problems reported at morecambe bay, page-8

More from the reader's of EHI..

The first one is a rehash of a post made some time ago and I would take it(or treat)it with a grain of salt
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Surprise surprise
29 Jul 10 19:40
I have been involved in 1.9 for a while now. Including at Morecambe Bay.

I really hope that at some point someone senior stand up and says that enough is enough.

The software is terrible. The processes are long winded and click heavy. There is next to no data checking (for example... register someone as male and set them up as someone else's sister!). Icons change throughout the program. The response time is shocking. There are columns in tables with no descriptions. Nested tables lose their formatting so information is all over the place. I could go on and on.

If a 1st year programming student submitted this as a piece of work they would fail... simple... I am a Computer Science graduate with my own software business.

The excuse "this is work in progress".... or "it's evolving" just doesn't wash any more... how so much money can have been spent on such a badly written piece of software I will never know.

With regards to the sandpit question... there are that many different environments on different builds you never know which one to try stuff out on.... upgrades happen with no useful corresponding documentation.... some things get fixed... some things stop working.

Please... someone... stop hiding behind excuses..... accept that this is not fit for purpose. Cut your losses and use one of the pieces of software out there that actually work.

I realise that there will be a lot of fallout if someone does grow a pair of balls.... but it HAS to be better than pushing on with this waste of space.


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6
Sandpit
29 Jul 10 21:36

In reply to the Sandpit testing comment.

IMO the problem from the off was the model of one size fits all rather than software development conforming to information standards to ensure interoperability between different systems.

Still - all of us with 20+years EXPERIENCE of delivering SUCCESSFUL healthcare IT projects were told we "didn't see the bigger picture"......









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7
Re: sandpits and castles in the air
29 Jul 10 23:53
Yes, there were supposedly (awfully named) sandpits, but it seems from what I have heard that the testing done in them was so bound up in contractual niceties, and rigid test scripts that real users have not been allowed anywhere near them, or to wander freely into and expose those cul-de-sacs that only users can find.

Millenium appears to be a very American-focussed system, so the data structure is suited to raising bills American style, not counting patients. It has been around a long time, and had lots of extra bits bolted on over time. Which creates richness, but stretches the original concepts

Lorenzo we are told was built from the ground up, and has all the opposite problems, of being very raw and underdeveloped.

GP systems, and many of the lesser (but working) secondary care systems (for the last 4 years threatened with extinction, so poorly resourced) have had exposure and feedback from users over a long period, which has often been accepted by the supplier to enhance their offering, and keep existing customers, or in some cases paid for once and shared freely.

The NPfIT contracts removed or contorted these mechanisms, and with both LSP and NPfIT between the expert supplier programmers and the expert users and NHS technical teams, most of the 'yes of course we can change that' became 'it will cost you lots to change that', or under the original DG, rigid standardisation says change your clinical or admin process.

So the sandpit issues are more over who was allowed to play in them, and whether the castles they built looked anything like ones the NHS could actually use.


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8
Transparency Please
30 Jul 10 04:34
Shall we hear from the other recent go-lives, in the interest of transparency, please?

The silence from the Royal Berks and the Newcastle has been deafening, but then again, a Code of Conduct on disruptive behaviour is in force.


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9
System
30 Jul 10 08:24



I am sure all the necessary levels of testing would have been done and every angel of day to day operations were reflected in test scripts.

In my own opinion the problems were:

End User Testing
A bit of training issues, if there was a problem with inputting data this must have been identified in training and initial level of testing
Interoperability of two systems working fine in a test environment and working fine in a live environment are two totally different things
I am not sure what the roll out plan was, but the roll out plan should have been one department/ward rather then a big bang approach
Many PMs have their own ideas of implementing things and dont take into consideration what other managers are saying based on their level of experience and expertise.

Stating all this, I beg to differ from myself because a system can be 100% working fine in a test environment but when its expose to live data and patients in can go belly up once again due to lack of vision by the main stake holders.


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10
Roots
30 Jul 10 08:58

With any large scale deployment issues will be experienced after go-live. If they are not then the system simply isn't being used.

However you have to look at the specific issues and drill down to the root cause before blame is attributed to different areas

Staff having to work 2 hours each day: poor system? poor training? unfamiliar business processes? increased workload?

No access to system: low availability? forgotten passwords? bad system functionality?

These may fall under different areas of responsibility so all parties including the trust may be at fault (but let's face it none of us posters really know)

The scattergun approach to resolving problems ultimately means that lessons are never learnt and improvements made for the next deployment.



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11
Are you sure on your facts?
[email protected]

30 Jul 10 10:22

Some of the statements about the sandpits are simply not true. A release that goes through the full NPfIT development lifecycle, as Lorenzo releases do, are deployed into one of a number of National Integrated Sandpits (NIS or sandpit) for multiple phases of testing. One of the latter phases of testing is Model Community business process testing performed by real users. During the preparation for MC testing, test scripts are written which are reviewed by the NHS users, who are then invited in the to execute the tests. The results and any problems found are then reported back to the supplier. Im not saying the process is perfect, Im just saying some of the comments above are not correct.



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12
Angels...
30 Jul 10 11:54

I realise it was probably a typo, but I'm now intrigued by the Angels of Day to Day Operations...

In reality, when you deploy large systems, no matter how much you prepare, you always have the niggles as the product settles in and the people who have always done things in a particular way to make theirs and their patients lives easier in the old systems, battle to find the most effective 'work arounds' in a new system... This isn't always functionality availability - it's often about 'I used to do this, so how do I do that now'...

At the end of the day, people whose primary focus is delivering care are asked to change the way they've worked as well as do their job... and that's always going to be a challenge, particularly when you're fundementally changing the way in which the whole 'system' works and not just one small area.

Perhaps you should cut these guys a bit of slack and give them the time to be what they are... angels of day to day operations!!





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13
going live soon !
[email protected]

30 Jul 10 12:17

Our trust is soon to go live with Lorenzo so watch this space.

To pick up the point about testing I can confirm that extensive testing is being done, and this has been ongoing for quite some time. We are, however, still finding issues !



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14
Angle, Angels
30 Jul 10 13:16




I meant to say angle's not angels lol. I appreciate the fact that these people are changing the way how they do things but based on what is reported could be seen as lack of training, the interface between the two systems not working properly and all clearly points out to lack of testing.

Systems are meant to ease off the work load of people not increase them. Problems are for sure to be faced but the impact of these problems could then be classified as an initial problem or a major problem which could have been identified at early stages.

Its the responsibility of the whole project team to ensure that everyone using the system knows how to use the system to its full capacity



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15
"Doing things differently"
30 Jul 10 17:16

Were any Business Processes actually examined and re-engineered at the trust?

If not WHY NOT?

Re-examining existing business processes in the most fundamental of things to do when implementing new systems - why do I find myself repeating this time and again and were the business processes in use the trust tested in the sand pit?

Again, if not why not?

And Big Bang approaches are high risk - we should all know that.