New CEO of the Health Services Authority Craig Brown is confident the Cerner integrated health care information technology system can still be effective in the Cayman Islands, especially if a proposed plan to have data hosted remotely is implemented.
Last month in Finance Committee, HSA Deputy CEO Shirlene Henriques said the system, which was implemented in October 2003, was still not performing properly.
‘We have not reached where we should be,’ she said, adding that not all of the system’s modules have been implemented.
The Cerner system has been plagued by difficulties, starting with a chaotic rollout and continuing problems such as computer freeze-ups and multiple entries of the same item.
However, Mr. Brown, who recently travelled to Cerner’s headquarters in Kansas City, Missouri to learn more about the system, said he believes it can work here.
‘I’ve seen the system,’ he said in an interview last week. ‘Cerner is one of the leading [health care] software companies in the United States.
‘It’s a company worth being a part of,’ he said.
Mr. Brown said Cerner’s goal is to have its system in 25 per cent of the world’s health care market within 10 years. The success of the system here in Cayman plays a role in that expansion.
‘[Cerner] sees this as a stepping stone for their international business,’ Mr. Brown said.
There were several reasons the Cerner system has had difficulties since its rollout, Mr. Brown said, starting with the fact the HSA did not have sufficient computer hardware – possibly only one-third of what was needed – to run the system. As a result, it was unable to fully implement the system.
In addition, Mr. Brown said the software is now four generations behind, which has not allowed improvements to be incorporated into the Cayman system.
Mr. Brown made it clear, however, that there have been mistakes made by the HSA as well in implementing the Cerner system, including an inadequate training programme.
The Cerner system consists of a clinical module and a financial module, the latter of which has been particularly problematic here.
HSA Chairman Pastor Al Ebanks said that when the Cerner financial module – called ProFit – was purchased for Cayman, it was basically a prototype.
‘The Cayman Islands was one of the first five or 10 [places] to get it,’ he said, noting that there are usually hitches in any new computer software. Not getting the upgraded software when it was released compounded the problem.
Despite the past problems, Mr. Ebanks also believes in Cerner.
‘As a board, we’ve taken a long and detailed look at Cerner,’ he said. ‘We’re convinced it can work. We’re committed to move forward and so [is Cerner].’
Mr. Ebanks called the Cerner system the top of the line.
‘It’s the Cadillac of medical software, and we have it. We now have to make it work.’
Mr. Ebanks said Cerner very much wants the system to succeed here and elsewhere.
‘One thing that is clear to me is about Cerner’s commitment, and not just to us. They’re putting millions of dollars into this programme to make it the premier industry clinical and financial software.’
To address the hardware inadequacies, the HSA is moving toward having the system data hosted in the United States.
‘Remote hosting is an option… we believe this is the step we have to take,’ Mr. Ebanks said, adding that Cerner provides remote hosting for some 100 other health care facilities in the United States
‘It is far less expensive than trying to upgrade all of our hardware,’ he said.
Although a formal deal has not been reached, Mr. Ebanks is optimistic remote hosting will become a reality.
‘We’re very hopeful, if all goes according to plan, [remote hosting will begin] before the end of the year,’ he said.
Mr. Ebanks said there is still a challenge in getting HSA management and staff to accept the notion Cerner can succeed in the Cayman Islands after all the past problems.
He said a trip taken by HSA senior management last month to Bayfront Hospital in St. Petersburg, Florida – which runs the same Cerner programmes the George Town hospital has – helped a lot.
‘While [Bayfront Hospital] has some issues [with Cerner] as well, they’re very happy with what they have.’
HSA managers got to talk to Bayfront staff members who used Cerner, Mr. Ebanks said.
‘Some of the [Cayman] folks were quite excited when they saw some of the thing the system could do.’
As a result of the trip, there’s renewed confidence in the system from senior managers.
‘There’s been some good buy-in by some of the key people,’ Mr. Ebanks said. ‘They see it can simplify their work.
‘If it will make people’s life easier and can be shown to do that, not just on a whim and a promise, we can all breathe a great sigh of relief.’