Kent and Medway NHS and Social Care Partnership Trust saved £600,000 and completed its RiO deployment three months early, after taking a unique decision not to migrate any data from its legacy system.
The trust implemented RiO v5.4 over six months from April to September last year, when the target completion date was 31 December. The original budget was £1.7m, but it ultimately cost the trust £1.1m.
Director of operations Marie Dodd said the key to these outcomes was the decision not to migrate data from the legacy ePEX system. Project manager Tim Goodwill said data migration had caused problems for RiO deployments in the past.
Because data was not automatically migrated, clinicians were responsible for loading the basic information from each of their cases. This was then synched with the spine and personal demographics service.
They could also choose to migrate other relevant information if they wanted. Otherwise, they can still view the data in the ePEX system when needed.
Dodd said the process was relatively time consuming for some clinicians, who had to load 30-60 cases, but it saved time for the project in the long run and allayed their concerns about duplicate records in the system.
It also meant the trust had “much cleaner data” going into RiO, with all new patient information entered into the new electronic record.
Dodd said she believed the decision not to migrate any data had not been taken by any other trust. The legacy system will be read only for this year; at the end of 2012, the data will be archived.
Dodd said the trust also saved money by having a much lower than expected ‘did not attend’ rate for training sessions for 3,000 staff.
The trust had decided it was important to hire a project manager who had rolled out RiO several times before.
“We wanted the benefit of that knowledge and the benefit of being able to troubleshoot the project,” she said.
The project manager also had a relationship with local service provider BT, which helped create a strong shared problem solving approach between the two organisations, she added.
The trust is due to take Release 1.1 this November which will give it a lot more clinical functionality. Dodd said clinicians were particularly interested in deploying e-prescribing functionality.
The trust was also interested in how RiO could support a more mobile workforce.
Dodd said that alongside implementing RiO, the trust had been building a business intelligence system to make it easier to produce reports for commissioners which would maximise income and minimise penalties.
A report to the trust board in March detailed issues some staff are having in using these reports.
“As RiO was implemented, the trust was also introducing a more structured approach to performance management expecting managers to use the BI reports to identify where data capture was poor and take action to resolve this,” it said.
“While some managers found this an easy task some are still finding it difficult to understand what the reports show, the implications of the content and what they should actually do to resolve any issues.”
“Further operational guidance and explanation is being developed in service lines to maximise the use of the reports and support managers who are less confident,” the paper added.
The trust got RiO through the National Programme for IT in the NHS, for which BT is LSP for London. The £600,000 in savings will be reinvested in other IT projects.
© 2012 EHealth Media.
Imaginative decisionjust_instantiate 145 weeks ago
Well done Kent and Medway. Data migration can become as big a task as the definitive implementation. The biggest problems are almost always mostly to do with data quality (often the main reason for the demise of the old system). Projects usually start with the wrong question: "how will we migrate the data?", implicitly jumping to the conclusion that it will be a major electronic data transfer excercise. Kent and Medway have asked the right question: "What do we need to do with the information in the old system?"
Migration is expensiveNeelam Dugar 145 weeks ago
Old data in read only format for one year. This may work for now but as NHS systems become more digital, important patient data like lab report, path reports, discharge summaries, etc will need to be migrated. Hence defining an exit strategy at the outset is key
1. What is important from a patient safety perspective--clinical letters, discharge summaries, lab reports, radiology images & reports etc
2. Keep these clinical docs in a vendor neutral format--CDA in a VNA
3. These can then be imported into a new vendor sytem at end of contract with no expensive migration.
Not the only TrustContrarian 145 weeks ago
Bradford CareTrust deployed RiO a few yeas ago and decided to take the same decison. Resulting in a very quick deloyment compared to those done via LSP.
Historic information was available via read only in legacy systems post deployment. Data and reporting was combined in data rehouse solution.
Archived leagacy system?CertaCitrus 145 weeks ago
I presume this still means extracting data from the legacy system, documenting the relationships between data items and making it available from some form of data viewer.
I can understand the reasons for not migrating, it can be easier to just reenter the data but for patient data, such as progress notes, it must be migrated and would be relatively simple to do so.