Electronic data migration at HMP Leeds - NHS Connecting for Health

Prison
Health
IT
Case Study
Electronic data
migration at
HMP Leeds
Most prisons are switching to TPP SystmOne
Prison from a paper-based system. However,
a small number of prisons are currently using
alternative clinical IT systems and are therefore
weighing up the merits of undertaking an
electronic data migration.
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Working with NHS Leeds, its primary care trust
(PCT), HMP Leeds is the first prison in the country
to undertake an electronic data migration. Chris
Rowlands from HMP Leeds and Mark McDaid
and Safiya Mayet, project team from NHS Leeds,
share their experiences.
HMP Leeds, a category B local prison, accepts
offenders from around West Yorkshire. It houses
around 1200 prisoners, with an average turnover
of 450 per month. The prisoners are served by a
healthcare wing run on a 24/7 basis by around
100 staff.
The prison had been using EMIS PCS for a couple
of years prior to implementing TPP SystmOne
Prison. EMIS was well-established and staff were
familiar with it although they still used paper for
sending and receiving records.
The rationale
So why did HMP Leeds and Leeds PCT opt to
undertake an electronic data migration?
Staff within the healthcare wing were well
familiar with EMIS PCS and therefore used to
information being quickly and easily accessible.
Having got used to the system there was some
reluctance to move to a different one, no matter
what the benefits of doing so. The thought
of starting from scratch again was deemed
hugely impractical. Against that background,
electronically migrating the patient data was
viewed positively because it would mean less
disruption to users.
The team say that, with so much information being
held on EMIS PCS, they did not feel they could risk
losing any of this in a manual migration. Continuity
of information was essential to providing continuity
of care. For instance, the prison has approximately
350 prisoners who are being treated on an ongoing
basis for substance misuse. In addition, more than
three quarters of the prison population are on
prescription medication and the team felt that it
would not be acceptable to be unable to access
the prescription information following the system
switch-over.
The team were also mindful that, following some
deaths in custody previously, the prison had been
criticised for using both paper and an electronic
system concurrently. They therefore saw a
significant risk in turning off one IT system and then
manually inputting information into another: it
would have led to the ‘joint running’ scenario, even
for just a temporary period, that they were so keen
to avoid.
As a result, although the PCT had been initially
reluctant because of cost and the high level of
prisoner turnover within the establishment, it was
agreed to plump for an electronic data migration.

Prison
Health
IT
Case Study
The process
On paper the actual data migration process
looked straightforward. However, there were
certain practical challenges that needed to be
overcome.
The first step was for CSC/TPP to take a data
extract from EMIS PCS. Chris reviewed the
extract, making sure that it was representative of
the healthcare wing’s caseload.
The extracted data was then put into a dummy
version of TPP SystmOne Prison and checked for
accuracy. Although this was done initially by TPP
they needed to ask Chris questions about the
extract, so that records could be ‘mapped across’.
Working on-site at the prison, the healthcare
team – chiefly Chris – got steadily more involved
in checking and qualifying a cross-section of the
data in the dummy system. The extract was then
signed-off.
At this stage a final extract from EMIS PCS was
taken and migrated onto the TPP SystmOne
Prison. The healthcare team then had 11 days
between the extract being taken and TPP
SystmOne Prison going live (although seven days
is considered achievable) and reverted back to
paper during this period.
Leeds were happy with the quality of records
they had after the migration. They found that all
the information was where it should be, and that
it was all accurate and to the standard expected.
All the prescriptions were fine. “As long as the
data was read coded it migrated OK to TPP
SystmOne Prison,” says Chris. “But clearly, the
data migrated can only ever be as good as the
data held in the original system.”
Templates were not migrated. These needed to
be re-created in TPP SystmOne Prison, where
there was not already a standard template in the
system.
Lessons learned
So what lessons were learned during this process?
The team say that above all, a dedicated member
of staff is needed within the healthcare team to
lead on the data migration, liaising with both
CSC/TPP and the PCT, and ensuring that data
checking happens in a timely manner.
It needs to be treated very much as a project in its
own right, they say, with a proper plan in place.
Every individual involved needs to understand
how the process will work and what is expected
of them and when.
In terms of timescales, data migration was
meant to increase the deployment process for
TPP SystmOne Prison to 16 weeks but Leeds
made a conscious decision to go for 20 weeks.
The feeling within the team is that the act of
migrating the data is not too much of an issue,
it’s the training and business change activities
which are time-consuming.
Resource also needs to be made available within
the healthcare team to support the data checking
process. Based on their own experiences, Chris
and Safiya believe that the ideal would have
been to have at least three members of staff
available to help with this task, each with their
own terminals to work at.
They and Mark also say that serious consideration
needs to be given to backfilling for staff who are
helping with the project. And, as far as possible,
staff changes which may take place during the
data migration and wider deployment process
need to be anticipated, alongside issues such as
annual leave.
They also say that system knowledge is
important. Healthcare staff supporting the
electronic data migration need to have a good
knowledge both of the old system and TPP
SystmOne Prison. The team say that without
this knowledge the data checking will take a lot
longer.
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Prison
Health
IT
Case Study
There was also the simple issue of communication
and access. Chris admits that, at times, TPP found
it difficult to get in touch with her. As she was
the person most involved in verifying the data
this served to lengthen the timescales for the
data migration. She says that establishing fast
and effective communication routes with both
the supplier and PCT is essential.
Mark adds: “And, if problems occur during
either the electronic data migration and wider
implementation, it’s important to stick to the
process with the project team and escalate the
issues via the correct route.”
Final reflections
Looking back, Chris, Safiya and Mark all believe
that electronic data migration was the right
decision for HMP Leeds. It was based logically on
key factors including level of usage of the current
system (in this case, EMIS PCS), quality of data
on the system and whether and how paper was
being used.
Despite the challenges they feel that
summarising from paper would have been just as
challenging, if not more so, and perhaps prone
to error.
Thinking about the business change issues, the
team also accept that, given the initial reluctance
of some staff to switch to the new system, more
could have been done to promote the benefits of
TPP SystmOne Prison. They feel that some specific
benefits to highlight would have been the ability
to share prisons’ records across establishments,
the reporting functionality in the system and the
ability to take uploads from LIDS.
They also say that, although high turnover of
prisoners might be seen as an argument against
electronic data migration, HMP Leeds has a lot of
prisoners who leave the prison and then return.
The amount of prisoner turnover in the period
between the final data extract being taken,
and the system going live, was not substantial
enough for them to change this view.
They do say, though, that following the
implementation staff have adapted to TPP
SystmOne Prison very quickly. This is partly down
to having enough super-users in place who can
support other members of staff. “We have 20
super users – one for every department within
the healthcare wing,” says Chris. “All band 7
staff were super users, as were all the GPs. We
thought this was essential given we’re a 24/7
operation.”
NHS Connecting for Health is the national
organisation which is supporting your
local NHS to introduce new computer
systems and services. These will help
deliver better, safer care for NHS patients.
For more information about this, visit:
www.connectingforhealth.nhs.uk
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4509 (April 2010)