Wirral places clinical trials at its core

Wirral University Teaching Hospital NHS Foundation Trust is aiming for two firsts. If all goes to plan, in May 2010 it will be the first trust in the UK to implement Cerner's PowerTrials clinical research module. The software, which aims to integrate research processes, will also be the first phase of a slightly delayed trust-wide programme to introduce Cerner's Millennium suite of clinical information software. In February 2009 the trust, which runs Arrowe Park and Clatterbridge hospitals, exploited purchasing freedoms associated with its foundation status and signed an 'out of cluster' contract with Cerner, rather than opting for Lorenzo as part of the NHS National Programme for IT. Luke Readman, director of information at the trust, says that Cerner Millennium will replace existing software, including systems to support patient administration and clinical tests, which have been in place for about 17 years. "We are running about 50 clinical trials, mostly drug trials across a range of specialities, and the biggest problem is identifying patients for recruitment," Readman says. "It might be something as simple as, does the patient have a certain condition and do they have any other illnesses, say diabetes as well. What we have to do now is to manually trawl records and rely on individuals to identify patients. "But because PowerTrials is an integral part of the clinical system, all that information is contained within it and so we will be able to identify patients who meet the criteria for the clinical trials much more easily." In addition to increasing the participation of patients and clinicians in clinical trials, the new system is expected to streamline clinical trial screening and enrolment, and integrate the collection of research data into research systems. It will also include rigorous metrics for study feasibility, research prioritisation and oversight. Chief operating officer and deputy chief executive for the trust Gary Doherty says: "The collaboration with Cerner will allow our organisation to more effectively manage the clinical trials process and reduce the time and cost associated with conducting research." Readman expects the benefits of the new clinical trials system to be apparent within six months to a year after implementation. "And we will be assessing it to check that we do, bearing in mind that as an organisation we do get some income associated with conducting trials." The trust is keen to expand its research base and the new clinical trials system could help achieve this, he says. "There is a large and complicated set of mechanisms around research in health in the UK. There is the Department of Health, which sponsors research through biomedical research centres, research collaborations through the National Institute of Health and some directly funded through commercial organisations, such as drug companies. "The new system gives us an advantage compared with other organisations, because you have to compete to win the clinical trials work. If you are better at it and are able to recruit more patients to it you are more likely to be successful." Wirral had been due to go live with Cerner Millennium, which in addition to PowerTrials includes modules for outpatients, accident and emergency, operating theatres and patient administration, in November 2009. In preparation it implemented a new data centre and computers to support the new software. Readman says the decision to postpone was made because of safety considerations. "We put in place a process to check that we transferred all the data from the old systems as safely as possible," he says. "During that process, we decided that it was sensible to give ourselves a bit more time to see how it works, rather than proceed to the original timetable, ensuring confidence in the safety and completeness of the replacement." "Our trust has a rich history of developing IT to support the way patients are treated and to improve clinical safety and it will give us a platform to continue to develop the expertise and deliver the best for patients that we can do into the future," he adds.