System Failure of 26 May
Discussion was had around the disruption to services experienced by most Users. A back-end fix to Resource Publisher should have been deployed to practices with RP. Human error saw this pushed out to all sites. This caused a domino effect which led to disruption across the EMIS Web estate.
This was not part of a patch release, so was not expected to have any negative impact at all, so there were no concerns in releasing this ahead of a bank holiday.
The meeting was attended by the EMIS Communications Department Lead so that we could discuss the comms issues experienced by Users on the day. The committee shared the following feedback:
- EMIS Now referred only to issues being experienced with RP and made no mention of the inability of many users to load patient records. This led to additional confusion and left users feeling ill informed about the ongoing problem.
- EMIS shared that they followed their standard approach for performance issues – we shared our view that this was not sufficient or acceptable when faced with an enormous functional issue which was nation wide and impacted patient care.
- NHSE did not send information out to all ICBs as is their agreed process for such incidents.
- Users would expect immediate information about such a situation, with regular updates at agreed times. This information should go to all sites, not just to users who have signed up for service updated via EMIS Now.
- The information from Suzy Foster was appreciated but came much too late. Users did not know if they would have a fully functioning system on the day after a bank holiday. Information should have been sent out much more quickly.
EMIS are undertaking a full evaluation of their systems and processes and have been honest and transparent in all discussions with the NUG around these events. We feel that they are committed to learning from this event and will review their communication strategies and policy for managing any future incidents.
64 Bit Update
An explanation of this change and the expected benefits was shared for we less techy NUG members – this change will allow EMIS Web to make more use of available memory, which will help with the spinning blue wheel (which apparently many users call Kylie!). With the current version, you could upgrade your desktop which would make other applications run faster, but EMIS would not be able to access the additional RAM. Up front work to the system is needed before the 64 bit update can be pushed out. The advanced work is contained in patch 9.20.7 and the 64 bit release will be pushed out in 9.21.0. The team are 94% of the way through testing and it is about to be pushed out to pilot sites. We are likely to see the full roll out happen in Mid-July, but any issues found in testing would delay this.
Conversations were had based on User feedback about the fact that we are told things are coming soon but are a very long way off. The NUG asked that more specific time frames are advertised, such as Q3 2023 etc with the understanding that time frames could be adjusted is testing and pilot sites identify additional development is needed.
Prescription Bulk Signing
Bulk Signing is live in several pilot sites at the moment. Patient safety aspects have been agreed with NHSE and information will be available on EMIS Now. EMIS have kindly shared a copy of this with us which will added as a file. Please note this may be subject to change.
The code has already been released to all sites and will be activated once the pilot phase is complete and error logging and performance issues have been reviewed. Feedback and monitoring from pilot sites have already led to changes, so the team are committed to rolling this out when they are confident that this large change will not cause any performance issues.
PIL User Issue
EMIS team will investigate via the log number and will update me outside of the meeting. I will chase them if I do not hear anything.
Resource Publisher
The team are making an infrastructure change to Redis (cache). This will help RP to deliver resources more quickly. RP is a complex module and is always running in the background, silently absorbing system resources. This is a back-end change and not part of a patch update, so changed will begin to be deployed next week. They are eager to see what impact this change will have on the live system, as positive results in the test system. It is anticipated that the 64bit upgrade will also have a significant impact on RP performance.
The long-term plan is to completely rebuild RP. Work has begun to move elements to the Cloud, allow EMIS to benefit from more advanced data base and cache technology.
Document to Code User Issue
The EMIS team will speak to the development team and will let me know what the time frame is for this fix to be released.
QRisk
Batch adding of QRisk2 has been removed after discussion with NHSE, this is felt to be a patient safety and good practice change. QRisk 3 still needs to pass assurance process with NHSE as it is a medical device. It will be released in EMIS as soon as it is signed off.
Rachael Lankshear