The National Programme for Information Technology Patrick McGahon – Director of Service and Commercial Development University Hospitals of Morecambe Bay NHS Trust Single Patient Record sPR

Agenda Cutover Summary Progress Since Go-Live What has gone well What has not gone well – Main Issues Service Management Performance Dual Keying Release 2 Questions

Lorenzo Care Management UHMB went live with Lorenzo Release 1.9 over the bank holiday weekend May 2010 UHMB became the first Acute Trust in England to implement the Lorenzo Care Management functionality Cutover activities from iPM commenced on 24 May 2010 – approx 40,000 data items transacted over the cutover weekend by over 100 staff All hospital wards were transitioned to Lorenzo in a phased manner over the bank holiday weekend by 30 May 2010 Outpatient services went live on Tuesday 01 June 2010 with Final stage of acceptance accomplished Thursday evening

Lorenzo Care Management Big Bang deployment across 5 sites and 3500 users The Full scope of Functionality was deployed including PDS, LRs and Arrival Booths The Trust went live with a number of known software issues Fixes for these issues were scheduled in conjunction with CSCA for delivery 2 weeks post go- live During this 2 week period, the Trust mitigated the risk of not having these fixes and hence not having a ‘clean process’ by incorporating a number of temporary workarounds

Summary Week 1 & 2 Quieter than expected during week 1 Deliberately a 4 day week – bonus of a school holiday as well Mainly log on and how do I do type issues with a few configuration issues unique logons and 420 concurrent users Week 2 – was the first working day for a significant number of staff User frustration – they now think they know what to do Many more configuration issues Specific application issues raised unique logons and 360 concurrent users Weekend off

Summary Week 3 & 4 Focus on backlog, Trust settling down Tangible progress made on issue resolution Deployment of expert teams to target areas Aggressive use of DQ dashboard unique logons and 360 concurrent users Service Pack 3 deployed at the end of week 3 contained 50 targeted fixes

Summary Week 5 & 6 Number of System Issues reducing Number of Data Issues Increasing Users attempting to do more with the application as each week goes by DQ dashboard now demonstrating that the organisation is transacting significant volumes of data

What has gone well Project Management Parallel runs Dry run – cutover Executive support Issue Management

Main Issues Data Migration fall out Trying to shoe horn iPM into a rigid RTT structure Performance Users have now caught up with the system Backlog Backlog catch-up from Referral into episode CDS Issues due to backlog Inconsistencies ‘Inconsistent’ behaviour being exhibited on occasions by Lorenzo

Service Management End user support is now being provided via site based control rooms Since Go-Live, the control room managers have had a team of floorwalkers at their disposal and it has been their responsibility to ensure that they provide 24/7 Lorenzo support based on the needs of each of the individual departments

Service Management

Performance CSC Team looking at 4 key areas of Performance: Area 1: Server Side Performance - This will be done by creating an automated "dashboard" of key transactional data Area 2: Client Side Performance - This will initially be done by CSC teams being on site working with end users to create a list of Hot Spots of poor performance. Area 3: Business Process Performance – CSC Specialists on site to work with users to identify areas of Business process that can be re- engineered or targeted for improvement Area 4: Multi-sessions - Allow multiple login session for selected users

Communications/Project Management Weekly Area Meetings – with key operational areas Weekly Booking/Out-patient Meeting – Director of Service & Commercial Development with Operations Bi-weekly Site Clinics – Staff can talk Director of Service & Commercial Development and Head of Informatics to discuss issues/progress (alternate sites/alternate weeks) Weekly communication to staff on issues/progress

Dual Keying 20 staff dedicated to keying transactions into i.PM Full scope of i.PM not achievable Replicating data keyed into Lorenzo Protects organisation against technical issues with Lorenzo CDS Trust Roll Back Option – As post ‘go-live’ period increases it takes longer to rollback

Release 2 Emergency Care: Emergency Care supports the provision of unscheduled care within Emergency Departments (ED) and minor injuries units Functionality supports numerous areas including registration, initial assessment, enables users to track and manage the patient’s physical and clinical journey within the department Provisional ‘Go-live’ date of Tuesday 7 th September

Release 2 TTO/Prescribing: Scope of project includes: Capture of Medication details on admission Creation of an electronic discharge prescription Automatic capture of discharge and medicines reconciliation information in the discharge summary Go-Live Ward 2 at FGH – Expected Mid October 2010 Following a two week period of bedding in, project based support and lessons learned, the deployment will be extended to Wards 4 and 5 Go-Live RLI wards 20 and 22 – Expected Mid November 2010

Any Questions?