Engagement Period May 2016 – June 2017

The Challenge

Cloud21 were initially brought in to write the Data Migration strategy for the Trust's transfer of Clinicom and Symphony data as part of its CSC Lorenzo deployment programme. The Cloud21 team subsequently led in the end-to-end delivery of the data migration workstream and in the development of a new Trust Data Warehouse to combine legacy data with the new Lorenzo feeds.

As the go-live date approached further Cloud21 resources were sought to develop and manage the Trust's cutover plan.

The migration project scope included patient demographics, open referrals, 2 years ED activity history, current patient waiting list entries, and future outpatient clinic configuration and appointments.

Cloud21 worked with the Information team to develop routines to combine legacy activity data with ongoing Lorenzo data to support seamless reporting from the new IDS: DW warehouse. Further collaboration enabled the ETL process to be successfully deployed in the Trust’s mirrored server, rather than clustered server environment.

New SSRS web reports were developed by Cloud21 to run against the new IDS: DW data structures. Reports included RTT and other waiting list management reports, and UNIFY returns for RTT, A&E,MAR and QAR.

The Approach

Cloud21 provided a highly skilled Informatics and data migration team to work with the Trust in the delivery of data migration and Informatics services for the project.

The team worked closely with the Trust information, project configuration and business change teams to understand and accommodate known issues with source data systems, ensuring that the data selected for migration was consistent, accurate and would support the business after go-live.

A suite of bespoke data quality reports were developed for the trust to focus on key issues. These reports enabled the trust to address many of their issues and assured the quality and integrity of the data prior to load.

The Patient Tracking List (PTL) was generated from validated sources, which enabled the Trust to focus on closing referrals erroneously left open following completion of treatment. Assurance of the RTT position was critical for the operational management to agree the Trust decision to go live.

The team also supported and validated personnel, locations and clinic configurations throughout the project, providing Product Specialist level support that complemented the CSC specialist resources.

Cloud21 successfully delivered all data migration aspects of the programme, migrating 35 million records representing the Trust’s patient, ED, waiting list Clinic configuration and Clinic appointment records with a 99.98% success rate. The remaining records contained known critical inconsistencies and were manually corrected and transferred.

Again working closely with the Information team, Cloud21 deployed a reporting instance of its IDS: DW to support the Trust’s future reporting and analytical needs.Cloud21 also worked closely with the Trust to adapt the IDS ETL routines to handle a mirrored server environment.

Collaborative work resulted in delivered routines to merge and link legacy data with future Lorenzo activity, supporting seamless longitudinal reporting of Trust performance, and the IDS CDS module was deployed to enable generation of SUS CDS returns with immediate effect.

Cloud21 also delivered a new suite of online reports to support:

• RTT and waiting list monitoring and management, including Audiology waits
• UNIFY returns for RTT complete and incomplete pathways
• UNIFY returns for Audiology waits
• UNIFY monthly and quarterly diagnostic tests returns
• UNIFY A&E monthly reports (monthly SITREP)
• UNIFY monthly (MAR) and quarterly (QAR) activity

The IDS census module was deployed to enhance data capture to allow delayed discharge reasons to be captured each day, to support monthly reporting requirements.

In March, Cloud21 stepped in to provide management of the Trust’s cutover process at go-live, successfully planning and delivering a smooth transition to the new Lorenzo system.

Extract, Transform and Load (ETL)

The load and validation routines used for the Lorenzo data migration were subject to four upgrades during the lifetime of the project.

The Cloud21 team worked closely with CSC and Trust colleagues to ensure that changes to the IFF specifications were incorporated into the Cloud21 transformation routines, and thoroughly tested prior to trial and final data migrations. All changes were incorporated into the ETL processes to ensure that migration processes were repeatable and fully auditable.

Trial Load Management:

A Data Quality check, two trial loads and a dress rehearsal took place prior to the go-live weekend of the May Spring Bank Holiday. All these activities included delivering files to the supplier for either a formal validation process or loading into Lorenzo. Interim runs were completed on a weekly basis to monitor configuration and data quality issues.

The transformation and load process was typically completed within a 24hr period and was initially used to validate the accuracy and completeness of the source data and transformation routines.

Once the data processes had been fully validated and proved to be repeatable, the trial loads were used to validate the accuracy and completeness of the Lorenzo configuration, especially consultant and clinic build. Full, end to end migration also enabled both Cloud21 and the Trust information team to make use of migrated data to feed into their new data warehouse and test the new reporting systems.

Deployment Expertise:

The remit of the Cloud21 team extended beyond the data migration project to providing guidance and support across the deployment programme, which included:

Strategic guidance and support across senior and operational deployment work streams, enabling decision making at all levels.

Configuration: Provided reports and extracts from the legacy system. Assessment of data quality and identification of configuration gaps.

Reporting and Information: Data reconciliation and new data warehouse deployment and development to meet the reporting needs of the Trust.

Training: The IDS data warehouse was provided with a set of user guides and followed up with hands on user training. This enabled the trust Informatics team to take ownership of the warehouse and to develop additional data sets and functionality as required.

Post Go - LiveSupport

Following the successful migration and cutover to Lorenzo the team provided additional support in the two weeks following go live to triage any data migration issues and provide the Trust with support on other issues as required.

Following the successful migration and cutover to Lorenzo the team provided additional support in the two weeks following go live to triage any data migration issues and provide the Trust with support on other issues as required.

How did our work deliver value to the Client?

The Cloud21 team provided expert knowledge and skills across technical, operational and and strategic elements of the deployment programme.

With unrivalled expertise of data migration practices and healthcare system knowledge, and extensive experience of Lorenzo data migrations the team successfully mitigated the Trust's data migration and reporting risks, delivering a smooth transition with minimal disruption to service and allowing the Trust to return to business as usual in a short time.

Providing expert Data Migration and Informatics guidance across the EPR programme ensured the right decisions and actions were taken by the Trust at the right time, enabling a successful system implementation with minimal operational risk. The Trust was able to report June RTT performance by the national reporting deadline.

Testimonial

“The Trust's replacement of the Clinicom PAS was part of a larger programme of change, so its replacement with CSC Lorenzo had to be successfully completed within a strict timeframe. The Cloud21 team contributed to this by bringing their knowledge, experience and flexible approach to the project; they assisted in several areas including the formulation of the Data Migration strategy, the development of extracts from multiple source systems and managing DQ and mapping issues.

The team also negotiated with CSC to use a hybrid of their recommended approaches to achieve the best possible solution for the Trust, transformed data to meet CSC’s load requirements and incorporated additional tools to support and supplement trial load testing cycles.

Without Cloud21’s involvement the transition to Lorenzo would not have been as successful”

Martin Callingham
Chief Information Officer
Mid Essex Hospital Services NHS Trust