in the South to go-live with Cerner Millennium had the system deployed by Fujitsu, when it was local service provider for the region.

After Fujitsu exited the programme, BT was awarded a contract to upgrade the existing Millennium installations - which were reduced from eight to seven when one trust switched off the system.

The June 2011 report says Cerner R0 had “limited functionality” and benefits realisation was “scanty."

The BT upgrade was designed to deliver a “new or enhanced suite of benefits” to each organisation. The CRS Live Sites Executive is monitoring whether these have been achieved.

Each trust has identified its top five benefits, creating a register of 35 benefits. The most common benefits being monitored are clustered into groups.

Those relating to connection to the Patient Demographic Service include: improved recording and accuracy of demographic details; results requesting, reporting and viewing in one system; reducing delays in patient care; and reduction in duplicate requests for tests.

Those related to efficiency include: data automatically integrated into the discharge summary; maternity and emergency department in one integrated system; and increased theatre utilisation.

With regards to quality and safety, the potential benefits are: a reduction in clinical incidents; and improved governance and consistency of care, while better payment coding allows for improved recovery of costs.

“As staff, roles and utilisation become more dynamic a second wave of benefits are being considered and unexpected benefits are being reported,” the report says.

However, reports that EHI has been able to obtain for some trusts suggest these are not being closely quantified, or expressed in financial terms.

Trusts that agreed to provide interviews and statements to EHI also provided information suggesting that benefits have been slow to be realised; in part because they have only recently started to deploy more clinical functionality.

Buckinghamshire Healthcare, Surrey and Sussex Healthcare, and Weston Area Health NHS Trusts all said they now had a stable platform, on which they are developing additional functionality.

However, a report to the board of Winchester and Eastleigh NHS Trust dating from last June indicated that while it had identified and realised some benefits, it was finding it hard to realise others where key functionality had not been deployed and “core functionality” was “underperforming.”

EHealth Insider has contacted all of the Southern trusts that went live with Cerner Millennium in 2006 and 2007 to ask about the benefits they have realised. There is a fuller account of their responses in the Insight section.

EHI will be publishing more stories on Millennium in the South. anybody with information can contact reporter Rebecca Todd in confidence.