The Pennine Acute Hospitals NHS Trust

How InterSystems makes overhauling key systems easy

Doctor ImageThe Pennine Acute Hospitals NHS Trust provides hospital based and community and integrated healthcare for the north-east of the Greater Manchester region, covering a population of over 820,000 people across Bury, Rochdale, North Manchester and Oldham. Delivering healthcare services to around 820,000 people, it is a large trust with an operating budget of over half a billion pounds.

With such a large number of residents and points of care, having a clear picture of patient information available throughout the Trust is a must, and interoperability between systems is essential in boosting efficiency and ensuring people get the care they need in a timely fashion. That’s why when it needed to update its solutions, the Trust turned to InterSystems’ expertise and highly advanced technology tools.

A need to modernise

Christine Walters, Director of Information Management and Technology services at The Pennine Acute Hospitals NHS Trust, acknowledged that the organisation’s existing Trust Integration Engine (TIE) system was unable to support the Trust’s IM&T Strategy with outdated technology incapable of meeting the organisation’s evolving requirements.

As well as the strong interoperability solutions Ensemble was able to offer the Trust, one key selling point was InterSystems’ expertise when it came to handling the transition.

Jon Astle, Integration and Development Manager, advised: “It [the TIE] was not able to cope with the future workload, as it often ran at near maximum capacity, had no automatic failover resilience, and there were reliability issues. Sometimes the unpredictability of the solution meant that it could take us up to eight hours to fully recover the system.”

Another solution was needed and this is where InterSystems Ensemble came in.

Making a challenging migration easy

As well as the strong interoperability solutions Ensemble was able to offer the Trust, one key selling point was InterSystems’ expertise when it came to handling the transition. This was an important consideration to The Pennine Acute Hospitals NHS Trust, as the process was expected to be a highly complex, time-consuming task.

Mr Astle explained that the Trust’s existing patient administration system (PAS) was developed more than 20 years ago and therefore was missing several key modern functionalities. For instance, it did not support HL7 messaging and the messages it did produce did not contain enough data to produce a fully populated HL7 message.

To solve this, the migration needed to take place in two phases. Firstly, communications between the TIE and the PAS had to be replicated and enriched with additional demographic data. The second phase was then to produce the customisations for each system and do a complete message comparison between the old TIE and the new TIE.

Mr Astle said: “We included on-site training for Ensemble where we were trained for five days by a product specialist/sales engineer. This I would absolutely recommend, as even though we had years of previous HL7 and interfacing experience, and one of the team had several years of Caché experience, it means you can hit the ground running.”

“Being able to meet the sales engineers who assist with the setup and also attend on-site for any consultancy days also made the whole experience seamless,” he added.

InterSystems Ensemble made this process much easier and more pain-free than the Trust had been anticipating, especially given how outdated and complicated the old system was. In addition to the in-depth expertise involved with the migration, the level of support offering in transitioning staff members to the new system was also highly valuable to the Trust.

Enhanced functionality

2 DoctorsAs well as bringing their systems right up to date – and securing them for many years to come – the Ensemble system provides The Pennine Acute Hospitals NHS Trust with a range of functions it did not have before, with the advanced system monitoring alerts being among the most useful.

“One of the major gripes we had regarding the old TIE is that we didn’t have any alerting, either visually or via email,” Mr Astle explained. “If an error was highlighted with an interface or a transaction then we had to look into text log files – and 99 per cent of the time the log files had cycled and we had missed the error so we had to try and replicate it.”

However, with Ensemble, it is much easier to spot any errors and track down the source of the issue so it can be resolved quickly and easily.

InterSystems Ensemble has also greatly reduced the amount of time staff at the Trust have to spend on general maintenance of the TIE. Mr Astle estimated this has been cut from as much as four hours a day to under half an hour, while the amount of callouts the IT department receives to respond to problems with the system has dropped from several a week to almost none.

More tools to help patients

The Pennine Acute Hospitals NHS Trust also elected to use a Spine Mini Services add-on to HealthShare. Spine Mini Services has allowed them to integrate real-time patient demographic lookups into their messaging flows and is used by the Data Quality group to help ensure that patients are correctly identified when admitted to hospital.

New admission and update messages received by the TIE are checked to see if they have a missing NHS number, an untraced NHS number or missing GP details. If any of these are highlighted, then a check is done against the Spine. If the results come back with a match, the traced NHS number is added to the record and applied to the record moving forward.

The Trust is also to develop a mechanism to automate the registration of new babies who are often unnamed at birth.

If no results are found, a new task is created to help staff find the right details. This helps improve efficiency and reduces inaccuracies by gaining patient information in a timely manner – ultimately increasing patient safety.

“I was hugely impressed with the way InterSystems worked with Mr Astle in liaison with System Managers to enable the Trust to take on such a complicated project and complete it quickly and painlessly. Over 130 interfaces from 32 operational systems were successfully developed, tested and migrated within seven months.”

— Paula Martin
Trust Project Manager for the Integration/Migration

The Trust will also make use of additional data items available via Spine Mini Services as they become available, for example the child protection flag. These data items can be used to provide timely alerts to relevant healthcare professionals.

The results of these systems are that The Pennine Acute Hospitals NHS Trust now has access to a much more modern, futureproofed system for managing its information and ensuring strong interoperability across the organisation. Paula Martin, Trust Project Manager for the Integration/Migration advised, “I was hugely impressed with the way InterSystems worked with Mr Astle in liaison with System Managers to enable the Trust to take on such a complicated project and complete it quickly and painlessly. Over 130 interfaces from 32 operational systems were successfully developed, tested and migrated within seven months.” The successful partnership between InterSystems and the Trust also helped ensure everyone was prepared for the migration and the final transition was able to take place seamlessly.