Lancashire Care NHS Trust
NHS Care Record Service
‘The deployment experience’
About the Trust
• Specialist Mental Health Trust
– Size = average acute trust
– 68 sites across 200Sq Miles
– 11 hospital sites, 750 beds
– 6 legacy PAS’, not much else
– 9 PCTs, 3 Local Authorities
– 4 COINs (Good infrastructure)
Topics for discussion
• Project planning
• Deployment
• Where are we now
• Lessons Learnt
Why go live first?
• 6 PAS’ with little or no access
– LTH switching off
– Risks no worse
– Greenfield site
– Organisation ‘up for it’
– Support of SHA & CSC
Project planning
• Developed good working relationship with
CSCA
– Strong project management
• Spent time on brief and PID
– Trust keen to get full bundle functionality
– Little or no external validation by NHS
– Lots of scrutiny by CSCA
Pre-deployment work
• Training
– Good master training
– Didn’t cover full scope
– Time lag between training and live
– Unstable training environments
– Different builds training vs live
– No spine access (PDS & Postcoder)
Pre-deployment work
• Training Continued
– No time to configure environments
– Local confusion over modules
– No time to customise to local operation
• Registration Authority
– Changes to RA software build
– Linking role to real job role (AfC)
– Use SMS to deploy.
Pre-deployment work
• No visibility of application
– Lack of knowledge - Trust & CSCA
• Data migration
– PMI and Casenote details – in house work
– Lots of testing, but no resolution to health
records problem until night before!
– Problems with incremental loads
– Changing data migration spec
Pre-deployment work
• Configuration
– Lack of understanding (more Trust than CSCA)
– Dubious I-Config
– Consequences of coding on application
• Impact on future reporting
• Shared sites
• Impact on strategic instance
• How codes appeared to users (order etc)
Going Live –
th
29 March
2005
• Long days and nights
• Confusing process for authorisation
• 100% commitment from CSC
– Technical bridges worked well
• Lots of configuration problems
– Unstable at first
– Fail-over didn’t work
Where are we now?
• Over 10 months live
• Deployed in all hospital areas
• First community sites deployed
• Psychology in progress
• HDM installed & ‘working with errors’
• Most staff are positive.
Where are we now?
• More stable recently
– 683 Faults logged
– 4000+ records failed CDS
• Much greater understanding of the product
• Reporting should be fixed in Erlanger
• Upgrading could be better
– Erlanger still a mystery with 2 days to go
• No signed Deployment Verification Document
Key themes
• Better communication
• No assumptions
• Clarify expectations
• Learn from this experience
Things that didn’t go well
• Product Knowledge
• Testing / configuration
– Access to the live environment
• TOO Many Faults
– Not tested properly!
• Lack of understanding
– The Authority & CSCA
Recommendations
• Spend time on your PID
• Insist on access to the software ASAP
• Testing, Testing, Testing
• Training, Training, Training
• Establish post go-live support
• Formalise handover of project to operations
• Be patient!
What goes around, comes
around
“That it will ever come into general use,
notwithstanding its value, is extremely
doubtful because its beneficial application
requires much time and gives a good bit of
trouble, both to the patient and to the
practitioner because its hue and character are
foreign and opposed to all our habits and
associations.”
The London Times in 1834…the stethescope
Questions?