Urgent replacement of "vital" health system

Saturday 23 May 2020

Around £15 to 20m will spent replacing one of Health & Social Care's key Electronic Patient Record (EPR) systems to avoid "endangering" the island's healthcare services.

The States approved HSC's urgent bid for funding a replacement, after committee members warned that a key digital system, which allows doctors and other healthcare practitioners to efficiently and securely record, track and analyse patient data, had become outdated and will no longer be operational from 31 march 2021.

Despite approving the capital allocation, many States members were unhappy that HSC had metaphorically "put a gun to their head" by forcing upon them an "urgent" proposal which had not been raised before and which they had been given little option but to support. 

So strong were their objections, to the amount asked for and the handling of the situation, that six members voted against it and another four abstained.

One of the most vociferous critics was Deputy Neil Inder, whose professional background led him to call this a "disaster" from top to bottom. 

"There has been a huge failing here in the system," he said.

"Having been in the business for 15 years, I cannot see how it can cost £15 to £20m for what are very small pieces of hardware."

Pictured: Deputy Neil Inder was outraged by the proposal, saying it looked to him like a "disaster in the making".

He said the financial case for this multi-million project amounted to "what is effectively one side of A4 paper", aiming his criticism at States services rather than HSC politically.

"This will be a mistake and cost us millions and millions over the years. I do not trust this procurement process and I do not trust this capital allocation process one iota. It is a disaster in the making as we never started in the right place."

One Deputy who felt compelled to vote for HSC's proposal was Peter Ferbrache.

"We won’t have any option to approve what has been put in front of it.

"I look at our overall management of this and it causes one to raise one’s eyebrows."

The States’ Health & Social Care services, including those at the hospital, currently use an EPR system known as TRAKCare 2012, provided by a company called InterSystems.

However, it is a legacy version of the system which, when the agreed contract arrangements end on 31 March 2021, will no longer be formally supported by the provider.

"This lack of contractual support, combined with an ageing and increasingly vulnerable system, has the potential to result in an increased frequency of system issues and make any such issues more difficult, time consuming and expensive to resolve," HSC said in its policy letter.

Pictured: HSC Vice-President Rhian Tooley said her committee was not happy with the way the situation had been handled, and did not like having to bring it to the States as an urgent proposition. 

"As such, these circumstances generate a number of significant operational risks for vital services. System issues and downtime have the potential to weaken the States’ ability to deliver health and care services, particularly in the hospital where the system is  most relied upon.

"It would also make it more difficult for professionals to share the data required for clinical decisions and for the States to monitor the performance of the islands’ overall health and care provision. In this context, it is essential that work on a new EPR solution is urgently progressed.

"A modern replacement system is an essential building block for the desired improvements to Bailiwick health and care, such as greater interoperability of systems and enhanced data sharing across the professions within the Partnership of Purpose.

"These advancements will also contribute towards the agreed States’ goals for patients to be able to access their own health information and manage elements of their own healthcare, aims which would be far more difficult to achieve with the current less flexible and outdated EPR system."

Pictured: The Princess Elizabeth Hospital.