Heather O'Brien, director of information systems for the acute trust, told HC2009 in Harrogate that it hopes to see benefits in the next financial year. "The amount of resources needed before go live and around go live was far more than we expected," she told the conference on 29 April 2009.
Speaking in response to a question on how much introducing the software will cost, she said: "Think of a number and double it, at least." Good contractors "will cost the earth," she said, adding: "Anyone with Cerner on their CV has a licence to print money in London".
She described Royal Free's go live in June last year, which was the first in its type of trust, as "a very, very big project," adding: "It's not a secret that the Royal Free had a significant number of problems."
She said the trust had seriously underestimated the amount of work involved in moving from its old system to Cerner, and anyone planning this process should "double, if not quadruple, your timings".
The trust moved all its inpatients across in one weekend, with outpatients following over a 10 day period. It had carried out a dry run, but this did not reveal the amount of work involved. "Many of us worked through the night to get patients on the system before the go live," she said.
O'Brien advised those yet to change systems to reduce clinical activity around the changeover if possible, and to find extra IT staff. Royal Free's helpdesk received 700 calls a day during its transition, and was open around the clock. She also advised trusts not to underestimate the work involved with producing smart cards, such as printing them, allocating passwords and setting up roles.
She added that medical professionals at Royal Free were not fully prepared for the switch. "I don't think the doctors were that engaged before we went live," she said. "They didn't realise how much of an impact it would have."
O'Brien said there had been significant initial problems with the new system, with some tasks taking longer than on the old one. This had led some departments to revert to paper processes without telling anyone they were doing so.
Since then the trust has worked on making Millennium faster, such as by reducing the time taken to log-in from about 50 seconds to less than 20, and removing a BT splash screen. It also improved its guidance, including a guide to terms used within the software, and has changed some of Cerner's wording.
O'Brien said the trust is now back to "business as usual," and the Cerner system is providing benefits. These include the ability for users to access the picture archiving and communications system directly from Cerner, to book group appointments and regular day appointments with greater ease, and – in accident and emergency – to report possible children at risk. It is considering Cerner's products to replace its radiology and pathology systems.
The new system has also helped reduce paper within Royal Free. "No-one is naïve enough to think we're going to get rid of paper in the next 10 years," she said, but the trust should be able to make further reductions.
