This story is pretty incredible:
A new care record system has contributed to thousands of patients from Barts and the London NHS Trust potentially breaching the national 18-week referral to treatment time target.
The trust is facing a backlog of 23,000 potential breaches, and although it says the situation is improving – and it has resumed reporting on 18-week waits – it may “fail for the delivery of 18 weeks in 2009-10”.
Problems with the Cerner Millennium CRS, combined with poor trust data and procedures, are responsible for the problems.
In August, the backlog of admitted patients stood at 1,700. The trust also reported having a “non-admitted backlog of 26,640 on pathways”. This required validation as many were duplicates. The number has since reduced to about 23,000 cases.
The problems date back to the implementation of Cerner Millennium last April. By September 2008, the trust was projecting a £3m shortfall in income due to data, reporting and technical problems with its BT-provided system.
The trust has since introduced new systems and processes to manage patients and an 18-week patient tracking list. These are backed by weekly review by each speciality within the hospital. Trauma and Orthopaedics is the speciality with the highest number of backlogs.
The trust says that the sheer scale of case backlog will make it very difficult to clear, with seeing and treating patients likely to lead to a “dip in performance”.
The scale of the problem means some patients may be kept waiting for more than six months, twice the national target for treatment. An August trust paper states: “It was acknowledged that 26-week breaches may occur due to the quantum of the non admitted backlog.”
EMR is great when it works, but when it doesn’t this type of stuff happens. Although, it’s really hard to imagine missing 26,000+ cases. WOW!